Many people experience head pain or pressure and wonder about its cause. A common question is whether sinus pressure can manifest in the back of the head. While sinus issues usually cause facial discomfort, the intricate nerve network and specific sinus locations mean pain can be felt in unexpected areas, including the back of the head. This article explores the anatomical reasons for this and helps distinguish sinus-related pain from other headaches.
Understanding Sinus Anatomy and Referred Pain
The paranasal sinuses are four paired air-filled cavities within the skull and facial bones, surrounding the nasal cavity. These include the frontal sinuses (above the eyes), maxillary sinuses (under the eyes), ethmoid sinuses (between the eyes), and sphenoid sinuses (deep within the skull, behind the eyes). Sinuses produce mucus that drains into the nasal cavity, filtering inhaled air and protecting against infection.
Pain from the sinuses can extend beyond their immediate location due to referred pain. This occurs because the same nerves supply both the sinuses and other parts of the head. All four pairs of paranasal sinuses are innervated by branches of the trigeminal nerve.
The sphenoid sinuses, deep within the skull’s base, are particularly relevant to pain in the back of the head. Inflammation or pressure in these sinuses can irritate the trigeminal nerve. Their close proximity to vital structures contributes to the varied presentation of pain, which can be perceived in areas distant from the sinuses, including the top, sides, and back of the head.
Common Causes and Accompanying Symptoms of Sinus Pressure
Sinus pressure typically arises from inflammation or obstruction within the sinus cavities, leading to mucus buildup. Acute sinusitis, often caused by viral infections like the common cold, usually lasts less than four weeks. Chronic sinusitis persists for 12 weeks or longer, even with treatment, and can stem from various factors.
Allergies, such as allergic rhinitis (hay fever), are another common cause of sinus pressure. When allergens like pollen or dust are inhaled, this leads to inflammation of nasal and sinus membranes. Nasal polyps, growths in the nasal passages or sinuses, can also block drainage and contribute to pressure. Structural abnormalities, like a deviated septum where the wall separating the nasal passages is off-center, can impair normal sinus drainage and increase the risk of recurrent sinus infections and pressure.
Accompanying symptoms of sinus pressure often include:
Facial pain or tenderness around the eyes, cheeks, nose, and forehead, which may worsen when bending over.
Nasal congestion, a runny nose with thick, discolored mucus, and post-nasal drip.
Reduced sense of smell or taste.
Cough.
Fatigue.
Fever, particularly with infections.
Distinguishing Sinus Pressure from Other Headaches
While sinus pressure can cause pain in the back of the head, it is important to distinguish it from other headache types common in that area. Many self-diagnosed “sinus headaches” are actually migraines or tension headaches. True sinus headaches are generally accompanied by specific nasal and facial symptoms.
Tension headaches often manifest as a dull, aching pain, sometimes described as a band around the head, affecting both sides and potentially radiating to the neck. They lack nasal congestion, discharge, or facial pressure. Migraines are characterized by a throbbing or pulsating pain, often on one side of the head, and can be accompanied by sensitivity to light and sound, nausea, or vomiting. While migraines can cause nasal symptoms like congestion or a runny nose, the discharge is usually thin and clear, unlike the thick, discolored mucus of sinus infections.
Cervicogenic headaches originate from the neck, with pain starting in the neck and spreading to the head, often to the back, temples, or around the eyes. These headaches are associated with neck stiffness or limited range of motion and may be triggered by specific neck movements or sustained awkward positions. Unlike sinus headaches, cervicogenic headaches do not present with characteristic nasal or facial symptoms.
Relief Strategies and When to Seek Medical Attention
For managing sinus pressure at home, several strategies can help alleviate discomfort. Staying well-hydrated helps thin mucus, making it easier to drain. Steam inhalation, such as from a hot shower or a bowl of hot water, can moisturize nasal passages and help open them, reducing congestion. Applying warm, wet compresses to the face can also soothe inflammation and relieve pressure.
Saline nasal sprays or washes can effectively flush out irritants and allergens from the nasal passages, promoting drainage. Over-the-counter medications like decongestants can reduce swelling, while pain relievers such as ibuprofen or acetaminophen can help manage headache and facial pain. Use decongestant nasal sprays for only a few days to avoid rebound congestion.
Medical attention should be sought if symptoms persist or worsen, especially if they last longer than 7 to 10 days without improvement. A high fever, severe pain, or pain unresponsive to over-the-counter medications warrant a doctor’s visit. Immediate medical consultation is necessary for more serious symptoms like swelling or redness around the eyes, vision changes including double vision, a stiff neck, or confusion, as these could indicate a spread of infection or other serious complications.