Sinus Headache Remedies from an ENT Doctor


By Stephen Chandler, MD |10 August 2021|


If you’ve ever had a “sinus headache” then you know how uncomfortable they can be: throbbing pain in your head and around your nose, as well as nasal congestion and ear fullness. These sorts of headache symptoms are very common, but they’re often NOT caused by blockage of sinus drainage pathways or sinus infections. The first order of business is to determine IF your sinuses are a likely contribution to your symptoms, or is the headache source something completely unrelated. The ENT case history and subsequent examination are designed to help sort these things out. A detailed endonasal examination (microscopic evaluation of the internal nasal contents) and high resolution sinus Computed Tomogram (series of X-rays) go a long way to establishing a true Sinus Headache. This process may also lead to alternative causes such as migraine or migraine variant headache, muscle tension, cervical neuropathic, or cluster headache. Further imaging may be required (like an MRI) to rule out a central nervous system headache source. An accurate diagnosis is essential in order to create an appropriate and effective treatment and management plan. If it turns out that your sinuses are indeed the culprit, I’ve laid out some of the best treatment options for your symptoms below. 

Over the counter Systemic Medication:

The first line of defense against a sinus headache is often oral medication, this is a good option though there are some negatives. Decongestants can temporarily reduce inflammation and congestion; however, taking too much of a topical decongestant can make symptoms worse and systemic decongestants are notorious for causing increase in blood pressure, heart rate and insomnia. So, when using these medications it’s best to do so only as indicated, certainly no longer, without seeking the care of a physician. Antihistamines, on the other hand, are chiefly designed to treat allergy symptoms. An acute allergy attack can definitely be the cause for nasal tissue congestion. If you choose to try a course of antihistamine therapy, do consider the important common side effects. These often include excessive mouth and eye dryness, blurred vision and excessive drowsiness. Finally, painkillers like Ibuprofen can help reduce discomfort and fever, but similar to antihistamines, they may not treat the underlying symptom cause. Whatever medication you choose, be sure to follow the instructed dosing on the label; some medications can not safely be taken together. 

Nasal Sprays  

Another common option to help reduce nasal lining inflammation is to use a steroid nasal spray. Nasal corticosteroid sprays can be purchased over-the-counter or prescribed. They are designed to stabilize the lining of the nose and make it less likely to be reactive when stimulated. There are also topical nasal antihistamine sprays that serve to decrease mucus production by the nasal lining. While nasal steroids are often considered stronger than antihistamines, they can take hours or even days to reach their full effectiveness. There is a subset of patients with ‘mucosal contact headache’ caused by a septal deviation or spur impacting delicate, swollen nasal mucosal tissue. If your headache responds to nasal decongestant treatment there’s a good chance that you have such nasal anatomy.  The use of Afrin spray and others like it have a very high potential for addictive use, so be careful and only use this class of spray for a maximum of 3 consecutive days, unless directed otherwise by your physician.

Nasal Rinse 

My favorite option of the bunch is to begin nasal therapy with an effective, gentle sinus rinse. For any nasal spray product to be effective it must make contact with the nasal mucosal lining. If there is debris in the nose it acts as a barrier to effective nasal spray use. Nasal rinsing is a proven way to improve the effectiveness of nasal spray use and facilitates the treatment of sinonasal disease. By extension, it can help reduce secondary sinus headache symptoms. Products like the Complete Rinse are designed to safely flush out nasal debris and help re-moisten the nasal lining. Unlike other rinse systems, Complete Rinse naturally activates your Nasal Lock and helps prevent the choking and gagging common to use with other rinse systems. Complete Rinse is effective, safe, environmentally friendly, holistic, and reliable. 

Last (maybe best) Resort 

If you’ve tried some, or all of these methods, and are still suffering from discomfort after multiple medical treatment attempts then, by all means, please get in to see an ENT doctor like myself. Otolaryngologists are specifically trained to evaluate headache in the context of possible sinus disease. We have specialized equipment and expertise that really does help take the mystery out of “Sinus Headache” evaluation, diagnosis and treatment.
Dr. Stephen Chandler is a practicing Otolaryngologist in Montgomery, Alabama and Clinical Director of Sandler Scientific, LLC, manufacturer of CompleteRinse®. To schedule a visit with Dr. Chandler call 334-834-7221 Learn more at https://www.jacksonclinicent.org/. Complete Rinse is available on Amazon and at www.completerinse.com.