Sinusitis and Headaches
What is the most common symptom of a "sinus infection"? If you are like most people, you most likely think of sinus headache as a primary problem with sinus infection. Both sinusitis and headaches are very common problems. Because the sinuses are located in the front of the head, where most headaches occur, there is bound to be a lot of overlap between these two diagnoses.
Let's begin with a headache that is related to sinus disease. This occurs in the setting of a case of acute rhinosinusitis (ARS). ARS is defined as sinusitis symptoms and physical findings lasting less than four weeks. In the setting of acute bacterial rhinosinusitis, there is purulent drainage, which is comprised of large numbers of inflammatory cells responding to the presence of high bacterial counts in static mucus in the paranasal sinuses. This inflammatory process triggers vasodilation and irritation of nerves that lie just beneath the surface of the lining of the sinuses and nasal cavity. These processes trigger the pain response that we call sinus headache.
The difficulty in diagnosis comes when someone has "sinus headache", or headache located in the face area, without other symptoms of nasal or sinus disease, such as nasal obstruction or discolored discharge. Often, these patients have some other cause of headache, such as migraine headache. This is especially true of patients who are having recurring bouts of "sinus" which are essentially unresponsive to antibiotics. In many cases, a trial of a migraine headache medicine will completely eliminate the patient's symptoms.
Confusion about sinusitis and headaches is common and understandable. These conditions require a thorough medical history and head and neck physical exam. In addition, you may need nasal endoscopy, sinus CT or both to confirm your diagnosis. Consultation with you ENT physician can help differentiate whether you need treatment for sinusitis or headache. Call 205-980-2091 today to make an appointment