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What triggers sinus headache?

Sinus Headache Treatment

A sinus headache can be categorised as a headache that’s bilateral in nature with symptoms felt on both sides of the sinus, face and nose. Sinusitis, whether allergic, nonallergic or fungal, can cause changes in the pressure in the sinuses.

However, the sinus infection itself is often not the cause of the headache. Indeed, a sinus infection will often trigger neck pain, which in turn causes the referred pain around the head and is the actual cause of the headache. In a 2019 study, researchers reported 84% of sinus headache sufferers reported neck pain associated with headaches.

We treat many sinus headache sufferers at the Sydney Headache and Migraine Clinic, and we employ cutting-edge methods to determine whether your symptoms are stemming from your neck or brainstem. Once treatment starts, we expect a significant improvement to rapidly occur in 90% of our patients with Sinus Headaches and within the first 3 weeks of treatment consultations.

Understanding your Headache

Sinus Headache Symptoms

Your sinuses are spaces inside the bones of your cheeks, forehead and behind the nose that are filled with air, these spaces are used by the body to drain mucous. There are also sinuses in your brain. The forehead, cheeks and nose sinuses often get inflamed due to allergic reaction, such as hay fever, or from an infection.

This inflammation causes an increase of mucus secretion, which can result in a blockage of the sinuses. This can lead to additional painful symptoms, ranging from mild to severe, in the forehead, around the cheeks, below the eyes, behind the nose and even around the teeth.

The presentation of a sinus headache can be similar to a migraine and/or a tension-type headache.

To differentiate sinus headaches from the other types of headaches, patients will normally present with headache like symptoms and the following:


  • Runny nose or congestion during headache
  • Watery eyes during headache
  • Increased pressure or pain in sinuses
A man experiencing a Migraine

Understanding Your Headache

What Causes a Sinus Headache?

A sinus headache is thought to occur due to respiratory infections such as an allergy (e.g. hay fever) or a cold. This can result in headache and migraine like pain, due to the infection within the sinus.

During an allergic reaction, such as inhaling an allergen the sinus nasal cavity will sense a threat due to the presence of a foreign body. This treat is registered by the trigeminal nerve, which then transmits the information anteriorly to the superior salivatory nucleus. The body response, is to fill the sinus and nasal cavity with excess mucous, creating dripping out of the nose, or digested by swallowing. This gives the sensation of a blocked nose, headaches and migraines associated with sinusitis.

One of common causes for sinus headache is having a dysfunction in the neck. In this case, an overactive and sensitive trigeminal nerve will lead to a sensitised brainstem. What would normally be a normal response to allergen now results in immediate allergies and sinus headaches from a sensitised brainstem.

For example, when a non-allergic dust particle enters the nose and sinus, the body now registers this as a threat, due to a sensitive and heightened trigeminal nerve. The sensitised trigeminal nerve then transmits information to the superior salivatory nucleus to secrete excess mucous in the sinus and nose. This may lead to an infection to occur as there is an excess amount of mucous for bacteria to breed in. Once the infection occurs, migraines and headaches will usually follow, resulting in sinus headaches.

About The Assessment Stage

What To Expect During The Assessment

1. Comprehensive and in-depth examination

We instigate an in-depth assessment to identify all possible related factors that could be causing your headaches or migraines. The upper cervical spine, in particular, is thoroughly examined to identify possible issues.

2. Ligamental stability and vertebral arterial tests

We undertake careful examination of neck ligaments and vertebral arteries, ensuring only the highest standards of patient safety and comfort.

3. Temporarily reproduce your headache and migraine symptoms

As a part of the treatment process, we apply gentle and selective stress to the upper cervical spine in order to reproduce headache symptoms, which subside after 20-30 seconds. This helps to identify and treat the cause of your headaches.

Sinus Headaches Prevention


To improve general well-being and quality of life, physical activity has been shown to be very effective. Exercises can improve muscular endurance and strength and this can be added with simple exercises in your daily routine to improve your function.

Avoiding Triggers

Try avoiding certain foods, environments, smells and/or activities that have triggered your headaches in the past.

Reducing stress

Stress can play a large role in headaches. Having stress can often cause muscular tension, typically along the shoulder and neck muscles. Strategies such as breathing techniques, regular walks and/or doing activities that you enjoy are good ways of reducing stress.

I’ve tried everything! What else can be done to help my Sinus Headache?

Sinus Headache Treatment

Generally patients have tired over-the-counter painkillers, nasal steroid sprays, antihistamines, decongestant medications, sinuses with salt water, breathing in humidified air, flushing the nasal cavity and even surgery. Despite all your efforts you may still end up with continuous sinus headaches as you have not found the root cause of your symptoms. If this is the case, have you had your neck and brainstem assessed to investigate whether the cause of your symptoms are originating from the brainstem itself?

At the Sydney Headache and Migraine Clinic, we compete a thorough examination of the upper cervical spine to determine the severity of your sensitised brainstem.

If the brainstem is identified as the likely trigger of your sinus headaches, treatment can begin immediately. Once treatment commences we expect an improvement to rapidly occur in 90% of our patients with sinus headaches. We expect to observe this within the first 3 weeks of treatment consultations.

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