What Tests Diagnose The Causes Of A Sinus Headache
The health-care professional will likely begin by taking a history of the symptoms to help come to the diagnosis. Contributing factors in the development of sinusitis and headache may include a recent cold or upper respiratory tract infection, history of smoking, environmental allergies to dust or molds, as well as recent airplane travel, swimming or SCUBA diving, or other activities involving air pressure changes within the facial sinuses.
Physical examination may reveal tenderness to percussion, or tapping, over the affected sinus that reproduces the pain. Examination of the ears may reveal a serous otitis, or fluid levels behind the eardrum in the middle ear, that may suggest drainage problems in the face and sinuses. Examination of the nose may reveal swollen nasal passages and discharge. Evaluation of the mouth and teeth may find a source of infection, and the back of the throat may be examined for signs of postnasal drainage.
Treatment For Sinus Headaches
Your urgent care doctor will recommend you take a short course of a decongestant and/or an over-the-counter nasal spray to help reduce nasal membrane swelling. You may take a hot shower to loosen up the secretions and can hydrate with warm liquids. If the symptoms persist for a longer time, consult your walk-in doctor who will prescribe antibiotics.
What Are The Treatment Options
Your primary care provider, or a neurologist, can provide recommendations for treating your headaches based on their severity and frequency, and can rule out more serious causes of your headache. Treatment for migraines includes both over-the-counter and prescription medications and preventative medications for patients with severe or frequent headaches, or if headaches are present for more than 15 days per month.
Over-the-counter pain medications such as ibuprofen or acetaminophen can also be associated with rebound headaches or medication-overuse headaches if taken too often. Tell your doctor how often you take pain medications for headaches. Avoid triggers, and talk to your doctor about your sleep habits. Keep a headache diary to record your headache symptoms, triggers, and treatments.
Sinus headaches caused by migraines or tension headaches should not be treated with antibiotics. Because there are similar symptoms between acute sinusitis and migraine headaches with nasal and sinus symptoms, it can be difficult to tell if your symptoms are truly a sinus infection. Sinus pain and pressure without discolored nasal discharge is most likely not a sinus infection. If you have been diagnosed with frequent sinus infections and have been treated with repeated episodes of antibiotics without improvement, migraines or tension headaches could be causing your sinus pain and pressure.
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How Do You Diagnose Sinus Headaches Caused By Migraines
Sinus headaches are most likely due to migraines or tension headaches. Migraines are diagnosed by symptoms, including the frequency and severity of symptoms, family history, and by physical exam. Migraines can also include nausea and vomiting. These episodes may be triggered by hormonal changes, lack of sleep, certain foods or alcohol or caffeine, stress, or environmental changes like weather, altitude changes, or allergens. Many patients with migraines have family members who also experience migraine headaches.
If you have unusual or severe symptoms, additional tests such as an MRI of the brain may be ordered to rule out more serious conditions that can cause headache pain, such as tumors or bleeding around the brain. If you have repeated episodes of sinus pain and pressure, a nasal endoscopy or imaging such as an MRI or CT scan can determine if sinus pain or pressure is due to a sinus infection or other sinus pathology. A normal sinus CT scan while you have symptoms could help rule out sinusitis, and determine if migraines, headaches, or other causes of facial pain and pressure are causing the sinus symptoms.
Other causes of facial pain and pressure can include temporomandibular joint syndrome, clenching or grinding your teeth, trigeminal nerve pain, temporal arteritis , dental infection, or other neurologic causes of facial pain.
Can Sinus Pressure Cause Migraines
Sinus headaches and migraines are often commonly confused, but its important to know which type of headache you have since that affects the type of treatment you need.
In this blog, Dr. Cecil Yeung of Houston Sinus Surgery at the Yeung Institute explains more about sinus headaches and migraines, including whether sinus pressure can cause migraines.
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Sinus Migraines: All You Need To Know
Migraines are excruciating conditions that can leave women bedridden and hating life. When combined with pressure and pain in the nasal passages, you end up with a sinus migraine. Continue reading to learn all you need to know about sinus migraines, and get back up and going to a more concentrated you today.
Migraine And Neck Pain
While neck pain was previously thought to be a migraine trigger, recent studies show it is a symptom of migraine, not a cause. People with migraine often experience neck pain, including a stiff or tight neck or pain that spreads to or from the neck. Neck pain may be a common migraine symptom, including during the prodrome phase, but its often overlooked.
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Are These Your Symptoms
From those patients confirmed with a migraine diagnosis in the study:
- 83% noticed the weather affected their headaches
- 73% noticed seasonal variations in their headaches
- 62% said their headaches were triggered by allergies
- 56% had nasal congestion
- 25% had a runny nose
- 22% had red eyes
- 19% had watery eyes
You could be forgiven for thinking these symptoms are sinus related. They look a lot like the symptoms you might expect from a sinus infection so its no surprise that there is a significant amount of confusion between sinus headache and migraine.
