Ear, Nose and ThroatManaging ENT Pain Part II: Nose Pain and Headaches

Managing ENT Pain Part II: Nose Pain and Headaches

Headaches are not just uncomfortable. They’re expensive. In this second installment of our series on headache disorders, we’ll examine nose pain and headaches and the steps you can take for pain relief. Let’s begin with some of the most common causes of nasal discomfort.

Who is experiencing nose pain and headaches?

Nose pain and headaches 101 

Researchers have estimated that headaches annually cost $31 billion per year in lost productivity, increased sick days, and related healthcare costs. And that number only continues to rise. Part of the problem is that most people don’t quite understand that headaches have numerous causes.

Let’s look at 3 different types of headaches:

1) Sinus headaches

Sinus congestion, infections and related problems are one of the leading causes of headaches. The main culprit is the trigeminal nerve. The trigeminal nerve transmits signals from your sinuses along with other parts of your face to the brain. This nerve spreads throughout and causes intense head and facial pain. 

Doctors call this referred pain, and whether it is coming from your ears, nose, or throat—this often can be the reason why you might be experiencing headaches.  When the lining of your sinuses swells, this pain and pressure will cause a sinus headache.

nose pain and headaches woman with sinus headacheYou may feel pain in other places including:

  • along the bridge of your nose
  • in your cheeks
  • in the middle of your forehead

Inflamed sinuses are often unpredictable. In some cases, they may cause visible swelling or affect only one instead of both sides of the face.

Sinus infections or sinusitis affects 30 million Americans each year. They occur when mucus builds and the sinuses become inflamed, preventing proper drainage of bacteria, viruses, and allergens that may cause these uncomfortable symptoms. Generally, sinusitis will go away without medical attention.


However, seek the advice of your health care team if it:

  • lasts for longer than 12 weeks 
  • or causes pain associated with additional symptoms like fatigue, fever, and toothaches.

2) Hay fever (rhinitis)

Hay fever or rhinitis can be attributed to both allergic and non-allergic causes. We’ve all experienced symptoms of it including sneezing, itchy nose and the paradoxical simultaneous stuffy and runny nose. These symptoms create ENT related headaches as well as other forms of discomfort.

Allergy headaches occur when your immune system identifies something harmless like pollen or pet hair and triggers a reaction. In some cases, you may experience seasonal rhinitis, most often during spring or fall months when pollen counts are high.

Non-allergic rhinitis actually affects nearly one-third of adults each year. In this case, it’s not your immune system, but something else that’s triggering a reaction. Scientists haven’t reached clear conclusions on the causes of this, but have found high correlations between many environmental factors.

nose pain and headaches hay fever

For example, people living in areas with high pollution levels have been found more likely to suffer from non-allergic rhinitis. Other environmental factors include traveling between high and low-level humidity (i.e. in and out of air-conditioned environments) frequently, along with changes in temperature.

3) Migraine headaches 

One of the trickiest questions about head pain is whether something is a headache or migraine. If you experience recurring, intense headaches, consult with your doctor to see if you are suffering from migraines. Many people mistakenly confuse the symptoms of sinus infection and allergies with those of migraines. Migraines occur less often than tension-type headaches, but they are more severe. They are also 2 to 3 times more common in women than in men. 

In fact, a recent study showed that over 86% of people who were initially diagnosed as suffering from a sinus headache were reclassified as patients likely suffering from migraines. As a result, many people with migraine symptoms go untreated for years. The main problem is that many of the symptoms overlap, including increased nasal discharge, cluster headaches, and nasal congestion.

If you have suffered recurring nose pain and headaches for over 12 weeks, ask your doctor what your migraine treatment options are.  

Headache treatment options

In many cases, the old combination of rest, OTC anti-inflammatory medications and plenty of fluids is enough to help ease the symptoms of nose pain and headaches. However, if you are experiencing severe sinus pain and headache, schedule a doctor’s appointment right away. This is doubly important if the pain continues to increase or the painkillers do not help.  

