One of the treatable causes of headache is headache attributed to acute sinusitis. Sinusitis occurs as a result of infection or inflammation of the sinus cavities around the nose. It is seen frequently especially after common cold, flu, or allergic conditions.

This inflammation in the sinuses manifests with nasal congestion, pressure sensation in the facial region, and headache. Pain generally:

• Is felt in the forehead, cheeks, around eyes, and nasal bridge,
• Increases with bending or forward movement,
• Can be more intense in morning hours.

Headache attributed to acute sinusitis is quite common in society and appears more frequently especially in cold weather or during winter months when infections increase. It can negatively affect daily life, reduce work and school performance.

What is Headache Attributed to Acute Sinusitis?

Headache Attributed to Acute Sinusitis is a pain condition that occurs as a result of sudden inflammation of the sinuses, which are air-filled cavities in our skull. Sinuses are natural air cavities located around our nose and in our forehead and under normal conditions facilitate our breathing by filtering clean air.

Our sinuses are located in four main regions: in our forehead (frontal), in our cheek (maxillary), in the bridge of our nose (ethmoid), and at the back of our head (sphenoid). Headache Attributed to Acute Sinusitis can occur in any one or several of these regions simultaneously.

Headache Attributed to Acute Sinusitis generally lasts less than 4 weeks and shows sudden onset. This headache is severe.

What Causes Headache Attributed to Acute Sinusitis?

There are many reasons for the occurrence of Headache Attributed to Acute Sinusitis:

Viral Infections: The most common cause is common cold and flu viruses. These viruses swell the inner membranes of our nose, blocking sinus canals. Accumulation occurs in blocked sinuses and inflammation begins.

Bacterial Infections: Sometimes bacteria also come into play after viral infection. This situation further intensifies sinusitis pain, and when bacterial infections are added, Headache Attributed to Acute Sinusitis lasts longer compared to those developing with viral infections.

Allergy: Hypersensitivity to allergens such as pollen, dust, animal fur causes sinus membranes to swell. This swelling narrows sinus canals and prepares the ground for inflammation.

Nasal Deformity: Nasal bone curvature (septum deviation) or nasal turbinate enlargement disrupts sinus drainage. This situation creates suitable environment for Headache Attributed to Acute Sinusitis.

Air Pollution: Cigarette smoke, chemical substances, and dirty air irritate sinus membranes, increasing the risk of infection development.

Dental Infections: Especially infections in upper jaw teeth can spread to the maxillary sinus, causing Headache Attributed to Acute Sinusitis.

Climate Changes: Sudden temperature changes, changes in humidity rate, and pressure differences can trigger sinus problems.

What are the Symptoms of Headache Attributed to Acute Sinusitis?

The symptoms of Headache Attributed to Acute Sinusitis are quite typical and easily noticed by patients:

Pain Characteristics: Pain is generally felt in the forehead, around eyes, upper part of cheeks, and nasal bridge. It is a throbbing, pressing-type pain. You feel as if there is swelling inside your head.

Pain Increasing with Position Change: The most characteristic feature of Headache Attributed to Acute Sinusitis is that it increases when you bend forward, lower your head, or lie down. This situation arises from pressure increase in sinuses.

Nasal Discharge and Congestion: Thick, yellow-green colored nasal discharge is one of the most prominent findings of Headache Attributed to Acute Sinusitis. Nasal congestion is also observed.

Sensitivity in Facial Region: Pain increases when you press on regions where sinuses are located. Especially cheeks, forehead, and around nose become sensitive to touch.

Fever and General Discomfort: If there is bacterial infection, fever may occur. Weakness, fatigue, and a general feeling of discomfort accompany.

Loss of Smell and Taste: Due to sinusitis infection, reduction in sense of smell and taste or complete loss may occur.

Ear Pain and Pressure: Since sinuses are connected to our ear, sometimes there can be pain and pressure sensation in the ear.

Toothache: Especially in maxillary sinusitis located above the upper teeth, throbbing pain can be felt in upper jaw teeth.

International Classification of Headache Disorders (ICHD-3) Diagnostic Criteria – 11.5.1 Headache attributed to acute rhinosinusitis

Headache and/or facial pain must be related to acute sinusitis.

Acute sinusitis diagnosis must be confirmed by clinical, endoscopic, or imaging methods.

There must be at least two findings supporting causation relationship between pain and sinusitis:

Headache appearing with the onset of acute rhinosinusitis.

Headache disappearing with resolution of rhinosinusitis.

