Friday, 28 March 2014

Headaches Related with Sinus Infection

The sinus headaches are a particular type of headaches, felt as a dull, throbbing pain. The headache is caused by sinusitis, which is an inflammation of your sinuses (itis in latin means inflammation, so whenever you come across something that ends with an its, that’s what it refers to). The inflammation can have different causes such as: infection, an allergic reaction (are you allergic to something?) or autoimmune issues (autoimmune disease, immuno suppressant medication, etc).

The next question (in case you didn’t already know) is, what are the sinuses? The sinuses are air spaces in the skull (frontal, ethmoidal, maxillary and sphenoid). In case of an infection, the membranes get swollen to such an extent, that the pressure can cause pain (forehead, nose, cheekbones).

Making the right diagnosis & differences between sinus headache and migraines

Like mentioned before, acute sinusitis (viral or bacterial) should not last longer than eight weeks. If it lasts more than that, then you’re dealing with a chronic sinusitis and you should visit your local doctor.

Acute sinusitis diagnosis can be made based on the symptoms mentioned above and confirmed by a CT scan. One of the roles of the sinuses is to drain the mucus, so when sinusitis occurs, the ducts that connect the sinuses to the nose get obstructed. Draining the mucus can come to a halt (or be significantly slowed down), which is why a nasal discharge is to be expected with sinusitis.

As mucus can’t be drained properly, it becomes the perfect place to host bacteria, fungi or viruses to grow. This will lead to other complications, the most common one being infection.

Not all reported sinus headaches are actually produced by sinusitis. It is reported that about 90% of the cases are just migraines. We’ll talk about the differences later, after we’ll walk you through the symptoms.

There are different types of sinusitis: acute, subacute or chronic. Acute sinusitis should be gone in less than 4 weeks, subacute 4-8 weeks, and chronic more than 8 weeks. Distinguishing between them can be a daunting task. However, it seems almost everybody gets at least one time acute sinusitis at one point in their life or another.

What are the symptoms

The first symptom is a dull, constant, possibly throbbing facial pain. The pain can be localized in the maxillary (cheek area), somewhere above the eyes (means the frontal sinus cavity is involved), behind the eyes (the ethmoid sinus has swollen). The pain typically gets worst when you bend over or lie down. It will also start on one side, but after a while, it “travels” to the other as well.

Another symptom is a green nasal discharge. It may contain blood or pus. Don’t worry if it does, it’s normal.

Because of the pressure build up, your inner ear may be affected. The inner ear is responsible for equilibrium, so you may feel dizziness.

Sinusitis can be bacterial or viral (caused by a bacteria or a virus). It can be pretty hard to tell which, but it is said that if it lasts more than 10 days it’s bacterial. One common complication of this condition, is infection.

I mentioned infection, because that leads to the next possible symptoms: fever, chills, muscles pain or swollen lymph nodes (aka swollen glands).

Also, a swollen face due to the inflammation of the sinuses is one of the usual, visible symptoms that might lead you to think it’s more than a migraine.

As the pain is caused by the pressure build up, if you move you make sudden movements or there’s a quick temperature change, the pain will intensify (that happens because these external factors influence pressure, which increases and therefore you feel more pain).

If the maxillary sinuses are involved, you may experience toothache.

As you’ve heard me saying before, sinus headaches and migraines can be pretty hard to differentiate, which is why 90% of the time, the self diagnosis of sinusitis is actually a migraine, and in some cases only a CT scan can be the definitive answer.

The main problem is that migraines can activate trigeminal nerves, which innervate the sinuses, which makes the pain you feel pretty hard to pinpoint accurately. As a side effect, a runny nose can be triggered, which makes it look more like sinusitis. One way you can know for sure it’s sinusitis it’s the thick green nasal discharge. This does not happen when you have a migraine. Migraines usually go away in hours and are localized to one area only. Another way you can guesstimate a sinusitis is the fact that the pain is worst when you bend over (difference of pressure, which triggers more pain).

The chronic sinusitis however, as opposed to the common acute sinusitis, is a much more severe condition that can lead to other serious complications. The diagnosis is based on the symptoms (note: I forgot to mention that the symptoms of chronic and acute sinusitis are the same, so the only viable option to distinguish between the two is duration), CT scan that will confirm an inflammation of the sinuses and analyzing a sample of the discharge (with chronic sinusitis, an infection is almost guaranteed to show up and tests are necessary to determine which type of infection you’re dealing with).

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