If your sinus headache is a result of sinusitis, your doctor will likely prescribe antibiotics and decongestants. For headaches caused by allergies, there are many OTC antihistamine specific medications available like cetirizine (Zyrtec), loratadine (Claritin) and fexofenadine (Allegra) that are now available and affordable in generic form.

These antihistamines have minimal side effects and work effectively to reduce discomfort. Combined with a prescription nasal spray, which may also contain antihistamines or steroids, you’ll be able to find quick and effective pain relief. 

For recurring sinus headaches lasting over three months, it’s essential to see a doctor.

nose pain and headaches health care for headaches

In many cases, you may be referred to an ear, nose and throat specialist. These headache center specialists will ask about your medical history, symptoms and examine your sinus tracts along with your throat and other areas. They may even do an MRI scan or X-ray so they can check for internal issues.

In rare cases of chronic non-allergic rhinitis, some people may need specific surgery to widen sinuses to improve air and mucus flow. In this case, the surgeon will either remove tiny amounts of tissue from your sinus cavities or use an extremely small balloon-like device, which is used inside the sinus cavities to widen them. These surgeries are generally quick procedures with minimal recovery time for the patient.

Home remedies

If you are suffering from sinusitis, there are several effective home remedies you can use to treat your symptoms. Please note that these are not long-term solutions and are best used in combination with other treatment methods like anti-inflammatory medication and rest.

Let’s look at 3 of these remedies: 

1) Steam

Breathing in steam is a great way to open your sinuses and nasal passages. This will help to reduce nose pain and headaches. You can do this easily by:

  • bringing some water to a boil
  • allowing it to cool for 1-2 minutes
  • pouring it into a heatproof bowl or large container
  • covering your head with a towel and leaning your face slightly over the container
  • breathing slowly and deeply in and out through your nose

2) Neti pot/saline solution

Neti pots have been used in traditional medicine for thousands of years and can be very effective in relieving pain. They are an excellent way to clean your nasal passage, particularly if they are blocked by allergens, dust or other pathogens. You can buy specially designed neti pots, but you can also easily make your own with things you have lying around the house.

To use one:

  • Begin by dissolving one teaspoon of salt and one teaspoon of baking soda in a pot of boiled water.
  • Wait until it cools to somewhere around 105 degrees. If you don’t have a thermometer, the temperature should be somewhere between lukewarm and a cup of tea.
  • Wash your hands with soap and warm water. Now pour a small amount of the mixture in your palm.
  • Then sniff the water into your left nostril. Follow this by sniffing into your right nostril.
  • Repeat until your nose feels relieved.

Want to see a neti pot in action? Check out this video: 

You can also use a small plastic bag to create a funnel to more directly pour the solution into your nose just as you would with a neti pot.

3) Warm washcloths

If you are really in a pinch and don’t have any medication or alternative options handy, a warm washcloth can help reduce inflammation and pain. All you need to do is place a washcloth in warm water. Wring it out and hold it over your forehead and nose for 5 minutes. Repeat this multiple times per day.

The bottom line on nose pain and headaches 

Nose pain and headaches are very closely related. It’s essential to understand the cause of your nose pain, as that will help to effectively treat the headache. If an infection is blocking your nasal passages, then you may need antibiotics and decongestants. If allergies are the source of your nose pain, then look to antihistamines and nasal sprays for symptom relief.

Finally, remember that long-term recurring sinus pain headaches are extremely rare. This is often the result instead of migraines. If you find yourself suffering from sinus headaches lasting more than 12 weeks, then ask your doctor to test you for migraines. Regardless of the cause of your nose pain and headaches, you can take advantage of these home remedies to find temporary relief until you find a long-term solution.

Read part I of this series on ENT pain here

How do you manage nose pain and headaches? 

Tell us about your pain journey in the comments.
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