There are many causes of headaches – entire medical books have been written on the subject. In my practice, I see many people who are seeking help to figure out what is making their head throb so badly. Naturally, their biggest concerns are things like brain tumors and strokes. Once they have those things checked out, get negative results and find out they are not dying, the question still remains: why does their head ache so much?
Near the top of the list of reasons is a potential sinus problem. Every day, I see patients who are experiencing facial pressure and headaches. After asking the usual questions about their sypmptoms (Do you have allergies? Have you had nasal trauma? Can you breathe through your nose? Do you blow out green mucous when you have your headaches? How’s your sense of smell?), I have to surmise that the headache is likely sinus-related.
After looking up their nose to check for a crooked septum, polyps or green mucous, I have to decide whether the symptoms are sinus-related. The patient in the exam chair is convinced that they do, indeed, have a sinus problem. So to definitively determine whether or not it’s the cause of the headache, we eventually end up scheduling a CT (Computerized Tomography) scan of their head.
What’s most amazing to me is that half of those scans end up coming back negative! Even when the patient and I both are pretty convinced that the problem is a sinus infection, we are very often surprised when the scan is normal. We look for evidence of blockage, polyps, infection and so many, times there are none.
In this era of high health insurance co-pays and deductibles, how does one tell if their headache is likely to be sinus-related? Well, the best we can do is examine the symptoms of patients who test positive for a sinus problem and develop a list of symptoms that seem to correlate with that condition.
Here they are:
- Pressure and pain in the cheek areas is a decent indication of maxillary sinus problems.
- Blowing green/yellow mucous for more than a week is another, especially if the mucous has a foul odor.
- Upper canine and molar tooth pain is a good clue, as well.
- Blockage of airflow on one side more than the other is a symptom of a septal deviation (crookedness). While this causes airflow issues most of the time, the curvature can block proper sinus drainage and cause infection.
- Dramatically reduced sense of smell is a pretty good indicator that there are polyps blocking the smell nerve, which is located very high up in the nose. Polyps will also block the sinus drainage area and cause mucous to back up into the sinuses. Just as stagnant water will eventually grow something, stagnant mucous will grow something too: bacteria, and lots of it.So, there you have some clues to tell whether a headache is likely sinus-related. Odds are that if you have headaches but none of the symptoms described above, a CT scan of your head might look perfectly normal. It’s probably a good idea to look for possible causes in another chapter from that “Big Book of Headaches.”
