Overview
You're congested. You feel pressure around your eyes, cheeks and forehead. And your head is throbbing. It feels like a sinus headache — but don't jump to conclusions.

Headaches can accompany sinusitis, a condition in which the membranes lining the sinuses become swollen and inflamed. But many people who assume they have sinus headaches actually have migraines or tension headaches.

When sinus headaches caused by sinusitis do occur, proper diagnosis and treatment are the keys to relief.

Signs and symptoms

Headaches caused by sinusitis often appear as soon as you get up in the morning. You may feel pain, pressure, and fullness in your cheeks, brow or forehead. The pain may get worse when you bend forward or lie down. If sinusitis becomes chronic, the headaches may become a constant dull ache.

Other signs and symptoms of sinusitis may include:

• Yellow-green nasal discharge
  
• Sore throat
  
• Fever
  
• Cough
  
• Fatigue
  

Causes

Sinusitis can be caused by colds, allergies, bacterial or fungal infections, problems with the immune system, or structural problems in the nasal cavity. The resulting pressure changes in the sinuses can trigger headaches.

Risk factors

Sinusitis can affect anyone. You may be more likely to develop chronic sinusitis if you have:

• Asthma
  
• Nasal growths (polyps)
  
• Allergies to dust, mold or pollen
  
• A weak immune system
  
• A condition that affects the way mucus moves within your respiratory system, such as cystic fibrosis
  

When to seek medical advice
Consult your doctor if your headaches are severe or if they're accompanied by:

• Fever higher than 100.5 F
  
• Pain, swelling or redness on your face or around your eyes
  
• Confusion
  
• Stiff neck
  

Tender sinuses may be one sign of sinusitis. The doctor may use a thin tube with a light (endoscope) to examine your nasal passages. He or she may also test mucus samples from inside your nose for evidence of a bacterial or fungal infection.
Sometimes imaging studies such as computerized tomography (CT) scans and magnetic resonance imaging (MRI) are recommended as well. Computerized tomography uses a computer to create cross-sectional images (like slices) of your brain and head by combining images from an X-ray unit that rotates around your body. With magnetic resonance imaging, a magnetic field and radio waves are used to create cross-sectional images of the structures within your brain.

Treatment
If you're diagnosed with sinusitis, your doctor may recommend antibiotics. Be sure to finish the entire course of medication — even if your signs and symptoms disappear before all the pills or capsules are gone. This is the only way to eradicate the bacteria causing the infection. If the sinusitis is related to inflammation or allergies, your doctor may prescribe corticosteroid nasal sprays or pills.
As the sinus infection clears up, the sinus headaches should disappear. In the meantime, over-the-counter pain relievers, decongestants and saline nasal spray might help you feel better. Use these products only as directed. It may help to drink plenty of fluids as well.
If a structural problem in your nasal cavity is contributing to sinusitis or sinus headaches, surgical correction may be recommended.
If you continue to experience headaches, your doctor may look for other possible causes.

Prevention
To reduce the risk of sinusitis, keep your sinuses healthy.

• Wash your hands often. Soap and water can help you avoid the upper respiratory infections that can lead to sinusitis. You may want to ask your doctor about a yearly flu vaccine as well.
  
• Avoid irritants. Avoid cigarette, cigar and pipe smoke. These and other air pollutants can cause your sinus membranes to swell.
  
• Use a humidifier. Adding moisture to dry indoor air can help prevent sinusitis — but don't overdo it. High indoor humidity can promote mold and dust mite growth. Be sure the humidifier is clean and free of mold.
  

If you develop a cold or other upper respiratory infection, take good care of yourself. Drink plenty of fluids. Keep your nasal passages clear by gently blowing your nose, one nostril at a time.