Choose your most prominent symptom

Sinus pain


Airway obstrucion



Headaches are a very common problem. When headaches overlap with other sinus problems, like congestion, airway obstruction, and drainage, then it is common to assume that the headaches are from a sinus origin problem. Sometimes it can be difficult to confirm the link but it is important. Primary headaches and sinus origin headaches are treated much differently. For the purposes of this page, headaches are pain that is above the eyes, over the temple, on the top of the head or in the back of the head.

Headaches associated with an acute upper respiratory infection

A few things come to mind if headaches come on during an acute illness.
  • A common cold usually doesn't have prominent headaches

  • An acute bacterial infection can cause headaches, an acute bacterial infection causing significant headaches needs to be seen by a doctor.

  • The Flu can cause headaches, usually there is a prominent cough and muscle aches too. A doctor can prescribe medicine to help a flu.

  • Strep throat can cause significant headaches, this is more likely if you can breath through your nose but have a prominent sore throat.
Headaches that are frequent and chronic with prominent nasal symptoms

Usually this is the easiest one. People who have chronic prominent nasal symptoms and headaches often prove to have chronic sinusitis or some anatomic abnormality. In some people the two issues are sort of independent, but in many the headaches and the sinus problems are clearly linked.

If you can be described as headaches that are frequent and chronic with prominent nasal symptoms,then you should see a sinus specialist. In many cases you will initially be treated for chronic sinusitis and if things remain unimproved a CT scan may be recommended

Headaches that are frequent over time with just a few nasal symptoms

Pain that presents in locations more commonly thought to be standard headaches can occasionally be from ethmoid infection or obstructions (pain between eyes or over forehead) or the sphenoid sinus (top of head or back of head). On occasion, infection and obstruction in these sinuses will cause only a few mild sinus symptoms. This mix of symptoms can be harder to diagnose in an efficient manner.

If there are few other sinus symptoms, then it is probably best to pursue treatment for headaches initially; the following choices become available:
  • treat the patient for chronic sinusitis, based on and educated guess, and see if this helps their headaches

  • proceed with a CT scan to obtain additional information helpful in making a correct diagnosis

  • proceed with neurological consult

Even when one has a moderately low suspicion that the headaches are sinus origin, it can be cost and time effective to perform CT scans of the sinuses in the early stage of the workup. The CT scans that are used for this purpose are relatively inexpensive and easily obtained. If a sinus problem is found, and if it might be the source, it changes the treatment plan immensely.

Your Headache...

Is it a type of migraine?
Can pain be from allergies?
Chronic sinusitis perhaps?
A septal bone spur?

Let us help you figure it out.
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