The best way to avoid or get rid of a sinus headache is to treat the underlying sinus inflammation. Sinus pain caused by allergies may be helped by allergy medications and medicated nasal sprays. Your doctor may prescribe antibiotics or corticosteroids. Lifestyle changes, such as using a humidifier or irrigating your nasal passages with salt water, may also help. Several dietary supplements and herbs may help prevent colds and flu, shorten their duration, or work together with antibiotics to treat your infection and support your immune system. Flushing the nose and sinuses with saline solution may also help.
Doing the following things can help reduce congestion in your sinuses:
- Using a humidifier
- Using a saline nasal spray
- Breathing in steam 2 to 4 times per day (for example, sitting in the bathroom with the shower running)
- Quickly treating allergic and asthma attacks
Other techniques that might help include:
- Stretches for the head and neck
- Relaxation techniques (see Mind-Body Medicine section)
Antibiotics. Your doctor may prescribe antibiotics if they suspects you have a bacterial infection. To treat acute sinusitis, you may take from 10 to 14 days of antibiotics. Treating chronic sinusitis may take longer, usually 3 to 4 weeks.
Nasal corticosteroids. These prescription sprays reduce inflammation of the nose and help relieve sneezing, itching, and runny nose. They are most effective at reducing symptoms, although it can take anywhere from a few days to a week after you start using them to see improvement.
- Beclomethasone (Beconase)
- Fluticasone (Flonase)
- Mometasone (Nasonex)
- Triamcinolone (Nasacort)
Antihistamines. Antihistamines are available in both oral and nasal spray forms, and as prescription drugs and over-the-counter remedies, to treat allergies. Over-the-counter antihistamines are short acting and can relieve mild-to-moderate symptoms. All work by blocking the release of histamine in your body.
- Over-the-counter antihistamines: Include diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton), and clemastine (Tavist). These older antihistamines can cause sleepiness. Fexofenadine (Allegra), cetinzine (Zyrtec), and loratadine (Claritin) are newer antihistamines that do not cause as much drowsiness.
Decongestants. Many over-the-counter and prescription decongestants are available in tablet or nasal spray form. They are often used in combination with antihistamines.
- Oral and nasal decongestants: Include Sudafed, Actifed, Afrin, and Neo-Synephrine. Some decongestants may contain pseudoephedrine, which can raise blood pressure. People with high blood pressure or enlarged prostate should not take drugs containing pseudoephedrine. Avoid using nasal decongestants for more than 3 days in a row, unless specifically instructed by your doctor, because they can cause rebound congestion. Do not use them if you have emphysema or chronic bronchitis.
Triptans. In one study, 82% of people with sinus headaches had a significant response to triptans, a medication commonly used for migraines.
Surgery and Other Procedures
For chronic sinusitis that does not respond to medication, your doctor may recommend endoscopic sinus surgery, which may be done to remove polyps or bone spurs. Some doctors also recommend enlarging the sinus opening. A newer procedure called balloon rhinoplasty involves inserting a balloon inside the sinus cavity and then inflating it.
Sinus surgeries are done by an ENT specialist.
Nutrition and Dietary Supplements
Several supplements may help prevent or treat sinus headaches, either by reducing sinus inflammation, or by helping to ward off colds. (See Sinusitis for more details.) Because supplements may have side effects, or interact with medications, you should take them only under the supervision of a knowledgeable health care provider.
- Bromelain. Several studies suggest that bromelain, an enzyme derived from pineapples, may help reduce inflammation and swelling and relieve symptoms of sinusitis. However, not all studies agree. Bromelain is often combined with quercetin, a flavonoid or plant pigment responsible for the colors found in fruits and vegetables, which may act as an antihistamine. Bromelain may increase the risk of bleeding, so people who take blood thinners, such as warfarin (Coumadin) or clopidogrel (Plavix) should not take bromelain without talking to their doctor first. Taking bromelain with ACE inhibitors may cause a drop in blood pressure, called hypotension. Bromelain may interact with certain antibiotics as well. Speak with your doctor.
- Quercetin. In test tubes, quercetin stops the production and release of histamine, which causes allergy symptoms, such as a runny nose and watery eyes. It is often combined with bromelain. However, there is not yet much evidence that quercetin would work the same way in humans. More studies are needed. Some people may prefer water-soluble forms of quercetin, such as hesperidin methyl chalcone (HMC) or quercetin chalcone. Quercetin may interact with certain medications, so ask your doctor before taking it.
- Probiotics (Lactobacillus). Probiotics, or "friendly" bacteria, may help if you are taking antibiotics for sinusitis. They may also reduce your chances of developing allergies. People who have very weakened immune systems or who take drugs to suppress the immune system should ask their doctor before taking probiotics.