Headache occurring together with findings specific to sinusitis:

• Nasal congestion,
• Nasal discharge (especially purulent),
• Hyposmia/anosmia (smell reduction/loss).

Pain being limited to ipsilateral nasal and paranasal sinuses.

Headache should not be better accounted for by another International Classification of Headache Disorders diagnosis.

ICHD-3 especially emphasizes causation relationship between headache and sinusitis. That is, not every sinusitis leads to headache, nor should headache always be thought to originate from sinusitis. Therefore, differential diagnosis is important in clinical evaluation (migraine, tension-type headache, etc. should be excluded).

How is Headache Attributed to Acute Sinusitis Diagnosed?

Headache Attributed to Acute Sinusitis diagnostic process consists of the following steps:

Detailed History Taking: Your doctor asks when your pain started, pain characteristics, location, severity, and in which situations it increases and decreases. Information is obtained about whether you had flu recently, your allergy history, and nasal problems.

Physical Examination: Your doctor examines inside your nose with special instruments, checks whether there is sensitivity by pressing gently on sinus regions. Your throat and ear examination are also performed.

Nasal Endoscopy: When necessary, nasal interior and sinus entrances are examined in detail with a thin, flexible camera (endoscope). Inflammation in sinuses can be seen with this method.

Imaging Methods:

• Paranasal Sinus X-ray: The simplest imaging method. Shows whether there is fluid accumulation in sinuses.
• Paranasal Computed Tomography (CT): The most valuable imaging method in diagnosing Headache Attributed to Acute Sinusitis. Shows the condition of sinuses in great detail.

Laboratory Tests: If you have fever, blood test can be performed. By taking a nasal discharge sample, which microbe to treat against can be determined.

Differential Diagnosis: Your doctor distinguishes Headache Attributed to Acute Sinusitis from migraine, tension-type headache, cluster headache, and other pain types.

Treatment of Headache Attributed to Acute Sinusitis

The aim in treating Headache Attributed to Acute Sinusitis is to eliminate inflammation, ensure sinus drainage, and control symptoms.

Medication Treatment

Antibiotic Treatment: If there is suspicion of bacterial infection, your doctor gives you antibiotics. It is very important to use these medications regularly and for the full duration. They are mostly used for 7-10 days.

Painkillers and Fever Reducers: Painkillers such as paracetamol and ibuprofen are used for Headache Attributed to Acute Sinusitis. These medications both reduce pain and alleviate inflammation.

Nasal Sprays:

• Decongestant Sprays: Open nasal congestion but should not be used for more than 3-5 days.
• Steroid Sprays: Reduce inflammation and can be used longer in allergic cases.

Antihistamines: If there is an allergy situation, antihistamine medications are used. These both reduce allergic reaction and control nasal discharge.

Mucolytic Drugs: Thin thick secretions in sinuses and facilitate their elimination.

Supportive Treatment That Can Be Done at Home

Steam Inhalation: Inhaling hot water steam softens sinuses and facilitates drainage. You can inhale steam 2-3 times a day for 10-15 minutes.

Hot Compress: Applying hot compress to painful areas can alleviate Headache Attributed to Acute Sinusitis.

High Fluid Consumption: Drinking at least 2-3 liters of water per day thins secretions and facilitates their elimination.

Nasal Washing with Salt Water: Nasal cleaning with salt water cleans sinuses and reduces inflammation. This process can be done 2-3 times a day.

Elevating Head of Bed: Elevating your head of bed 30-45 degrees while sleeping improves sinus drainage.

Surgical Treatment

If Headache Attributed to Acute Sinusitis does not respond to medication treatment or complications develop, surgical intervention is rarely needed:

Sinus Drainage: When necessary, a small intervention can be performed to drain coagulated fluid accumulated in sinuses.

Endoscopic Sinus Surgery: Minimally invasive surgery can be applied to open sinus canals and ensure ventilation.

Preventive Measures

To protect from Headache Attributed to Acute Sinusitis, we recommend paying attention to your hand and nasal hygiene, as well as your general health.

• Pay attention to hand hygiene, wash your hands frequently.
• Give importance to nasal hygiene.
• Manage your allergy treatment with your doctor.
• Avoid contact with people who have flu and common cold.
• Stay away from cigarettes and dirty air.
• Strengthen your immune system.
• Get adequate sleep and eat a balanced diet.
• Be physically active.

Headache Attributed to Acute Sinusitis is a condition that can heal in a short time with correct diagnosis and appropriate treatment. When you notice symptoms, consulting a doctor without delay ensures both quick relief from headache and prevention of possible complications. With regular medication use and doctor control, Headache Attributed to Acute Sinusitis can be successfully treated.

