The sinuses are cavities in the skull that rest just behind the face, which help humidify the air we breathe and may even enhance the human voice. It’s common for patients with a headache in this area to refer to it as a sinus headache; however, the lay term “sinus headache” is somewhat controversial because the headache experienced by the patient may not be due to an issue with their sinuses at all. Let’s discuss three potential causes of what may be self-diagnosed as a sinus headache.

RHINITIS: When the lining of the sinuses becomes inflamed, a patient may experience nasal congestion, runny nose, sneezing, itching, nosebleeds, recurring ear infections, snoring, mouth breathing, fatigue, and headache. Acute rhinitis can be due to a viral infection, while patients with chronic rhinitis that can flare up from time to time are more likely to experience a reaction to allergens that include pollen (from trees, grass, or weeds), dust mites, mold, cockroach waste, animal dander, fumes, odors, temperature, hormonal changes, certain medications (including overuse of nose sprays), environmental changes, smoke, certain food and/or spices, and more. Identifying and avoiding triggering allergens, eating a healthy diet, and taking certain vitamins or supplements can help an individual self-manage their condition but failing that, medical treatment may involve antihistamines, nose sprays, decongestants, asthma meds, allergy treatments, and even surgery.

SINUSITIS: If fluid collects in the sinuses, it can become a breeding ground for bacteria and cause an infection. A patient with sinusitis may report symptoms that include a runny/stuffy nose, facial pain/pressure, post-nasal drop, sore throat, cough, bad breath, and headache. The Centers for Disease Control and Prevention notes that patients with a sinus infection can usually self-manage the condition with the aid of a warm compress, a decongestant or nasal spray, and a humidifier. But, if the symptoms are severe, worsening, last longer than ten days, or are accompanied by a fever that persists for more than four days, the patient should seek medical attention as more additional care—potentially a course of antibiotics—may be necessary.

OTHER TYPES OF HEADACHE: As noted previously, a patient’s headache may feel as though its origin rests in the sinuses, but the underlying cause may be elsewhere. A study published in 2019 included 174 patients who sought care for a sinus headache. After a thorough examination, only 13% met the diagnosis criteria for headache associated with rhinitis or sinusitis. On the other hand, 53% received a diagnosis of migraine headache, 31% had tension-type headaches, and 3% could not be categorized. Another study that included 31 individuals with self-reported sinus headaches and 30 with no history of headache revealed that those in the sinus headache group were more likely to exhibit abnormal cervical spine function. There’s an abundance of research that shows that disorders of the neck may be the primary cause or contributing factor for several types of headache.

The current research suggests that sinus headaches are often self-misdiagnosed and the individuals with headaches believed to be attributed to a sinus-related issue should be examined for other forms of headache, including an evaluation of their cervical spine and associated tissues. Doctors of chiropractic are not only trained to evaluate musculoskeletal disorders of the neck but can also provide treatment to restore normal function, which may reduce the frequency and intensity of many forms of headache.