Sinus Headache? Ask Your Doc These Questions
Your ENT (ear, nose and throat doctor) tells you that you suffer from sinus headaches. It's a relief to finally have a name for that chronic pounding in your head, but now what? According to Ralph Metson, M.D., a sinus specialist at the Massachusetts Eye and Ear Infirmary in Boston, it's important to ask the right questions so your doctor can tailor your treatment specifically to you. Here are the 10 questions to ask your doctor when the diagnosis is sinus headaches.
1. How do you know they're sinus headaches and not some other type of headache? You'll feel pain from a classic sinus headache above or below the eyes in the cheek or forehead region. In contrast, you'll feel the pain of a tension headache along the sides of the head. With a migraine, you may experience some of the same symptoms as with a sinus headache but accompanied by nausea and light sensitivity. It also usually lasts a few days, whereas a sinus headache may gradually get worse over a one- to two-week period.
2. Does this have anything to do with allergies? It's a possibility. Your doctor will review associated symptoms such as itchy eyes, a runny nose and incessant sneezing, and if allergies are part of the problem, he may treat the allergies along with the headaches or refer you to an allergist.
3. I have a lot of post-nasal drip. Could this have anything to do with my headaches? If you suffer from sinusitis -- an inflammation of the sinus cavities in your nasal passages caused by a viral, bacterial or fungal infection -- you may experience congestion and post-nasal drip characterized by thick, discolored mucus -- which, in turn, may contribute to sinus headaches.
4. What is the best home remedy? Your doctor may recommend saltwater irrigation, a method of cleaning the nasal passages by flushing out your nose with warm saltwater. To do this, you can use a centuries-old method called the Neti Pot, a small plastic or ceramic teapot, or one of the newer squeeze-bottle systems such as NeilMed. Research shows that both offer some relief by washing away the mucus, bacteria and allergy partials that contribute to sinus headaches.
5. Will any over-the-counter medications help? Perhaps. Decongestant pills, like Pseudofed, open up blocked or swollen nasal passages so they can drain more effectively. Long-term use of these medications is safe; however, Metson says to steer clear of topical and nasal sprays, which can cause a rebound effect and a worsening of symptoms if used for more than three consecutive days.
6. How about any of the so-called alternative or complementary methods of relief? There is compelling evidence that acupuncture treats sinus headaches and migraines successfully. Precisely how it does is still unclear, but it is one of the few alternative treatments approved by the U.S. Food and Drug Administration and may be covered by your insurance. Have your doctor recommend an acupuncturist who specializes in headache treatment.
7. What about herbal regimens? Though many patients swear by them, there is little conclusive evidence that natural remedies such as echinacea, golden seal, ginger or bromide offer any relief from sinus symptoms. Be sure to let your doctor know if you are taking any herbal supplements. They can interfere with other treatments or medications.
8. What about prescription drugs? If your doctor thinks you have a sinus infection, he will prescribe an antibiotic. If you have serious allergies, he may prescribe a nasal steroid spray. which, unlike nasal spray decongestants, is safe to use and has no rebound effect.
9. What about surgery? An anatomic obstruction may block sinuses, making it difficult to breath and putting you at risk for chronic headaches. In these cases, outpatient surgery may be warranted to remove swollen or diseased tissue so that the openings can drain properly. More than 80 percent of patients report significant improvements.
10. What if nothing works? If your ENT has exhausted all possible treatments, discuss getting a CAT scan to see if there are any underlying causes he may have missed. A CAT scan is more useful than an MRI because it shows your doctor the bony outline and interior of the sinuses, so it is easier to determine if there is any inflammation or obstruction that has gone unnoticed with other testing. You should also ask about a referral to another type of specialist, such as an allergist, in order to have your problem viewed from a different angle.
More on Sinuses:
What Is Sinusitis?
Sinus Headaches
