That troublesome headache might not be a migraine or brought on by tension. It could be caused by sinus trouble, said doctors at Baylor College of Medicine.

“Our sinuses are air-filled spaces in our skull located behind our cheeks, forehead, eyes and the bridge of our nose,” said Dr. Mas Takashima, assistant professor of otolaryngology at BCM and director of the Baylor Sinus Center.

“The sinuses work to humidify and cleanse the air, lighten the weight of the skull, and provide resonance to the voice. Sometimes, the sinuses fail to function correctly, leading to sinus pain caused by an infection or nasal congestion.”

Distinguish between sinus, migraine

Takashima said a physician’s first step when seeing a patient complaining of headaches is to make sure the pain is sinus related. Doctors ask about the patient’s history of allergies, sinus infections, or congestion problems to pinpoint if the sinuses are the cause of the pain.

“Correctly diagnosing the pain is important because, for example, you don’t want to treat a migraine with allergy medication,” said Takashima. “A toothache can actually cause pain in the cheek area, which is often times confused for sinus problems. Your doctor may tap on your teeth to see if that triggers sinus type pains.”

Symptoms, treatments

Migraines typically include nausea or light sensitivity, while tension headaches are normally caused by muscle tightness and can be relieved through relaxation and massage.

Sinus headaches usually occur along with congestion. The drainage passageways of the sinuses into the nose can get blocked and fluid can accumulate in the sinuses, causing pressure. Many things can cause sinus pressure and pain, such as sinus infections, nasal allergies, nasal polyps, septal deviations as well as enlarged vascular structures in the nose called turbinates.

“Sinus pain can also be exacerbated by the weather or even plane travel as the pressure changes in the air around you,” said Takashima. “I like to use the analogy of a bag of chips. If you go up in an airplane with an unopened bag of chips, the bag expands because the pressure outside the sealed bag starts to decrease as the plane goes higher. Since the bag is sealed, the pressure inside cannot equilibrate with the outside pressure. If the sinuses are clogged, the same thing happens in your head, which causes pain.”

Therapy is based on cleansing and decongesting the nose. This can be accomplished with something as simple as nasal irrigation using salt water. Steam, as found in a hot shower, may also provide decongestion and relief. If the problem is caused by infection then antibiotics are used. If it is allergy related, allergy medications may be prescribed. Occasionally surgery is required to keep the passages open.