Sinus Headache

What are the sinuses?

Sinuses of the face are cavities or spaces within the bones that help humidify air and secrete mucus to help with air filtration. Additionally, they contribute to the strength of the skull and its ability to resist trauma and allow more resonance in 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 and 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

What is a sinus headache?

Should the ducts that connect the sinuses to the back of the nose become inflamed, the ability of the sinuses to drain is decreased, and pressure builds within the affected sinus. There may also be associated swelling and inflammation of the lining of the sinuses, possibly resulting in increased mucus and fluid secretion. This increase in fluid and pressure causes the pain of a sinus headache. The term sinusitis is used to describe inflammation of the sinus (sinus + itis = inflammation).

What causes a sinus headache?

While a sinus infection (sinusitis) can be due to a viral infection much like a cold that causes swelling in the nose and decreases drainage of the sinuses, an allergic reaction (such as hay fever) may also begin the process of inflammation. As with any inflammation, there is swelling that in this case decreases the ability of the sinuses to drain and increased inflammatory fluid production (just like the weeping observed with a skin injury). The combination of more fluid and less drainage leads to the pain and pressure of a sinus headache.
Nature does not like stagnant fluid, and after a period of time bacteria and viruses can travel from the nasal cavities into the fluid and cause an infection. Less commonly, fungal infections may cause a sinus infection, and even more rarely, tumors can invade the sinus.
The maxillary sinus sits underneath the eye within the cheekbone. The upper teeth attach to the lower portion of this bone, and dental infections can travel up the root of the tooth and infect the sinus directly.

What are the symptoms of a sinus headache?

Pain is the primary symptom of a sinus headache, usually due to the increased pressure and decreased drainage from the affected sinus cavity. The pain of a sinus headache is often described as an increasing pressure sensation overlying the area with an associated tenderness to the touch. The pain occurs upon changing position of the head or when first getting up out of bed, which is due to the increased pressure within the sinus cavities.
Symptoms with sinus infection

• If an infection is present, there may be fever, chills, malaise (feeling poorly) or myalgias (achy muscles).
  
• Greenish-yellow nasal drainage may occur.
  
• Swollen lymph nodes (swollen glands) may occur in the neck if an infection is present, no different than the swelling of lymph nodes that accompanies acute pharyngitis (sore throat) or otitis media (ear infection).

Symptoms with sinus inflammation

• If there is sinus inflammation without infection, the drainage may be clear.
  
• If the maxillary sinus is inflamed, there may be pain felt in the upper teeth since the sinus is located in the bone where those teeth are located.

When should I seek medical care for a sinus headache?

Many people correctly self-diagnose sinusitis and treat themselves at home with fluids by mouth and breathing humidified air to loosen secretions and promote drainage. However, accessing medical care should be considered if a fever is present, there is swelling that can be felt in the face (perhaps signaling an abscess formation), or if the person exhibits a change in behavior or thinking.
Medical care may be appropriate if the pain does not respond to over-the-counter pain medications such as ibuprofen or acetaminophen or if symptoms last longer than 10 to 14 days.