Dear Dr Garner,

I moved last year from my own house in Bay Ridge, into an apartment building. It is so hot and dry in the apartment, that I find myself getting headaches each day. I think they are sinus headaches. Could you please tell me the treatment, if any? I feel like moving out of the apartment.

 - Big-time Sinus headaches in Bay Ridge

Dear Big-Time,

Sinus headaches can be very tricky to diagnose. The same nerves that cause pain from sinus headaches also cause pain related to tension headaches, tooth aches, and migraines. While pain in the sinus area does not automatically mean that you have a sinus disorder, this is the time of year, when the sinuses are most likely to become inflamed.

This usually occurs after a cold, or even from environment conditions such as the dry heat you mentioned. The lining of the sinuses become very thick, and the passage of sinus fluid is blocked, and pressure builds up causing the pain from the pressure. The discomfort often occurs around the eyes, in the forehead, and the upper teeth (disguised as a toothache). The key point to take away from this is  that an examination  for sinus problems should be considered when treatment for a migraine or other headache is unsuccessful.

Sinus headaches tend to worsen as you bend forward or lie down. The main way to improve the symptoms is to reduce sinus-lining swelling and improve the drainage of the sinus fluid. There are several at home steps that help prevent sinus headaches or alleviate its pain.

They include: 

1. Breathe moist air – Relief from a sinus headache can be achieved by humidifying the dry air environment. This can be done using a steam vaporizer or cool-mist humidifier, steam from a basin of hot water, or steam from a hot shower. 

2.  Alternate hot and cold compresses – Place a hot compress across your sinuses for three minutes and then a cold compress for 30 seconds. Repeat this procedure three times per treatment, two to six times a day. (The sinuses are located behind the cheeks, eyes, and forehead.)

3. Nasal irrigation- This helps to remove debris and dust particles and other pollutants reducing the inflammation of the lining of the sinuses. It helps shrink the sinus membranes, and thus increases drainage. There are several over-the-counter nasal rinse products available. You can discuss which is best for you with your pharmacist or doctor.

4. Over the counter medications – Some are highly effective in reducing sinus headache pain. The main ingredient in most relievers is Aspirin, Tylenol or Motrin.

5. Decongestants – The pressure decreases with decongestants. In some cases, nasal steroid spray may be recommended.

6. Alternative medicine – Herbal medicine such as magnolia flower, in conjunction with other herbs, such as mint and chrysanthemum, may help. There is not an abundance of scientific evidence proving its value, but it is something to consider, with little risks from its use.  

If all the above treatments are not effective, a visit to an ear, nose and throat specialist may be necessary. He or she might suggest a CT scan of the sinuses to see how much blockage there is. In the vast majority of cases, there is no indication for antibiotics, as the infection is usually related to a virus, for which antibiotics are not effective. Your ear, nose and throat doctor may perform a procedure known as endoscopic or image guided surgery, where he or she can look at the sinuses directly, and clean out areas to improve flow.

I would not consider moving out of the apartment just yet. Most cases of sinus headaches can be successfully treated. It is a very common condition with more than 37 million other Americans suffering from at least one case of sinus infection and headache per year. The rise in the number of cases may be due to an increase in air pollution. The key thing for you to remember is that while your headache may be due to sinuses that it is a good idea to visit your doctor to see if there might be another cause.

The signs of sinus headache, include facial pain, pressure, nasal obstructions and discharge, diminished sense of smell; and cough. In addition, their may be fever, bad breath, fatigue, and tooth pain. A sinus infection may last four weeks or more. Usually there is a presence of thick, green or yellow nasal discharge. In some cases the condition may become chronic, with symptoms lasting for 12 weeks or more. One should never smoke. If one cannot stop permanently, at least stop during the sinus problem. There is no special diet to follow, but drinking extra fluids helps to thin the mucus.  

What are the consequences of not treating an infected sinus?  There may be unnecessary pain and discomfort. In rare circumstances, meningitis or brain abscess and infection of the bone or bone marrow can occur.  I thank you for your question, and hope you schedule a visit to your doctor to figure out the best plan of attack. In the meantime, hang in there with your apartment and I hope this story will have a happy ending.

Until next time, have a great week and be well.

* Reprinted with permission of The Tablet