Results found that 9 out of 10 patients in the study had migraine, not sinus headache.
Furthermore, the 100 patients from the study had seen an average of 4 physicians each and had gone on average 25 years without the correct diagnosis or significant relief.
Thats 25 years without significant relief and 4 physicians who had gotten the diagnosis wrong!
The lead investigator of the SAMS study Dr. Eross says It was hard to convince some of them that they actually suffered from migraine headaches, said Dr. Eross. Many were shocked.
One in ten people from the study knew they had migraine, but thought they had sinus headaches in addition. In reality they actually suffered two different types of migraine, one with sinus symptoms and one without, Dr. Eross noted.
Much of the pain or pressure is in the face, on both sides, so it doesnt occur to them that this might be a migraine. Dr Eross
Why Do We Misdiagnose Migraine As Sinus Headache
Research studies show common sinus symptoms occur with migraine. In one study, 45% of migraine patients had at least one symptom of either nasal congestion or watery eyes. Migraine is also underdiagnosed and undertreated, meaning that a self-diagnosis of migraine is less likely.
A study involving almost 3,000 patients was important in evaluating the frequent complaint of sinus headache. In this study, the participants had at least six sinus headaches in the six months prior to entrance into the study. They had neither a migraine diagnosis nor treatment with a migraine-specific medication. What were the results? Eighty-eight percent of the participants had migraine and not sinus headaches.
Another study, called the American Migraine Study II, showed that many people who were diagnosed with migraine thought they had sinus headache. Significantly, there were almost 30,000 study participantsonly about 50% who were diagnosed with migraine knew they had migraine before the study. The most common misdiagnosis was sinus headache.
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When To Seek Medical Advice
Most cases of otitis media pass within a few days, so thereâs usually no need to see your GP.
However, see your GP if you or your child have:
- symptoms showing no sign of improvement after two or three days
- a lot of pain
- a discharge of pus or fluid from the ear some people develop a persistent and painless ear discharge that lasts for many months, known as chronic suppurative otitis media
- an underlying health condition, such as cystic fibrosis or congenital heart disease, which could make complications more likely
What Are The Sinuses And What Do They Look Like
Sinuses of the face are cavities or spaces within the bones that help humidify the air and secrete mucus to help with air filtration. Additionally, they contribute to the strength of the skull and its ability to resist trauma. The sinus cavities also allow more resonance to be added to the voice.
The sinuses are often referred to as the paranasal sinuses because of their location and connection to the back of the nose. The sinuses develop as air sacs within the bones of the skull, which are named by their location.
- Frontal sinus: located above the eyes within the frontal bone of the skull
- Maxillary sinus: located beneath the eyes under the cheekbones within the maxilla bone of the face
- Ethmoid sinus: located in the ethmoid bone separating the eyes from the nose
- Sphenoid sinus: located in the sphenoid bone at the base of the skull
While infants do have sinuses, they are very poorly developed. The maxillary sinuses cannot be seen on an X-ray until 1 to 2 years of age and the frontal sinuses are not seen until age 5 or 6.
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Sinusitis And Sinus Headaches
What most people dont realize is that true sinus headaches are actually quite uncommon and are often over diagnosed or misdiagnosed. Sinusitis is an inflammation of the sinuses, often due to a bacterial infection. The sinuses are air pockets that are situated at certain points in the facial bones. Scientists are not certain the exact purpose of sinuses. Some believe that it helps enhance the voice through resonation while others believe it may be a way for the body to humidify the air during inhalation. They are usually empty but do have a very thin mucus layer along the walls.
There are four pairs of paranasal sinuses, meaning that there are two at the same points on the left and right. They are:
- Frontal sinuses: above the eyes just over the eyebrows
- Maxillary sinuses: on each side of the nose, in the cheekbone
- Ethmoid sinuses: between the eyes, under the bridge of the nose
- Sphenoid sinuses: behind the eyes and ethmoid sinuses
Inflammation of the sinuses can occur due to bacterial, viral, or fungal causes and can present in one of the sinus pair, or several. If there is an infection present, it is important that it is treated. Failure to properly treat a sinus infection can cause serious health risks and can create a propensity to develop sinus infections in the future.
What Are Sinus Headaches
Real sinus headaches are almost always from a sinus infection. Sinus infections are common with 10% to 30% of the population experiencing at least one sinus infection each year.
Sinus infections are also known as sinusitis or rhinosinusitis. This occurs when the sinus becomes inflamed. Common symptoms include thick nasal mucous, blocked nose and facial pain. Sinus infections may be caused by an infection, allergy or air pollution. Most cases are due to viral infection. Infections are often transmitted through coughing, sneezing, kissing, contact with contaminated surfaces, food or water or contact with infected animals or pets.
To understand how sinus headaches are confused with migraine its important to know what migraine is.
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Things To Know About Sinus Headache
- Sinuses in the face are air spaces that develop from the nasal passages and help with air humidification and mucus secretion.
