What Is a Sinus Headache?

A sinus headache is pain that comes from a sinus infection. The sinuses are hollow spaces created by the bones in your face, which can fill with mucus when you are congested. When mucus gets trapped inside the sinuses, the resulting pain can feel like a headache. 

Here, we explain what a sinus headache feels like, how to know if a headache is from a sinus infection, and how to treat it.

What does a sinus headache feel like?

You can usually tell if you have a sinus headache based on your symptoms. Sinus headaches feel like a pressure-like pain in the forehead and the areas below the eyes. 

They often happen at the same time as other symptoms of a sinus infection, including:

• Nasal drainage and congestion

• Fever or chills

• Change in smell

• Tooth or ear pain (the pressure in your sinuses is sometimes felt in these areas, even though this isn’t where the infection is actually located) 

Symptoms of a sinus infection by location

The symptoms of your sinus headache will depend on which sinus areas are infected. You have four main sinuses in your head:

• The frontal sinuses are located above each of your eye sockets.

• The ethmoid sinuses are just below the frontal sinuses, around the bridge of the nose.

• Further toward the back of your head are the sphenoid sinuses. These are behind the ethmoid sinuses, and they’re the deepest sinuses in your head.

• The maxillary sinuses are located on the lowest portion of your face, beneath your eye sockets.

With this in mind, a sinus headache may cause pain:

• In your forehead (frontal sinuses)

• Between or above your eyes (frontal sinuses)

• At the top of your nose (ethmoid sinuses)

• Behind your eyes (sphenoid sinuses)

• Around your temples (sphenoid sinuses)

• Deep in your head, or at the back of the head (sphenoid sinuses)

• Below your eyes, or on either side of your nose (maxillary sinuses)

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• Is it a cold or a sinus infection? The symptoms can feel similar. But there are a few key differences that help you know which one you have — and how to treat it.

• Do you need an antibiotic? Most of the time, sinus infections are caused by viruses — but not always. Here’s what to know about antibiotics for a sinus infection.

• When is a headache an emergency? An ER healthcare professional explains the red flag symptoms that should warrant medical care right away.

But it’s important to note that the location of your pain doesn’t always match with the sinus that is infected. For example, you may experience pain above your eyes when your sphenoid sinus is infected. 

Treating sinus headaches

Most sinus infections are caused by viruses, not bacteria. That means an antibiotic won’t help. The best way to treat a sinus headache is to help get rid of the mucus in the sinuses. This includes:

• Placing a warm compress, like a towel soaked in warm water, over the painful area

• Using saline nasal sprays, which keep the inner part of the nose moist 

• Breathing humidified air, which can also help keep the nasal passages moistened

• Taking decongestants, like pseudoephedrine or fluticasone (Flonase), that help treat nasal secretions and congestion

• Taking over-the-counter (OTC) pain medications like acetaminophen (Tylenol) or ibuprofen (Motrin)

Even though most sinus infections are caused by viruses, there are some cases that are caused by bacteria. It can be challenging to figure out if a sinus infection is from bacteria. The following symptoms suggest the infection could be caused by a bacteria:

• Symptoms that last over 10 days without improvement

• Symptoms that initially improve, then get worse again

• Fevers that last more than 3 days

• Severe pain or pressure

These symptoms don’t always mean there’s a bacterial infection. But they’re a sign you should see a healthcare professional to see if you need an antibiotic. If you do need an antibiotic, the most common one is amoxicillin. But there are a few different options, depending on your medical history and allergies.

Preventing sinus headaches

To prevent sinus headaches, you can take steps to decrease the chance you’ll develop a sinus infection. Here are some things you can do:

• Treat seasonal allergies with antihistamines or nasal sprays.

• Treat nasal polyps. These can cause blockages that can lead to sinus infections. Polyps can be treated with corticosteroid nasal sprays like Flonase. Sometimes, they need to be surgically removed if they aren’t getting better with nasal sprays.

• Cut back or quit smoking. Avoiding cigarette smoke can help prevent sinus infections.

When to seek medical attention

Sinus headaches are painful, but they are usually not dangerous. But different types of headaches can be hard to tell apart based on symptoms alone. So, if you have any of the following symptoms, it could be a sign that something more serious is going on. Seek emergency medical care for the following symptoms:

• A headache that comes on suddenly and gets worse very quickly (a few minutes or less)

• Changes in vision

• Numbness, tingling, or weakness in your body

• A headache after head trauma

• Uncontrollable vomiting

• A fever and stiff neck (symptoms of meningitis)

• Disorientation, confusion, or lethargy

• A headache that feels like the worst of your life, especially if it’s a new headache in someone who’s older than 65

And even if you don’t have any of the emergency symptoms above, it’s still a good idea to see your primary care provider for any of the symptoms of a bacterial infection — as discussed above.

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Written by:

Cherilyn Davis, MD

Cherilyn Davis, MD, is a board-certified pediatrician in NYC. She's held local and national roles at the American Medical Women's Association, including board member of the physician division and physician chair of social media.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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