A sinus headache can range from mild to excruciating to the point at which you can feel debilitated. A sinus headache can also spark a migraine headache. This occurs when there is pressure on the blood vessels in the sinus cavities. Many patients have sinus headaches at times and migraine headaches at other times. Or sinus headaches can turn into migraine headaches.
It is possible to tell the difference between a sinus headache and a migraine headache. Sinus headaches often occur with other sinus signs and symptoms of sinus disease; these symptoms are absent during a migraine headache, unless the migraine is sparked by the sinus headache. A migraine is usually unilateral (on one side of the head) although it may involve both sides (bilateral). A migraine headache also tends to build over time and has four unique phases.
The first phase is known as the “prodrome,” which usually occurs a day before the migraine. You may either feel depressed or experience a sense of unusual well-being during this time. A migraine attack is often triggered by a period of intense activity associated with anxiety, tension, or rage. The actual migraine headache can occur at any time of the day or night but occurs frequently on waking.
The second phase is the aura. Although the aura differs for each sufferer, most people tend to repeat their aura pattern with each successive headache. Some report seeing black and white lines, like those seen by heat waves. Sometimes they experience black and white flashing lights or zigzag colored patterns with dark centers moving across their field of vision. There can be numbness of the face, arms, or feet. Others experience a loss of vision or ptosis (droopy eyelid), which can occur before the migraine. You may complain of vertigo (dizziness). As the aura disappears, you often experience a unilateral headache, which appears on the side of the head opposite to where you might have previously felt
the visual aura or numbness. The transition from aura to headache may be accompanied by light sleep or a momentary loss of consciousness. The aura usually lasts for 10-40 minutes.
The actual headache pain usually starts above one eye and spreads over the entire side of the head to the back; in some cases, the pain starts in the back and moves forward. The pain spreads and intensifies to a severe throbbing, aching headache and may be worse when lying down. Shaking the head, coughing, or straining/lifting can make the headache worse. Photophobia, or extreme light sensitivity, can occur with or without nausea, vomiting, or a chill. The duration of the headache is usually between 1 and 3 hours. The recovery is the last phase of the migraine. When the attack ends, you can experience a feeling of well-being.
There are other types of headaches that people suffer from that are not clearly linked to CAID or CAID symptoms. However, I would not be surprised to find that these headaches are indeed related. What’s more, it is possible to suffer from more than one form of headache at a time. We know that sinus headaches may occur simultaneously with any of these other forms. Some of these types of headaches are the following:
■ Vascular headaches encompass all headache conditions, including migraines and cluster headaches, in which blood vessels swell and cause a throbbing type of pain. Vascular headaches often increase during physical exertion.
■ Cluster headaches are a type of vascular headache that occur in groups over a period of time. For example, you might suffer from
4 to 10 headaches in a day. Sufferers of cluster headaches are generally affected in the spring or autumn. This type of headache is often described as a burning or piercing sensation. It may be throbbing or constant, and the scalp may be tender. These headaches are not known to be associated with CAID or allergies as of yet, but I think there may be some connection. Treatment is largely preventative: Those who suffer are often prescribed corticosteroids or antiepileptic drugs.
■ Temporomandibular joint (TMJ) pain was once thought to be caused by an arthritic change in the bottom jaw, but this type of
headache is now classified as myofascial pain dysfunction (MPD) syndrome and is thought to be caused primarily by muscular stress in the lower jaw brought on by the daily stressors of life. MPD is characterized by a dull, aching pain in and around the ear, with pain radiating to the side of the scalp, back of the head, or down the neck, and tender areas in the jaw muscles. You may also have a stabbing pain when you bite or touch the TMJ, and this can radiate to your ear. This headache is not directly caused by CAID. However, we know that there is a strong association between CAID and stress as well as dental disease. Both stress and dental disease are known causes of TMJ. Many of my patients suffer from both TMJ and sinus headaches. Treatment with drugs that prevent chronic tension-type headache is often effective, particularly tricyclic antidepressants. Your dentist may be able to make you a dental appliance and/or work on correcting your bite, which can alleviate TMJ pain, grinding, or a dental occlusion problem.
■ Tension headaches are the most common form of headache and are thought to be related to muscle tightening in the back of the neck and/or scalp. They are usually described as a dull, aching, and nonpulsating pain that can affect either or both sides of the head and occur in the forehead, temples, or back of the head and/or neck. Typical symptoms for this type of headache include a tightening band-like feeling that encircles the neck and/or head that is accompanied by a gripping, “vice-like” ache. If you experience this type of headache infrequently, OTC analgesics or antiinflammatories are good remedy choices. Meditation and exercises may be helpful. However, if you have tension headaches with any regularity, your doctor can prescribe an anti-depressant, which can help alleviate this pain whether or not you have been diagnosed with depression.