Sinus Infection Symptoms

Sinus headache, or perceived sinus infection symptoms, can be one of the most misdiagnosed headaches within the realm of headache treatment. Many times people will come to our clinic stating they "have sinus". The headache feels like pressure around their sinuses and yet the light bothers them.

What most people don't realize is that about 40% of all migraines have pain just between the eyes and around the nose. Therefore, the perception is that they are having sinus headache symptoms.

Read more about barometric pressure and headaches.

While many people with recurring "sinus" headache symptoms believe the changes in weather cause their headaches, in reality the barometric changes are causing migraines.

Changes in the weather are the third most common cause of migraine! (First two being stress and hormones.)

Being able to predict barometric changes might allow you to manipulate your medication to diminish the pain.

  • Testing for Sinus Headache

sinus infection treatment

To rule out chronic sinus infections, many doctors will order a CT or CAT scan of the sinuses. This is usually ordered by an ear-nose-throat specialist or ENT. When patients ask about "sinus" causing their headaches, I advise them that we can also see the sinuses when we order MRIs of the brain. The majority of the time, they are clear with no signs of infection or chronic inflammation.

If the scans are normal, despite the pain around the sinuses, it is not chronic sinusitis. At this point it might be advisable to talk to your physician about possibly getting and MRI of the brain, which will show a more detailed view of the brain than a CT.

Sinus Infection Symptoms

Many times, the pain can start just after a mild upper respiratory infection. Usually the infection was viral with a runny nose and the discharge is clear. What happens is that this infection paves the way, so to speak for a bacterial infection to invade the sinuses. A true sinus infection can be distinguished from other types of headaches when it is accompanied by the following symptoms:
  • Yellowish green thick discharge
  • Headache in the forehead and around the nose
  • Nasal congestion and obstruction
  • Post nasal drip
  • Fever and/or chills
  • Pain in sinuses when bending over
  • Tenderness to touch over sinus area
  • Fatigue

These symptoms can also be seen with a cold. But if the pain around your face and eyes and the thick nasal discharge continue for more than a week, you may have sinusitis. At this point it most probably is bacterial and would need an antibiotic. Remember: viral infections do NOT respond to antibiotics.

If this doesn't sound like you, then read more about different types of headaches to find out what might be causing your pain.

Sinus Infection Treatment

Sinus headache medicine may provide sinus headache relief. Sinusitus might be confused with migraine headache. Searching for sinus headache relief can be frustrating. If mild it may respond to rest and a short course (a week or less) of OTC medications.

Over the counter anti-inflammatories for sinus headache symptoms may help as will decongestants. If you suspect that you have an infection, please see your doctor.

If these sinus headache symptoms are a sinus infection, it is usually accompanied by nasal discharge, chills and a fever. The headache itself feels more like severe pressure across the forehead and around the nose. If very severe, your teeth might even hurt!

sinus headache relief

Other sinus headache medication such as pseudofed could help if used short term (1-2 weeks). However, be aware that many of these medications, if used longer than that can acutally worsen headaches.

Pseudofed is one of the worst offenders when used long term. It raises blood pressure, causes anxiety (reaaallly great if you already have a headache), and insomnia. A more holistic approach for sinus infection treatment is to use a Sinus wash system with a Neti Pot. I have had several patients try this for acute sinusitus and it does help.

Unfortunately, prolonged use of pseudofed and products like it lead to rebound sinus headache symptoms if you use it more than 7 days.

Sinus Headache Medicine

When discussing these types of medications it is important to realize that they are to be taken on a short term basis only. If you find that you need medication for longer than 7 days for your sinus headache symptoms, then you should consult your doctor. Remember, many of the OTC drugs were once prescriptions and as a result, long term use can provoke side effects.


Antibiotics are an appropriate sinus headache medicine if you have severe sinus pressure, greenish-yellowish discharge and/or fever and chills. One of the disadvantages of antiobiotics is that they can take at least 10-14 days to have the full effect. Why is this? Well the sinuses are empty spaces in your skull, with NO vasculature. Without arteries to carry medication to an area, the meds have to diffuse in slowly. This is why 7 days of therapy is inappropriate and unfortunately, many clinicians miss this.


There are two ways to take antihistimines and actually, as a class, they are one of the best sinus headache medicines.

  • OTC.
These include Chlor-Trimaton (chlorpheniramine), Tavist spray (clemastine), Benadryl (diphenhydramine) which comes in tablets and liquid and others. The newer drugs include Claritin (loratidine) and Zyrtec (cetrizine) which do not cause drowsiness, a common complaint of the others. Claritin and Zyrtec also come as a "D" combination formula which means a decongestant has been added.
  • Prescription.
Allegra (fexofenadine) is a longer acting antihistamine and it also comes in a combo "D" formula. Xyzall (levoctrizine) is a newer antihistamine. Be aware of the fact that the "D" formula is a form of pseudofed.


Steroids can help reduce inflammation associated with sinus headache symptoms. A medrol dose pak for one week is effective, as are nasal sprays. These are all prescription and include: Flonase(fluticasone), Beconase(beclomethasone), Nasonex (mometasone) and Nasacort (triacinolone).


Decongestants are another class of sinus headache medicine are mostly over the counter now and can be effective in opening up swollen nasal passages. It is important to stay hydrated while taking this sinus headache medicine, as it allow the drugs to break up congestion to be expelled through the nose.

Sudafed, Actifed, Afrin, and Neo-Synephrin are all OTC and may cause an increase in blood pressure. You should not take them if you have prostate, hypertension that is uncontrolled, emphysema or chronic bronchitis. When used for more that 5 days or so, rebound congestion can occur.

Should I Take My Triptan?

Many patients ask me this and my response is to try it. If it takes the headache away in under one hour then it was a migraine and not sinus. You might be surprised if you try this, to discover that all along the headaches were migraines.

Natural Sinus Remedies

Several different herbs can be used to treat a mild sinus headache symptoms. Willow bark (which is where aspirin came from) can be used to reduce fever and inflammation and perhaps even pain. Here is more information about natural sinus remedies. Don't forget, the Neti pot may also help as will methol and eucalyptus. For children, a little mentholatum at the base of the nose before bed at night, does help keep nasal passages open while they sleep. Just a swab, and do not put it in the nose.

Acupuncture can be effective 50% of the time for chronic migraine, but has mixed results in studies when looking at acute sinus infection treatment. Chiropractice care is also somewhat ineffective for an acute infection. Therefore, when it comes to sinus headache medication, it is important to get a proper diagnosis and treat sinus infection symptoms.


Annequin D, Tourniaire B, Massiou H. Migraine and headache in childhood and adolescence. Pediatr Clin North Am. 2000;47(3):617-631.

Sinus headaches. American Academy of Otolaryngology — Head and Surgery. http://www.entnet.org/HealthInformation/sinusHeadache.cfm. Accessed Dec. 30, 2011.

Bajwa ZH, et al. Headache symptoms other than migraine. http://www.uptodate.com/home/index.html. Accessed Dec. 30, 2011.

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