Care for a Sinus Headache

Sinus headaches are the result of swelling, inflammation or infection in one or some of the sinuses in your head. Many sinus headaches exhibit the same symptoms as tension headaches or migraines, but often have additional symptoms such as congestion, cough, sore throat, fatigue, or nasal discharge. They can be triggered by allergies, pressure changes in the ear, tooth infection, a cold, a bacterial sinus infection, or sinusitis. While it is important to consult your doctor to accurately diagnose the type of headache you are experiencing, there are a number of different ways you can treat a sinus headache using both medical and home remedies. In general, most sinus headaches and swelling are gone within four to eight weeks with or without medical treatment.

Steps

Getting Medical Treatment

1. Use a nasal steroid spray. Intranasal steroids, such as fluticasone (Flonase) or triamcinolone (Nasacort), which are now available over-the-counter, work by reducing inflammation in the nose. These sprays can be particularly helpful for sinus headaches that are triggered by allergies. Nasal steroid spray has the benefit of having no major side effects like those caused by many oral decongestants and antihistamines, such as drowsiness and dry mouth. Note, however, that it takes a few days for the steroid to build up to its full effect; this means that you will not experience immediate relief.
   • If you're using Flonase, the typical dosage is one spray per nostril twice daily. If you are using Nasacort, the typical dosage is two sprays per nostril once daily.
   • There are also other nasal steroids available with a prescription, such as mometasone Furoate (Nasonex).
   • Potential side effects include indigestion, nausea, headaches, and a bad taste or smell while using the spray.
   • New guidelines suggest that intranasal steroids should be the first line of treatment for sinus congestion.
2. Use decongestants. Using an over-the-counter decongestant or medication can help relieve pressure in your sinuses by unblocking the nasal passages and helping them to drain. You can get them in the form of nasal sprays or as oral medication and they can be purchased at most pharmacies. Consult your doctor to ensure that the decongestant will not affect any health conditions you may have, such as high blood pressure, or have any negative interactions with any medications you may be taking.
   • In addition, use a salt water nasal spray to help relieve congestion. Use it no more than six times daily. Nasal sprays other than the salt water variety may increase congestion or inflammation. Follow the dosage and usage directions that come with the nasal spray.
   • Nasal decongestant sprays should not be used for more than three days at a time. Longer term use has been linked to "rebound" swelling of the nasal passages.
   • Oral decongestants, such as Sudafed or Bronkaid pills, however, can be used for one to two weeks without supervision by a physician. While the "rebound" swelling is less common with oral decongestants, some people experience palpitations or a rise in blood pressure.
   • Avoid nasal sprays containing zinc. These have been linked to permanent loss of the sense of smell (though this is rare).
3. Take antihistamines. Some people find antihistamines useful, particularly in longer-lasting occurrences of sinus infections or people with allergies, because they can ease nasal congestion. Oral antihistamines include diphenhydramine (Benadryl), cetirizine (Zyrtec) and loratadine (Claritin). Note, however, that some older antihistamines such as Benadryl can have serious side effects for the sinuses, including the drying up of the mucous membranes of the nasal tissue and thickening the secretions, and can also cause drowsiness.
   • Take 25 – 50 milligrams of Benadryl every eight hours as needed for congestion. This drug may prove difficult to tolerate due to its side effects of drowsiness and “fogginess." You should consult with your doctor before giving children Benadryl.
   • Take 10 mg of Zyrtec once daily. Children older than six years of age may take this as well, in doses of 5 – 10 mg per day, depending on age and weight. There is also a liquid version available for children over two. Consult the instructions or follow your doctor's advice. This medication may cause some drowsiness
   • Take 10 mg of Claritin once daily. Second generation antihistamines such as this one have a much improved side effect profile and are less likely to cause drowsiness. Claritin is is available in liquid, pill, and other forms for children over age 2. Consult with your pediatrician.
   • You could also try a prescription antihistamine nasal spray such as azelastine (Astelin, Astepro) or olopatadine hydrochloride (Patanase).
4. Get pain relief. Relieve the pain with over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen (Advil) or naproxen (Aleve) which will help to open the airways by reducing the inflammation. They also reduce fever and relieve pain. Discuss these options with your doctor if you have any doubt about their usage and whether these medications are right for you.
   • Aspirin (Acetylsalicylic Acid) is a drug that works as an analgesic, relieving pain by inhibiting pain signals in the brain. It is also an antipyretic, a drug that reduces fever. Do not give to children under 18, however.
   • Acetaminophen (Tylenol) can be used for pain and fever but will not help with the inflammation. Acetaminophen is safe for children.
5. Consult your physician. If your headache recurs frequently, is very severe, or doesn't improve with home treatments, you should be checked by a doctor. Moreover, if the problem is due to growths, like polyps, or other defects blocking the sinuses, you may need surgery. Here are a number of circumstances where you should see your doctor:
   • If you experience soft tissue swelling over the frontal sinus with headache and fever. This can indicate an infection of the frontal bone.
   • If your eyelids swell, become droopy, red, or warm, or if you experience vision changes. This may be indicative of a rare but very serious condition which can result in permanent blindness. Fever and severe illness is usually present. If pain from a sinus headache moves to the eye or swelling around the eye, you should be evaluated immediately.
   • If your sinus pain is associated with the frontal sinuses. The infection can cause the formation of a blood clot in that area. Symptoms of a blood clot are similar to those of an eye socket infection, but in this case, the pupil of the affected eye will be dilated, or larger than usual.
   • Anyone with a sinus headache or infection and experiencing a personality change, stiff neck, high fever, altered consciousness, rash on the body, visual problems or seizures should seek immediate medical attention. These symptoms may mean that the infection has spread to the surrounding tissue, including the brain.

