Q&A on Recurring Sinus Headaches: When you just can’t ditch it


Q: I have sinus headaches.  They are killing me.  And, to make matters worse, when I go down to the “Doc in a Box”, the antibiotics that they prescribe don’t seem to help.  What gives?

A: Let’s start at the beginning: it may not be your sinuses. I could be wrong, but headaches severe enough to take time out of your day to seek help from a physician are rarely because of a sinus infection.  While sinusitis can trigger severe headaches, and there are severe complications from which headaches do occur, unless you have colored snot that has been worsening over days, it is not your sinuses. Quit blaming them. Just because your sinuses are in that area, the majority of the time they are not the reason for your headaches. Vascular headaches, migraine-variant headaches, frequently masquerade as “sinus headaches”.

You may be experiencing migraines.

As a sinus specialist, I get to see people that didn’t get better after treatment from their initial healthcare contact.  I find out why treatment from other smart, experienced physicians is not working. If you think about it, if your headaches were from a sinus infection, wouldn’t you get better from antibiotics and surgeries?  If it were from allergy, wouldn’t it get better with antihistamines?  The majority of the time you would. Headaches can be really complicated.

Q: Can I have ‘sinus’ and migraine?

A: Yes, you can have a sinus infection trigger your migraine.  Allergy, another sinus issue, is a leading trigger for migraine, as well.  But by far the leading triggers are tooth-grinding, “headache” foods, and stress. So, you’re probably wondering why you should even see an ENT doctor when you have these “not sinus” sinus headaches.

  • ENT doctors can help identify your headache as migraine, thereby taking away the urge to treat this as a sinus condition.
  • ENT doctors can help identify which triggers bring on your “sinus” migraines.
  • ENT doctors usually work with a ready group of referral sources to assist in treating those very triggers and the migraines themselves . This would include Neurologists, TMJ/bruxism dentists, and allergists.
  • ENT doctors can treat your sinusitis, which may co-exist or be the sole trigger for your sinus headaches after all.

Like I said earlier, headaches are complicated.  But they are usually quite treatable.  You just have to know your triggers.  You can do what you want with your stress – yoga, tranquilizers, exercise, and meditation help some people.  And night guards really do help teeth grinding issues and relieve stress on the joint.

But the food and beverage part of the headache equation is known.  For most people the biggest triggers for migraine are red wines, cured meats, chocolate, beer, certain cheeses, and some nuts.  But, hey, don’t panic!  I know that these are often the favorite items on the menu for most of us.  The National Headache Foundation has made up a list of substitutions for these delectable, cherished, yet migraine-inducing foods and beverages.

The highlight of my day is when I get a patient properly diagnosed, with a treatment plan in place, for a “sinus problem” that has baffled the patient and their caregivers for years, with hope and a new direction for care that the patient actually understands.