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Sinus Headache Evaluation in Gangnam, Seoul

Medically reviewed by Dr. Kim Yoo Suk, MD · Board-certified otolaryngologist · Former professor, Yonsei & Ajou University · Consultations in English

What is a sinus headache?

A sinus headache, or rhinogenic headache, is pain arising from inflammation or pressure in the paranasal sinuses. The frontal sinuses sit behind the forehead, the maxillary sinuses behind the cheeks, and the ethmoid and sphenoid sinuses between and behind the eyes. When these become inflamed and cannot drain, pressure and pain can develop in the corresponding area.

Is it really your sinuses?

Research consistently shows that most people who believe they have recurring sinus headaches meet the criteria for migraine, sometimes with nasal symptoms such as congestion or watery discharge triggered by the migraine itself. Tension-type headache is another common mimic. True sinus headache almost always occurs together with clear signs of sinus disease.

Symptoms suggesting sinus-related pain

• Pressure or pain over the cheeks, forehead or between the eyes
• Pain worse on bending forward or lying down
• Nasal blockage with thick, discolored discharge
• Reduced sense of smell
• Upper tooth pain on the same side
• Fever with acute infection

Symptoms suggesting migraine instead

• Throbbing pain, often one-sided, lasting hours to days
• Nausea, sensitivity to light or sound
• Clear rather than thick nasal discharge
• Triggers such as stress, sleep loss, hormones or certain foods
• Normal nasal examination between episodes

Causes

Genuine sinus headache is caused by acute sinusitis, flare-ups of chronic sinusitis, or blockage from polyps or anatomical narrowing. Pressure changes during flights or diving can cause pain in an inflamed sinus. In some patients, contact between the septum and the side wall of the nose is studied as a possible pain trigger, though this remains debated.

How it is diagnosed at our Gangnam clinic

Dr. Kim takes a careful headache history, including timing, triggers and associated symptoms. Nasal endoscopy checks for pus, swelling or polyps at the sinus openings. If symptoms or examination suggest sinus disease, a sinus CT scan confirms whether the sinuses are actually inflamed. A normal nose and CT during a headache episode strongly points away from the sinuses, and in that case referral to a neurologist may be the right next step.

Treatment options

When sinusitis is confirmed

• Saline irrigation and intranasal corticosteroids
• Pain relief with acetaminophen or anti-inflammatory medication
• Antibiotics if bacterial infection is likely
• Treatment of allergy and other contributing factors
• Endoscopic sinus surgery when chronic sinusitis does not respond to medication

When it is not the sinuses

Migraine and tension-type headache respond to different treatments. Recognizing this avoids repeated, unnecessary antibiotic courses and surgery that is unlikely to relieve the pain.

When to see a doctor

See an ENT if facial pain comes with nasal symptoms lasting more than 10 days or recurs several times a year. Seek emergency care for sudden severe headache, headache with fever and stiff neck, swelling around the eye, double vision, confusion or weakness.

Seeing Dr. Kim in English

Dr. Kim Yoo Suk is a former Yonsei and Ajou professor in rhinology who co-authored research on how symptoms relate to chronic rhinosinusitis diagnosis. He will tell you honestly, in English, whether your headache looks sinus-related. See hours and directions for visiting.

Frequently asked questions

How can I tell a sinus headache from a migraine?

Sinus headaches come with nasal blockage, thick discharge and reduced smell, usually during or after a cold. Migraines often bring throbbing pain, nausea and light sensitivity, and may cause a clear runny nose. An ENT examination shows whether the sinuses are truly inflamed.

Will sinus surgery cure my headaches?

Only if the headaches are caused by confirmed sinus disease. When CT and endoscopy show no sinusitis, surgery is unlikely to help and is not recommended. Dr. Kim recommends surgery only when objective findings support it.

Why does my face hurt when I fly?

Pressure changes during takeoff and landing affect the air inside the sinuses. If the sinus openings are swollen from a cold or allergy, pressure cannot equalize, causing pain. Treating congestion before flying can help; recurrent pain deserves an ENT check.

This page is general medical information written and reviewed by an ENT specialist. It is not a diagnosis. Symptoms differ between people — please see a doctor for an examination. In an emergency in Korea, call 119.