Using Home Remedies

1. Irrigate your nose. Mix eight ounces of warm water with 1/2 teaspoon of salt. Using a bulb syringe purchased at the drugstore, irrigate your nostrils with this homemade saline rinse to help loosen and liquefy your nasal secretions and relieve congestion. Try doing two sprays in each nostril.
   • Use water that is distilled, sterile, or already boiled and cooled. Always rinse the instrument after each use and let air dry before next use.
2. Use a Neti pot. A Neti pot is miniature tea pot-shaped device that has gained support from the medical community as a way of cleansing your sinus passages. Water from the Neti pot increases drainage and decreases inflammation in the nasal passages that contributes to sinus headaches. The Neti pot works by flooding warm water through one nostril and out the other. Do not use a Neti pot if you cannot blow your nose. You simply fill the “teapot” with warm water (120 degrees) and tilt your head to allow the water to pour into your right nostril and drain out the left. Then, do the other side.
   • Use water that is distilled, sterile, or already boiled and cooled. Always rinse the Neti pot with clean water and dish detergent after each use.
   • There have been some reports of rare amoebic infections via the Neti pot in areas with unclean water but there have been no such reports in the United States.
3. Keep your head elevated. When you go to sleep at night, place a couple of pillows beneath your head so that it is elevated. This will make breathing easier and keep the sinus pressure from building up and causing a headache.
4. Use steam. Fill a one-quart pot with water. Boil the water on the stove for a minute or two or until it is steaming vigorously. Then remove the pot from the heat and place on a heat resistant mat on a table. Drape a large, clean cotton towel over your head and then place your head over the steaming pot. Close your eyes and keep your face at least 12 inches away from the water so that you don't burn yourself. Breathe in through your nose and out through your mouth for five counts. Then reduce the inhales and exhales to two counts. Do this 10 minutes or for as long as the water is still steaming. Try to blow your nose during and after the treatment.
   • Keep any children away from the pot while it is boiling and while it is steaming. Try to do a steaming treatment when there aren't any children around.
   • You can use this technique frequently, up to every two hours. When you're out and about or at work, you can simulate a steam treatment by placing your face over the steam coming from a cup of hot tea or bowl of soup.
   • You can also add herbs and essential oils (one to two drops) to your steaming water. Spearmint or peppermint, thyme, sage, oregano, lavender, tea tree oil, and black lavender oil have either antibacterial, antifungal or antiseptic properties.
5. Take hot showers. Taking long, hot, Create a Steamy Shower works very similarly to the steam treatments described above. The hot water from the shower creates warm, moist air that is useful in clearing out blocked nasal passages and relieving sinus pressure. Try blowing your nose naturally. The heat and steam will help moisten and liquefy the secretions in the sinuses to better facilitate their evacuation.
   • You also achieve a similar beneficial effect by placing a warm compress on your face to help open up your nasal passages and relieve any pressure you might be feeling in your sinuses. Warm a moist washcloth in the microwave for two to three minutes. Always take care not to burn yourself.
6. Use a humidifier. The warm, humid air of a humidifier may ease nasal congestion and sinus pain by helping the nasal passages to drain and to bring down inflammation. Follow the directions that come with your humidifier.
   • Try placing the humidifier in your bedroom while you sleep as this is one time when people experience increased sinus pressure.
   • When your nasal passages are blocked, you need to focus on keeping your nasal passages and sinuses moist. Although many people think that if you have have a runny nose that dry air is the trick, dry air only further irritates the membranes in your nasal passage.
   • Humidifiers are especially good during the wintertime because the air in most homes is very dry due to central heating.
   • Even placing a hot bowl of water on your bedroom floor can increase the moisture in the air. Just make sure to put it in a place where you won't accidentally tip it over or step into it.
7. Do a Self Head Massage. Apply gentle pressure using your index and middle fingers, rotating in a circular motion over the forehead (frontal sinus) and the bridge of your nose and behind your eyes (orbital sinus) as well as under the eyes (maxillary sinus). Do this for several minutes and then blow your nose right after.
   • You can also apply an oil, such as rosemary or peppermint, as you massage that may open up your sinus passages. Just don't let the oil get into your eyes.
   • If you can get a friend to assist, lie down and have a friend massage your head. Have your friend place his thumbs above your eyebrows in the center of your forehead and draw the thumbs up toward the hairline, then lift. Repeat, but draw the thumbs to the temples, then lift at the hairline. Repeat a fraction higher each time until the whole forehead region has been massaged.
8. Drink fluids frequently. Keep the body hydrated by drinking plenty of fluids (at least eight full glasses a day). Nasal passages become congested when the tissue in the passages is inflamed and is unable to drain and drinking liquids will assist with nasal decongestion. The liquids assist with drainage by thinning out your nasal mucus and reducing the inflammation that leads to sinus headaches.
   • Thinned out mucus is much more likely to drain. Whenever you feel the beginnings of sinus headache, make a concerted effort to stay hydrated.
   • Water is best. Although juice tastes great, it is high in fructose and unneeded calories. If you don’t like unflavored water, then add a twist of lemon, lime or frozen strawberries.
   • Hot herbal tea may also help clear congestion while keeping you hydrated.
9. Exercise. Exercise is a natural decongestant. Getting your heart rate up just enough to break sweat can help clear your nasal secretions. If you can do some aerobic exercise, such as running or cycling for even 15 minutes, you may experience some relief.
   • You can even try moderate exercise, such as going for a brisk walk.
10. Eat something spicy. Hot salsa, peppers, hot wings, horseradish, and other spicy foods can get your nasal secretions flowing and thereby help to relieve the pressure in your sinuses. The nose is best blown when the secretions are moist and fluid. That is why remedies that generate this are effective.
    • For sushi lovers, try wasabi. The spicy topping will temporarily relieve sinus pressure and help clear your sinuses.

