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What triggers sinus headache?

Treatments for Sinus Headaches

A sinus headache is 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, sinus infections 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 air-filled cavities located in the bones of your cheeks, forehead, and behind your nose. These air-filled cavities help drain mucus from the nasal passages. While there are also sinuses in the skull, the forehead, cheeks, and nasal sinuses are most commonly involved in sinus headaches.

Sinus inflammation is usually caused by a viral infection, bacterial infection, or allergic reactions such as hay fever. This inflammation increases mucus production, leading to sinus blockage. A deviated septum or nasal polyps can also contribute to sinus congestion and sinus pain.

When sinus blockage occurs, it can cause painful symptoms ranging from mild to severe, including facial pain in the forehead, cheeks, below the eyes, behind the nose, and even around the teeth. The pain and pressure from a sinus headache often mimic migraine headaches or tension-type headaches, making diagnosis challenging.

How to Differentiate Sinus Headaches from Other Headache Types

  • Blocked or runny nose during headache
  • Watery eyes during headache
  • Swollen nasal passages
  • Sinus congestion or nasal congestion
  • Increased sinus pressure or sinus pain
A man experiencing a Migraine

Understanding Your Headache

What Causes a Sinus Headache?

A sinus headache is commonly triggered by respiratory issues such as a cold, sinus infection, or allergic reactions like hay fever. 

While allergies themselves are not infections, they can increase the risk of developing sinus infections by causing sinus inflammation and mucus build-up. This inflammation can lead to sinus congestion, creating pressure and pain that results in headache symptoms—often resembling a migraine.

During an allergic reaction—such as when dust or pollen is inhaled—the sinus nasal cavity detects the presence of a foreign substance. This stimulates the trigeminal nerve, which activates the superior salivatory nucleus in the brainstem. As part of the body’s protective response, the nasal cavity increases mucus production. This can lead to a blocked or runny nose, sinus congestion, and the pressure and pain commonly associated with acute or chronic sinusitis.

 

The Role of the Trigeminal Nerve and Neck Dysfunction

Another common but often overlooked cause of sinus headaches is dysfunction in the neck. When the neck or cervical spine is not functioning properly, it can over-activate the trigeminal nerve, leading to a sensitised brainstem.

This heightened sensitivity causes the body to overreact to even harmless particles, such as dust, registering them as threats. The trigeminal nerve then signals the superior salivatory nucleus to produce excessive mucus. This excess mucus creates an environment where a bacterial infection may develop, worsening sinus symptoms and leading to sinus headaches.

Once infection sets in, migraine headaches or sinus headache symptoms typically follow, intensifying the pressure and pain in the head, face, and nasal passages.

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

Exercising

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. Common triggers for sinus headaches include:

  • Exposure to allergens such as pollen, dust, or mould
  • Sudden changes in air pressure
  • Strong odours like perfumes or chemicals
  • Secondhand smoke
  • Cold and dry air
  • Viral or bacterial infections

Identifying and avoiding these risk factors can help in preventing sinus headaches.

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.

Home Remedies and Self-Care for Sinus Headaches

Alongside lifestyle changes and preventive treatment, incorporating home remedies can help relieve sinus pressure and reduce symptoms of sinus headaches. These methods support your overall sinus health and may reduce reliance on pain relievers or prescription medication.

Using a saline nasal spray or nasal irrigation techniques, such as a neti pot, can help clear the nasal passages, thin mucus, and reduce sinus congestion. Steam inhalation or breathing in humidified air helps to loosen mucus and relieve sinus pressure, especially during flare-ups of acute sinusitis or chronic sinusitis.

Applying a warm compress around the eyes, cheeks, and forehead can reduce facial pain and pressure. Staying hydrated and practising good nasal rinsing techniques also support the health of the nasal passages and sinus cavities.

These self-care techniques can be useful in preventing sinus headaches or managing mild sinus symptoms before they worsen.

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

Treatments for Sinus Headaches

Generally patients have tried sinus infection headache treatment such as over-the-counter pain relievers, nasal steroid sprays, antihistamines, decongestant medications, flushing sinuses with salt water, breathing in humidified air, flushing the nasal cavity and even surgeries such as functional endoscopic sinus surgery (FESS). Despite all your efforts you may still end up with continuous sinus headaches (or medication overuse 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 complete 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.

Tools for managing migraines.