Frequently Asked Questions About Headache Attributed to Acute Sinusitis

1. What is the Difference Between Headache Attributed to Acute Sinusitis and Normal Flu?

The fundamental difference between Headache Attributed to Acute Sinusitis and normal flu is the location and character of pain. In normal flu, headache is a general pain felt throughout the head, while Headache Attributed to Acute Sinusitis is located in the forehead, around eyes, cheeks, and nasal bridge where sinuses are located. In sinusitis, when you bend forward, shake your head, or lie down, pain significantly increases; this situation is not seen in flu headache. Additionally, in sinusitis, nasal discharge is thick and yellow-green colored, while in flu it is generally clear and watery. Sinusitis pain is pressing, throbbing in nature, and sensitivity increases when you press on sinus regions. Flu generally heals spontaneously within 7-10 days, while Headache Attributed to Acute Sinusitis can last for weeks if not treated and cause more severe symptoms.

2. How Long Does Headache Attributed to Acute Sinusitis Last? Does It Pass Spontaneously?

Headache Attributed to Acute Sinusitis generally lasts between 7-28 days, but this period varies according to whether you receive treatment. Mild viral-origin sinusitis can heal spontaneously within 10-14 days, but if bacterial infection has developed, antibiotic treatment is definitely necessary. In patients waiting without treatment, pain severity increases, nasal discharge turns yellow-green, and fever may occur. Especially in headache lasting longer than 10 days and progressively increasing, consulting a doctor is mandatory because complication risk increases.

With correct treatment, Headache Attributed to Acute Sinusitis significantly decreases within 3-7 days and completely heals within 2 weeks. Untreated cases can turn into chronic sinusitis and last for months, so early intervention is very important.

3. Is Headache Attributed to Acute Sinusitis Contagious? Will It Spread to People Around Me?

The contagiousness of Headache Attributed to Acute Sinusitis is frequently wondered by patients. Contagiousness depends on the underlying cause. Sinusitis itself is not contagious, but viral infections causing sinusitis (flu, common cold) are contagious. That is, you cannot catch sinusitis from a person with sinusitis. However, if the sick person’s flu spreads to you, sinusitis can develop in you afterward. Bacterial sinusitis is not contagious.

People with Headache Attributed to Acute Sinusitis should cover their mouth when coughing and sneezing, wash their hands frequently, and wear a mask in crowded environments if possible. If you have flu, take these measures to protect those around you, but know that sinusitis itself is not contagious. If multiple people in a family have sinusitis, the reason is not catching sinusitis from each other but being exposed to the same viral infection.

4. Which Doctor Should I See with Suspicion of Headache Attributed to Acute Sinusitis?

Headache Attributed to Acute Sinusitis can be initially evaluated by your family physician, who can refer you to the appropriate specialist if necessary. You should apply to the emergency room only if there is high fever, severe pain, swelling around eyes, or vision problem. Avoid doctors who only prescribe painkillers for Headache Attributed to Acute Sinusitis, because the underlying infection must be treated.

In case of severe and newly starting headache, you should consult with a neurology doctor. Ear Nose Throat (ENT) doctors can also directly see the condition of sinuses by performing nasal endoscopy and can request special imaging methods if necessary. Alternatively, you can also apply to Internal Medicine and Pulmonary Medicine doctor if you have an allergic background.

5. What Can I Do at Home for Headache Attributed to Acute Sinusitis? Is Antibiotic Definitely Necessary?

Supportive treatment methods you can do at home for Headache Attributed to Acute Sinusitis are effective and accelerate healing. The most important application is regular steam inhalation: lean over boiling water in a bowl 3-4 times a day and inhale steam for 10-15 minutes, this softens sinuses and ensures drainage. Nasal washing with salt water is also very beneficial; do nasal washing 2-3 times a day by adding one teaspoon of salt to a glass of warm water. Consume plenty of fluids (2-3 liters of water per day), this thins secretions. Sleep with your head of bed elevated, apply hot compress to painful areas.

Antibiotic use is not necessary for every Headache Attributed to Acute Sinusitis. Antibiotics do not work in viral sinusitis, they are only necessary if there is bacterial infection. Symptoms of bacterial sinusitis are yellow-green thick nasal discharge, complaints lasting longer than 10 days, fever, severe facial pain, and general condition deterioration. If these conditions are present, definitely consult a doctor and get antibiotic treatment.