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ENTs Guide to Sinus Headache Treatment

Headache Sufferer

There can be many causes of a headache. Primary headaches are caused by stand-alone events caused by structures in the head that are pain sensitive. Tension headaches and migraines fall into this category. More common are secondary headaches. These headaches are the result of another condition. This can range from drinking too much alcohol to eating ice cream. One of the most common causes of secondary headaches is inflammation of the sinuses. Many sinus headaches respond to at-home treatment. If the at-home treatments and don’t bring relief; make an appointment with the ear, nose and throat (ENT) doctor. You may have chronic sinusitis which causes chronic sinus headaches.

Sinus headache symptoms

Sinus headaches are generally caused by swelling. The membranes that line the sinuses become inflamed and this inflammation keeps the sinuses from draining as they should.

If the sinuses don’t drain properly then air, mucus and pus gets trapped. This causes the pressure pain you feel under the eyes and in the area of the upper jaw. Sometimes a sinus headache can be mistaken as a toothache. Many dentists have diagnosed sinus problems when they take an x-ray of a painful tooth and find inflammation in the maxillary sinus.

Sinus headaches can feel worse when you change positions. Simply bending forward can cause increased pain. In order to relieve the pain, you must reduce inflammation and increase drainage.

Put moisture to work for you

Moisture is one of the most powerful ways to bring relief for a sinus headache. Just inhale the steam from a pot of boiling water, breathe the steam from a hot shower or run a humidifier. Dry or thick mucous can’t drain easily. It just blocks the sinuses making the situation worse. Breathing in moisture will thin the mucus, opens up the sinuses and promote drainage.

Use a warm, sterile saline solution to flush the nasal passages and sinuses. This nasal irrigation will wash away dried mucus and other secretions. This helps the sinuses to drain.

Saline nasal spray is another way to get beneficial moisture into the sinuses and nasal passages. Using a saline spray adds moisture to thin mucus and increase drainage. Saline spray is not a nasal decongestant spray. Decongestant sprays can only be used with extreme caution. Saline spray can be used as often as necessary.

Moist heat from warm compresses on the sinus area can also thin mucus to promotes drainage.

Don’t forget to stay well hydrated. You need at least 8 glasses of water a day to keep mucus thin.

Over-the-counter medication

The most common over the counter medications for sinus headaches are decongestants, antihistamines and pain relieving NSAIDs. Some of these medications are packaged in combination formulas.

  • Decongestants: Decongestants reduce inflammation in the blood vessels. By reducing inflammation mucous is thinned and can drain more easily. Decongestants can be taken in oral tablets or capsules or applied topically with nasal spray. Nasal decongestant sprays should be used with extreme care. While they can provide temporary relief, the blood vessels become immune and require more and more use to get the same effect.
  • Always drink plenty of water with decongestants as they can cause dehydration.
  • Antihistamines: If the inflammation and congestion are the result of allergies, then antihistamines can provide relief. But antihistamines only work if the source of inflammation is an allergic reaction. Old style or first generation antihistamines cause drowsiness. The newer formulations do not cause drowsiness.
  • NSAIDs: Nonsteroidal anti-inflammatory medications reduce sinus headache pain by reducing inflammation. You may know NSAIDs by the generic names ibuprofen, acetaminophen and aspirin. The relief provided by NSAIDs is temporary.

How ENTs treat sinus headaches

If the common at-home treatments don’t provide relief or if your sinus headaches return again and again you need treatment by a medical professional. ENTs are specially trained in conditions that affect the nasal passages and sinuses.

An ENT can determine the cause of your recurring sinus headaches and prescribe medications to bring relief. If your sinuses can’t drain due to polyps, a deviated septum, inflammation or other obstruction then ENT can help. The ENT can perform a simple balloon sinus surgery to reshape the sinus openings or endoscopic surgery to remove obstructions and promote drainage.


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