Pressure around the eyes, forehead and cheeks usually means a sinus headache, but other conditions may be causing the discomfort. Sinusitis, tension, or a migraine may be causing the headache.
Besides pressure and pain in the forehead, cheeks and behind the eyes, a sinus headache may worsen if you bend forward or lie down. Such headaches may also be associated with a sore throat, fever, cough, fatigue or other cold-like symptoms.
Several symptoms help distinguish a sinus headache from a migraine headache. A migraine usually worsens with noise or bright light, and a migraine is often accompanied by nausea or vomiting.
Causes and Risk Factors
Sinusitis, whether allergic, nonallergic or fungal, can cause changes in the pressure in the sinuses that can then cause headaches.
Allergies, a weak immune system, nasal growths (polyps) or asthma can increase the risk of sinus headaches and sinusitis.
If your sinus headache does not respond to over-the-counter medications, you have a fever or the headache persists for more than 10 days, you should see a doctor. The doctor will conduct a physical examination and ask you about your headaches. The doctor may use an endoscope, which is a small, flexible tube, to look up into your sinuses. Mucus samples may also be taken to determine if a bacterial or fungal infection is present. In certain cases, a CT or MRI scan is used to check for other causes of sinus headaches.
In many cases, antibiotics are prescribed to treat sinusitis, which is often the cause of sinus headaches. If the headache is caused by inflammation or allergies, corticosteroid nasal sprays or pills may be prescribed.
Over-the-counter pain medication, decongestants and saline nasal spray can help with the discomfort caused by sinus headaches while other treatments take time to have an effect.
In rare cases, surgery may be required if the sinusitis is caused by an anatomical problem.
To help reduce the risk of sinus headaches, wash your hands often, avoid tobacco smoke and any allergens that you may be allergic to, and use a humidifier to moisturize the dry air in your home.
Cedars-Sinai has a range of comprehensive treatment options.