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The Myths of "Sinus Headache"

#1) My nasal stuffiness means I have sinusitis—myth.

Many myths confound the proper treatment of migraines presenting primarily as “sinus headaches.” The nasal congestion caused by migraines fails to distinguish itself from allergic rhinitis, sinusitis, and vasomotor rhinitis. Migraine causes inflammation in the nerves and blood vessels in the head. In the typical migraine headache the upper branches of the nerve, which supply the coverings of the brain, are involved and the head pain is the predominant symptom.

In cases of “sinus headaches” the inflammation starts within the nerve, causing sinus pain and nasal discharge and/or stuffiness. The branch that gives touch and pain sensation to the nose causes nasal discharge and the lining of the nasal passages to become swollen. Nasal congestion is very common with migraines. The nasal stuffiness is usually reversible as demonstrated in studies of the nasal passages—congested and swollen during the migraine, however, are normal before and after. The nasal congestion that develops in a migraine is not infection. Slowly, as the migraine goes away, the congestion will disappear.

#2) My nasal discharge means I need antibiotics for my sinusitis—myth.

If the patient has a 102 degree temperature and a thick yellow foul-smelling discharge, there certainly may be infection. It is even possible it could be bacterial. Then antibiotics would be appropriate. Many headache sufferers describe pain or pressure in areas around their sinuses. I was a medical investigator in a national study involving about 3000 patients with sinus pain thinking they had infections. Nearly 90% of the patients actually were having migraines.

Because of the location, many patients presume that their symptoms are caused by problems with their sinuses themselves. It takes infection under pressure to generate pain from bacterial sinusitis. Most patients with chronic bacterial sinusitis do not present themselves at the doctor’s office with high fever or pain. Certainly allergies and sinusitis and changes in the weather or barometric pressure can be triggers for migraine headache. Upper respiratory tract infections, chemicals, or smells can irritate the trigeminal nerve, and this nerve through the migraine mechanism is the source of headache pain. It is not good to make your trigeminal nerve unhappy.

More myths of “sinus headache” will be covered in the next article. To find additional information about “sinus headache”, migraines, fibromyalgia, temporomandibular joint (TMJ) syndrome, irritable bowel syndrome (IBS), palpitations, vertigo, hypoglycemia, panic attacks and their interrelationship, go to

About the Author: J. Wes Tanner, MD is a family practice and headache specialist who has been treating people for about 30 years. He has extensive experience in treating migraines and fibromyalgia with excellent success. In "Doctor, Why Do I Feel This Way?", Dr. Tanner exposes the secrets and myths about fibromyalgia and the migraine syndrome. To find out more, go to href="">

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