The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care practitioner.
As with supplements, there are many herbs that may help reduce your chances of getting a sinus headache by preventing or treating a cold, boosting your immune system, or reducing sinus inflammation.
Sinupret, a proprietary formulation containing European elder (Sambucus nigra), common sorrel (Rumex acetosa), cowslip (Primula veris), European vervain (Verbena officinalis), and gentian (Gentiana lutea). In two studies, Sinupret was found to work better than placebo in relieving symptoms of sinusitis. The herbs it contains may work by thinning mucus and helping the sinuses drain, and they may also help strengthen the immune system.
Although research is lacking, other herbs have been used traditionally to treat headaches:
- Chinese skullcap (Scutellaria baicalensis)
- Feverfew (Tanacetum parthenium)
- Willow bark (Salix spp.)
People who take blood thinners, or women who are pregnant or breastfeeding, should not take these herbs. People who are allergic to aspirin should not take willow bark. Feverfew can interact with several medications. If you are allergic to ragweed you may also be allergic to feverfew.
One of the most common reasons people seek homeopathic care is to relieve chronic headaches. Few studies have examined the effectiveness of specific homeopathic remedies. Professional homeopaths, however, may recommend treatments for sinus headaches based on their knowledge and clinical experience. In one study of homeopathy for sinusitis, more than 80% of the participants had significant improvement in their symptoms after taking the homeopathic remedy for 2 weeks.
Before prescribing a remedy, homeopaths take into account a person's constitutional type. In homeopathic terms, a person's constitution is his or her physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.
The following are remedies commonly prescribed for sinus congestion and headache:
- Arsenicum album. For throbbing, burning sinus pain that is relieved by lying upright in a cool room with open windows.
- Belladonna. For throbbing headaches that come on suddenly and feel worse with motion and light; pain is partially relieved by pressure, standing, sitting, or leaning backwards.
- Bryonia. For headaches with a steady, sharp pain that occurs most often in the forehead but may radiate to the back of the head; symptoms tend to worsen with movement and light touch, but firm pressure alleviates the pain; the person for whom this remedy is most appropriate is usually irritable and may experience nausea, vomiting, and constipation.
- Hepar sulphuricum. For headaches described as "a nail being driven between the eyes," these types of headaches are often accompanied by thick, yellow nasal discharge; symptoms tend to worsen with movement and light touch of the scalp and improve with pressure.
- Iris versicolor. For throbbing headaches that occur on one side of the head, especially after eating sweets; visual disturbances may also occur; these headaches are worse in the early morning, during spring and fall, and symptoms tend to worsen with vomiting.
- Kali bichromicum. For sinus headaches and congestion; pain often occurs between and behind the eyes; symptoms typically progress throughout the morning, worsen with cold and motion, and improve with warmth and pressure.
- Mercurius. For raw, swollen nostrils; this remedy is most appropriate for individuals whose pain feels as though the head has been placed in a vise; pain may also extend to the teeth; symptoms tend to worsen at night and the individual may alternate between sweating and having the chills; nasal discharge may be bloody.
- Natrum muriaticum. For headaches and congestion associated with allergies.
- Pulsatilla. For headaches triggered by eating rich, fatty foods, particularly ice cream; pain may move around the head but tends to be concentrated in the forehead or on one side of the head and may be accompanied by digestive problems or occur around the time of menstruation; symptoms tend to worsen at night and with coughing and blowing the nose; children often develop these symptoms while at school.
- Silicea. For sinus pain that improves with pressure, head wraps, and warm compresses.
- Spigelia. For stinging, burning, or throbbing sinus pain that often occurs on the left side of the head; symptoms tend to worsen with cold weather and motion but may be temporarily relieved by cold compresses and lying on the right side with the head propped up.
Although studies are few and have found conflicting results, some people may find that acupuncture helps relieve symptoms of sinusitis. An acupuncturist diagnosis headaches not as migraine, tension, or sinus, but rather as conditions deriving from "energetic" imbalances. Acupuncturists usually describe sinusitis as "dampness" which creates inflammation and congestion in the mucus membranes. This dampness is cleared by strengthening the spleen meridian and by working with the stomach meridian. Practitioners often perform needling therapy and/or moxibustion, a technique in which the herb mugwort is burned over specific acupuncture points, for this condition.
Although there are no studies on using chiropractic to treat sinus headaches, some practitioners suggest that it may decrease pain and improve sinus drainage for some people.
For headaches in general, relaxation techniques can be helpful. This is especially true for frequent headaches, such as sinus headaches. You may want to try these techniques:
- Biofeedback to control muscle tension
- Learn to meditate, breathe deeply, or try other relaxation exercises, such as yoga or hypnotherapy
- Try guided imagery techniques