Tips

• If you only have a headache, you probably don't have a sinus headache. These latter headaches typically have other symptoms, including a stuffed up nose, cough, sore throat, fatigue, and nasal discharge.
• Avoid smoking and alcohol. Stay away from smoking and secondhand smoke. Smoking may contribute to sinus headaches by increasing inflammation in the nasal passages, and preventing them from draining. In addition, limit your consumption of alcohol. Consuming alcoholic drinks may lead to swelling of the sinus and nasal tissues that contribute to sinus headaches.
• Stay out of polluted air. Pollutants and allergens may trigger sinus headaches by inflaming the nasal passages and keeping them from draining.
• Don't use electronics too much. The ray from the screen (no matter how low it may be) can increase the pain.

Warnings

• Although only rarely life-threatening, sinus headaches that result from sinusitis must be treated cautiously. The sinuses are in close proximity to the brain and the infection may travel to the brain tissue or eyes where it can cause permanent damage.

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• Get Rid of a Headache
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• Use a Neti Pot
• Clear Nasal Congestion
• Clear a Sinus Infection

Sources and Citations

See also

• Treat Nasal Infection Naturally
• Clear a Stuffy Nose
• Make Yourself Sneeze
• Get Rid of a Runny Nose
• Stop a Sneeze
• Clean Your Nostrils
• Prevent Nose Bleeds
• Get Rid of a Stuffy Nose Quickly
• Clear Nasal Congestion
• Drain Sinuses

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