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THE Single Most Common Misconception About Sinus Headaches

by Russell A. Faust, PhD, MD

When is a “sinus headache” NOT from your sinuses?

When it IS from your sinuses, what can you do about it?

Those of us with the diagnosis of sinusitis are familiar with a “sinus headache” – the pain and sense of sinus pressure.

We just know that the pain that we are experiencing is from our sinuses.  Research says, most of the time, we’re wrong.

Sinus Headache, or Something Else?

There is little information on children and sinus headaches.  However, there are several studies on adults with “sinus headache”.

These medical studies – more than one – have shocking results (shocked me, anyway): Most of the time that we think our headache is from our sinuses, we are wrong.  Here is the truth about “sinus headaches” and what to do about it.

The Reality of “Sinus Headaches”

In a study of 2,991 patients who were screened for a history of self-described or physician-diagnosed “sinus headache”:

• 84% complained of sinus pressure
• 82% of sinus pain, and
• 63% of nasal congestion

These are symptoms that most of us are familiar with, and that we ascribe to our sinuses, BUT:

Of these nearly-3000 patients in the study, 88% of them were found to have, not sinusitis, but migraine headaches or “migraine-like” headaches, by strict medical criteria (International Headache Society, HIS).

That bears repeating:

At least 88% of us who believe that we have sinus headaches do NOT.

In a recent review by the Mayo Clinic, only 3% of those who presented with “sinus headache” were actually found to have sinusitis.  Nearly all of them had some other cause of their headaches.

Again, the majority had migraine or “migraine-like” headaches.

Less commonly, the flip side of this coin is encountered. That is, occasionally a patient is seen by a neurologist for migraine headaches, but their underlying problem is really sinusitis.

To confuse matters even more, there are plenty of migraine sufferers who also have rhinitis, and their rhinitis triggers their migraine headaches.

Those people can be a diagnostic challenge.

This single area of sinusitis – the headache – is the greatest diagnostic dilemma in this area of medicine.

What to do with this information?

The bottom line?

A careful and accurate diagnosis is essential.

Appropriate treatment is essential. To receive appropriate treatment, you must have an accurate diagnosis.

Migraine headaches are treated quite differently from sinusitis.

See a specialist, get accurately diagnosed, then get appropriately treated.

Makes sense, right? You don’t want to be treated for sinusitis when what you really have is migraines, or vice versa.

What if you really DO have a sinus headache?

Let’s say that you do have accurately-diagnosed sinusitis, and that you do have associated facial pain and pressure.

What can be done?

First, get your sinusitis appropriately treated.  Getting rid of the infection or inflammation will help eliminate the symptoms.

This website has some information on decreasing the inflammation that is associated with rhinitis and sinusitis. In addition, here are some other things to consider:

What about the sinus pressure and pain?

Check out yoga positions designed to reduce sinusitis symptoms. I will review these here soon.

Acupuncture can provide excellent relief from sinusitis pain and pressure. Take a look at a couple guest-posts on this blog by Robin Green, acupuncturist. Follow the link to her own website for more about acupuncture.

Shy of needles?  Acupressure is an excellent alternative that you can even do yourself.  To begin with, search “acupressure” for some great internet resources on this remedy.

What to do for the pain?

For sinusitis pain, you can simply use the right forefinger and thumb to grasp the fleshy part of your child’s (or your own) left hand that makes a ‘V’ between the thumb and forefinger, gently squeeze, massage for 10-15 seconds.

This can significantly reduce the sense of facial sinus pain and pressure.

(WARNING:  NOT for pregnant women – it may induce premature contractions, and I don’t know nothin about birthin no babies!).

Resources

Eross EJ, Dodick DW, Eross MD: The Sinus, Allergy and Migraine

Study (SAMS) [abstract]. Headache. Vol. 44:462; 2004.

Schreiber CP, et al.: Prevalence of migraine in patients with a history of self-reported or physician-diagnosed “sinus” headache.  Archives of Internal Medicine. Vol. 164: 1769-1772; 2004.

Cady RK, et al.: Sinus Headache: A neurology, otolaryngology, allergy, and primary care consensus on diagnosis and treatment.  Mayo Clinic Proceedings. 80(7):908-916; 2005.

For migraine, here’s a good review of natural remedies: http://bit.ly/cD4kCF

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Hi, I’m Russell Faust, author of this blog, and I appreciate your comments and questions.  Keep ‘em coming.  Please, “be excellent to one another.”

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Tags: headache, medical evidence, migraine, sinusitis