Do Chronic Sinus Problems Cause Headaches?

Many of us have had sinus-related headaches, right? You know, these are the headaches that hurt over the sinuses (above the eyes or in the cheek bones next to your nose) and when you blow your nose, it’s not pretty! Sinus infections often lead to sinus headaches – wouldn’t you say that’s a true statement?

A November 2011 study begs to differ. Researchers took 58 patients with a diagnosis of “sinus headache” made by their primary care physician and asked them the following questions:

  1. Have you had a previous diagnosis of migraine or tension-type headache?
  2. Is their clinical evidence of a sinus infection during the past 6 months?
  3. Is there the presence of “mucopurulent secretions” (that’s the “not so pretty stuff” when we blow our nose)?

All 58 patients clearly seemed to have chronic sinusitis with an acute flair up and were given complete thorough examinations by a neurologist and an ears, nose, and throat specialist (otolaryngologist) on a monthly basis for 6 months during treatment. Surprisingly, 68% really had migraine headaches, 27% really had tension-type headaches, and 5% really had chronic sinusitis with recurrent acute episodes. Treatment during the 6 months included antibiotic therapy in 73% of the patients with tension-type headache and 66% with migraine. Sinus endoscopy (taking a look up the sinuses with a scope – ouch!) was performed in 26% of the patients, and therapeutic nasal septoplasty (surgery!) was performed in 16% of the migraine patients and 13% of patients with tension-type headache (a pretty BIG mistake, wouldn’t you say?). The conclusion was that many patients with self-described or primary care physician diagnosed “sinus headaches” have no sinonasal abnormalities but instead, met the criteria for migraine or tension-type headache.

So, what does this mean? Well, for one thing, too many antibiotics are prescribed for tension-type or migraine headaches and have no place in the treatment process of these two common headache categories. Side effects of antibiotics include (but are not limited to): stomach and intestinal irritation, nausea, and if one is allergic to the antibiotic, a potentially life-threatening condition called anaphylactic shock. Let’s not forget to mention that sinus surgery was performed in 29% of the cases where the sinuses were NOT causing the headaches and we all know the risks of undergoing anesthesia and surgery can include death and infections, among other problems.

Several publications have described chiropractic as a wise choice for the treatment of headaches. For example, see the large review of the literature on the “Effectiveness of manual therapies: the UK evidence report,” released in 2010 (http://chiromt.com/content/18/1/3). In this report, researchers found strong support for the use of manipulation (chiropractic adjustments) for the treatment of both migraine and cervicogenic-type (headaches that start in the neck) headaches. In this day and age, you can be very confident that choosing chiropractic services for headache treatment is a wise, safe, and very cost-effective approach for a very disabling condition.