Sinus headache

Sinus headaches are an uncommon type of headache caused by inflamed sinuses (sinusitis). They are felt as a dull, throbbing pain in the upper face.

Many people assume they have a sinus headache, when in fact it's much more likely to be either a migraine or tension-type headache.

It's important to see your GP if you have any type of bad headache that you cannot control with over-the-counter medicine, particularly if it lasts a week or more, so you can get a proper diagnosis and treatment.

What causes sinus headaches?

The sinuses are small air spaces in the skull, found behind the nose, eyes and cheeks. They open out into the nose, allowing mucus to drain and air to circulate normally.

When the lining of the nose and upper airways becomes infected – for example, with a cold – the infection can spread to the sinuses and cause them to become swollen. The small opening from the sinuses to the nose can become blocked, which leads to a build-up of pressure inside the sinuses. This is known as sinusitis.

For some people with sinusitis, the pressure builds up to such an extent that it causes pain, or a sinus headache.

You may feel stuffy and congested for a while, but it normally gets better once the cold goes away.

Sinusitis and sinus headaches can last much longer. This usually only happens if bacteria infect the trapped mucus, or your sinuses repeatedly swell up because of an allergy.

Symptoms of a sinus headache

A sinus headache is a constant, throbbing pain felt in the face (around the eyes, cheeks and forehead), usually only on one side. It tends to be at its worst first thing in the morning and may get better by the afternoon.

The pain may get worse when you move your head, strain or bend down, and when you experience extreme changes in temperature (such as going from a warm room into freezing air outside). It can also spread to your teeth, upper jaw and other parts of your head.

Your face may feel swollen and tender to the touch, and you will also have other symptoms of sinusitis, such as green or yellow mucus discharge from your nose and a high temperature (fever).

The symptoms of a sinus headache can be very similar to those of a migraine and tension-type headache, so it can sometimes be hard to tell which you have, but sinus headaches occur with other sinusitis symptoms, such as fever and nasal discharge.

Generally, if you have facial pain or a headache, but no other symptoms of sinusitis, you're more likely to have a migraine or tension-type headache.

Treating a sinus headache

If you have mild symptoms, you may be able to treat them at home by:

resting and drinking plenty of fluids
taking over-the-counter painkillers, such as paracetamol or ibuprofen
using over-the-counter decongestant nasal sprays or drops to help unblock your nose – although these shouldn't be used for more than a week at a time
holding a warm flannel to your affected sinuses for a few minutes, and repeating this several times a day
flushing the inside of your nose with a saline nasal spray or solution available from your pharmacist – this can help to reduce swelling in the sinuses by cleaning out mucus, bacteria and any allergy-causing particles

When to see your GP

See your GP if your headache doesn't improve after a week, gets worse, or keeps coming back. Your GP may recommend:

antibiotics – if a bacterial infection is thought to be the cause of your symptoms
antihistamines – if an allergy is thought to be the cause of your symptoms
corticosteroid sprays or drops to reduce the swelling in your sinuses

In some cases, your GP may refer you to an ear, nose and throat (ENT) specialist, who will carry out some tests to find the underlying cause of your symptoms.

If no other treatments help, your ENT specialist may recommend surgery to improve the drainage of your sinuses.