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Headaches are extremely common, but not all headaches are the same. Many people assume facial pressure, nasal congestion, or pain around the eyes means they’re experiencing a sinus headache. While that can be true, sinus headaches are often over-diagnosed, and many turn out to be migraines or tension headaches instead.

Understanding sinus headache characteristics, causes, symptoms, and treatment options can help you determine what’s really going on and whether it’s time to see an ENT.

What Causes Sinus Headaches?

A sinus headache develops when inflammation or swelling blocks normal drainage inside the sinus cavities. This trapped mucus and reduced airflow create pressure within the face, forehead, and nasal passages.

Common causes of sinus headaches include:

• Acute or chronic sinusitis
• Seasonal allergies or hay fever
• Viral or bacterial respiratory infections
• Nasal polyps
• Deviated septum or structural blockage
• Environmental irritants like smoke, dust, or pollution

Hormonal changes, including pregnancy and sinus headaches, may also increase nasal congestion, making sinus pressure more noticeable.

However, true sinus headaches are usually linked to active sinus inflammation, not just occasional stuffiness. These underlying issues influence sinus headache characteristics, including where the pain develops and how long symptoms last.

Signs of a Sinus Headache

Recognizing common sinus headache characteristics can help differentiate sinus-related pain from other headache types. Sinus headaches are typically accompanied by symptoms of sinusitis (also called sinus disease), not just head pain. People often report these common signs of a sinus headache:

• Facial pressure or fullness
• Thick or discolored nasal mucus
• Nasal congestion or obstruction
• Post-nasal drip
• Decreased sense of smell
• Ear pressure or popping
• Tenderness in the cheeks, forehead, or brow

Pain may worsen when bending over, lying down, or experiencing sudden temperature changes. Without other sinus symptoms present, the headache may not be sinus-related, which is why a professional evaluation matters.

Sinus “Eye” Headache

People often describe sinus pain as pressure behind the eyes, between the eyes, or around the bridge of the nose.

This discomfort occurs when the ethmoid or sphenoid sinuses are inflamed. It may also cause tearing, mild swelling, or eye fatigue, leading to a sinus eye headache. However, eye pain can also be migraine-related, so persistent symptoms should be assessed by an ENT.

Sinus Headache, But No Congestion

A sinus headache with no congestion is uncommon. Most true sinus headaches involve noticeable nasal symptoms. Facial pain without congestion may indicate:

• Migraine
• Tension headache
• Neuralgia
• TMJ disorder
• Dental problems

If you’re unsure, track your symptoms and discuss them with an ENT or headache specialist.

You Usually Feel Sinus Headaches in Your Face

Where you feel headache pain is a good diagnostic clue. Discomfort typically originates from sinus cavities found in the forehead (frontal sinuses), cheeks (maxillary sinuses), either side of the nose (ethmoid sinuses), or behind the eyes (sphenoid sinuses). There are a lot of sinus cavities in the head, so sometimes a sinus headache can still make your whole head hurt.

Sinus pain is often steady, dull, and pressure-like, not pounding or pulsating. It might worsen or change when you apply pressure to the face near an irritated sinus cavity, and it can shift with position, such as leaning forward or lying down.

Migraine vs. Sinus Headache

Distinguishing migraine vs. sinus headache can be challenging because both may include facial pain, nasal drainage, and pressure. Studies show that most self-diagnosed sinus headaches are actually migraines.

Signs more consistent with migraine include:

• Nausea or vomiting
• Light or sound sensitivity
• Tingling or vision changes
• Throbbing or pulsating pain
• Headache lasting 4 to 72 hours
• Family history of migraine
• Symptoms triggered by stress, hormones, or certain foods

Sinus infection and light sensitivity can occur together, but it’s far more common with migraines. If headaches keep recurring despite sinus treatment, a migraine may be the underlying cause. Because some sinus headache characteristics overlap with migraine symptoms, professional evaluation is often necessary.

Treatment for Sinus Headaches

Treatment for sinus headache depends on the cause, infection, allergies, structural blockage, or chronic inflammation. Many patients improve with conservative, non-surgical approaches.

Helpful home care options include:

• Nasal saline rinses or sprays
• Warm compresses
• Rest and hydration
• Humidifiers during dry weather
• Avoiding smoke or irritants
• Managing seasonal allergies

If symptoms persist longer than 10 days, worsen, or repeatedly return, evaluation by an ENT is recommended.

Best Medication for a Sinus Headache

Medication can relieve sinus inflammation, pressure, and discomfort, but many medications for sinus headaches only work when the headache is truly sinus-related. An ENT specialist may recommend relying on or starting with over-the-counter medication to manage symptoms.

Over-the-counter medicine for sinus headaches can combat discomfort from dry environments, relieve mild-to-moderate pain, and reduce congestion. Outside of a saline spray, it’s important to avoid overusing anti-inflammatories, pain medication, and decongestants. Overusing decongestants will eventually make the congestion worse. Always follow dosing instructions or speak with a clinician first.

OTC medications for sinus headaches include:

• Acetaminophen or ibuprofen for pain
• Saline nasal spray
• Antihistamines for allergy-related congestion
• Nasal corticosteroid sprays for inflammation
• Short-term decongestants (when appropriate)

Prescription medications for sinus headaches include:

• Antibiotics for confirmed bacterial sinus infection
• Stronger nasal steroid sprays
• Prescription antihistamines
• Leukotriene modifiers for severe allergies

If headaches continue despite treatment, imaging or sinus evaluation may be needed to rule out chronic sinusitis or structural issues.

Sinus Headache that Lasts for Weeks?

A sinus headache that lingers for several weeks might indicate chronic sinusitis, a blockage, untreated infection, or a misdiagnosed migraine. When the source of a problem isn’t getting any better, you are more likely to experience persistent inflammation and discomfort in your sinuses.

Chronic sinusitis lasts 12 weeks or longer and may also include fatigue, post-nasal drip, and ongoing congestion. Lasting sinus pressure is not normal, and early diagnosis can prevent long-term discomfort.

When to See an ENT for a Sinus Headache

Schedule a medical evaluation if you experience:

• Frequent or recurring sinus headaches
• Pain lasting longer than 10 days
• Severe pressure affecting daily life
• Breathing difficulty through the nose
• Facial swelling, fever, or worsening symptoms
• Headaches that don’t respond to OTC medication
• Uncertainty about whether the headache is sinus or migraine

An ENT can evaluate your nasal passages, sinus drainage pathways, and overall sinus function to determine the root cause and best treatment plan.

In some cases, long-term relief may involve allergy management or minimally invasive sinus procedures, such as in-office balloon sinuplasty or functional endoscopic sinus surgery.

ENT For Sinus Headaches in Metro Atlanta, GA

If sinus pressure, facial pain, or recurring headaches are affecting your quality of life, Northwest ENT can help. Our providers diagnose whether your headache is sinus-related, and recommend personalized treatment for sinus headaches options based on your symptoms, history, and imaging.

With multiple convenient locations across Metro Atlanta, we provide complete sinus care, from evaluation and medical treatment to in-office procedures and advanced sinus surgery when needed.

Schedule an appointment today to find lasting relief from sinus headaches and breathe easier again.