- Inflammation of the sinuses may decrease the ability of the mucus to drain, increasing pressure within the sinuses, which can cause a sinus headache. Common causes of inflammation include allergies, infections, or colds.
- Symptoms of a sinus headache include pain in the face that may worsen with bending down or straining
- pain that radiates to the forehead, temple, or cheek
- runny or stuffy nose
- persistent cough.
How Is Sinus Headache Prevented
If you have reoccurring headaches as a symptom of sinusitis or seasonal allergies, you may need to consider prescription medication to manage the condition.
Lifestyle changes to reduce congestion, like avoiding allergens and incorporating aerobic exercise into your routine, might decrease how many headaches you get.
In cases of chronic sinusitis, a nasal surgery like a balloon sinuplasty might be the only way to stop getting more sinus headaches.
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How Migraines Are Different
Migraines are much more common than sinus headaches, affecting about 15 percent of adults in America. The reason migraines are often mistaken for sinus headaches is that both can cause facial pain and a runny nose. The difference? With migraines, nasal discharge is thin and clear instead of thick and discolored.
Aside from different kinds of nasal discharge, a big difference between migraines and sinus headaches is that a migraine pain can happen in many areas. While sinus headaches are primarily felt in the face, migraines can cause pain around the temples, high in the forehead or in the back of your head. They often occur on only one side of the head, while sinus headaches are usually felt on both sides of the face.
Another distinguishing characteristic of migraines is that they frequently cause a throbbing or pulsing pain, as opposed to the pressure of sinus headaches.
Can Sinus Pressure Cause A Migraine
Sinus headaches and migraines have many symptoms in common, but theyre not the same type of headache. Once the underlying sinus issue is resolved, sinus headaches should go away. But with migraines, ongoing medication may be needed to help prevent them from recurring.
Sinus pressure may be somewhat linked to migraines, however. If you have allergic rhinitis, your nasal passages can become inflamed and irritated in response to an allergen. Its thought that the histamine release that occurs as part of the allergic reaction can cause migraines. In fact, people who have allergic rhinitis are more than 10 times more likely to suffer from migraines.
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What Is A Sinus Migraine
Technically, there is no medical condition known as a sinus migraine. Signs and symptoms of a sinus headache and migraine are easily confused since they overlap.
Nonetheless, many women suffer from a sinus headache – which can involve a fever, thick nasal secretions, or pain and pressure in the face and sinuses – that feels like a migraine, a moderate to severe headache that can make a woman nauseated as well as sensitive to lights and sounds.
As such, sinus headaches that feel like migraines will be referred to as sinus migraines from here on.
What Are Sinuses And Sinus Headaches
Sinuses are air-filled cavities located in the forehead, cheekbones, and behind the bridge of the nose. The sinuses produce a thin mucus that drains out of the channels of the nose. When a sinus becomes inflamed, usually as the result of allergies or an infection, the inflammation will prevent the outflow of mucus and cause a pain similar to that of a headache.
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Sinus Headache Or Tmj Migraine: How To Tell The Difference
Weve all had bad headaches from time to time. The pain can be so intense that you cant seem to imagine anything worse.
And then you have a migraine episode that seems to take the pain to the next level. In addition to the pounding headache, your cheeks and teeth seem to ache, too.
Unfortunately, some people have headaches like this on a regular basis. Theyve tried to treat it with over-the-counter remedies, but these can just be Band-Aid solutions.
The reason for this is because painkillers arent treating the main source of the problem which could be structural or mechanical.
The above symptoms the pounding head, achy teeth, and tender cheeks arent signs of a typical headache. They could be signs of a sinus headache or a TMJ migraine.
In order to successfully treat the problem, we have to identify the root cause. First we need to discern the difference between these types of head pain.
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Sinus Headache Or Sign
Many people mistakenly believe their headaches are due to sinus problems when actual reason is migraine. In reality, more than 85% of people who suspect that they have sinus headaches in fact have migraines.
Why the confusion between sinus headaches and migraines?
It begins with the many symptoms that both migraines and sinus headaches share, which include pressure in the face, an association with barometric/seasonal weather changes, and autonomic nervous system dysfunction. The autonomic nervous system controls many of the involuntary functions in your body including heart rate, blood pressure, and sweating. In the case of migraines, autonomic dysfunction can cause eye redness, eyelid swelling/drooping, tearing, sinus congestion, and even a runny nose.
Response to treatment can also further drive patients to believe that they have sinus headaches rather than migraines. For example, a patient may have a headache involving a pressure sensation in the face, and calls their primary care physician thinking a sinus infection is causing the symptoms. The doctor will often order a refill of medications that worked in the past for patients sinus problems. The patient feels better after taking these medications, and believes that the infection is cured.
Heres why you want to know whether you have migraines and not sinus headaches
Three telltale signs its a sinus headache and not a migraine
Three features that are more suggestive of sinus headache than migraine. These are:
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