Sinus Headache

Sinus headache / facial pain (characteristic of Sinusitis pain are dull, constant, aching pain over the affected frontal or sphenoid sinus area) is one of the general symptom complained during acute or chronic stages of Sinus infection. This pain (i.e. facial pain (pressure), headache) is typically localised to the involved sinus and is worsened when the affected person bends over or when in supine position. Rarely, sphenoid or Ethmoid sinusitis causes severe frontal or retroorbital pain and advanced frontal sinusitis can present as Pott's puffy tumor. During Acute sinusitis thick purulent nasal discharge (usually green in colour and with or without blood) and typical localised headache (toothache) are present. Whereas in Migraine (Migraine = episodic typical unilateral headache + often Vomiting + visual disturbances),photo phobia, phono phobia and Triad 1. premonitory visual (scotoma or scintillations) sensory or motor symptoms, 2. unilateral throbbing headache, 3. nausea and vomiting are present.

Recent studies on

Headache is a common symptom of sinusitis and "sinus headache" rarely but can be a misdiagnosis of a migraine. Acute sinusitis can cause pressure within the sinus cavities of the head, but this typically has associated pain to palpation of the sinus area and purulent greenish discharge from the nose. The use of the term sinus headache therefore is often misleading and results in under diagnosis of migraine. Recent studies indicate that up to 90% of "sinus headaches" are migraine^.

 This confusion occurs in part because migraine involves activation of the trigeminal nerves which innervate both the sinus region but also the meninges which surround the brain. As a result, direct determination of the site of pain origination can be confused on a cortical level. Additionally, nasal congestion is not an uncommon result of migraine headaches, further confusing the issue.

A recent study further demonstrated that most patients with "sinus headache" respond to triptan migraine medications, and state dissatisfaction with their treatment when they are treated with decongestants or antibiotics. The subtlety is that while most patients with sinusitis have some sort of facial pain, pressure, or headache, not all patients who attribute the symptom of headache to their sinuses may have legitimate diseases of the sinus. Acute and chronic sinusitis can cause pressure within the sinus cavities of the head, but this is associated with pain on palpation of the sinus area. Learn about it.