A bad sinus headache: what to know

Inflammation or blocked drainage around the nose can create pressure over the forehead, cheeks or behind the eyes, often with congestion, reduced smell or thick nasal discharge. Allergic rhinitis and a cold may trigger nasal swelling; sinusitis can bring facial pain and tenderness. Migraine may cause throbbing pain, nausea, light sensitivity or sound sensitivity and can include nasal symptoms, so a blocked nose does not prove that the sinuses are responsible. Dehydration, heat exhaustion, anxiety and some viral illnesses can also cause headache.

Rest in a quiet place, drink fluids regularly, and use saline nasal spray or rinsing according to instructions. Avoid smoke and note whether bending forward, heat, missed meals, light or menstrual timing affects the pain. A pharmacist can check whether a suitable pain reliever or nasal treatment fits your health conditions and current medicines. Do not take antibiotics left from an earlier illness.

Get emergency help for a sudden severe headache, new weakness, trouble speaking, seizure, confusion, fainting, stiff neck, or a high fever with a rapidly worsening illness. Seek prompt review for swelling around an eye, vision change, severe facial pain, repeated vomiting, or headache after a head injury. Dengue or heat illness may need consideration after relevant exposure or travel.

Do my symptoms fit sinus inflammation, migraine or another cause? Do I need an examination or testing? Which nasal rinse or pain treatment is suitable for me? What warning signs should prompt urgent care?