A deviated septum occurs when the wall between your nasal passages is displaced, leading to one nasal passage being smaller than the other. This common condition often raises questions about its potential impact on daily life, including whether it can cause headaches. While many people with a deviated septum experience no symptoms, for others, it can contribute to various health issues, including discomfort in the head.
Understanding a Deviated Septum
The nasal septum is the thin wall of cartilage and bone that divides the inside of the nose into two separate chambers, or nostrils. Ideally, this septum lies centrally, creating symmetrical nasal passages. However, in a deviated septum, this wall is off-center, leaning to one side. This displacement can be present from birth, or it can result from an injury to the nose later in life. Approximately 80% of the population has some degree of nasal septum deviation, though most deviations are slight and do not cause problems.
The Link Between Deviated Septum and Headaches
While not all deviated septums lead to headaches, certain situations can create a connection. One mechanism involves “contact point headaches,” where the deviated septum or a bony spur on it presses directly against sensitive tissues within the nasal passage, such as the nasal turbinates. This constant pressure can irritate sensory nerves, particularly branches of the trigeminal nerve, sending pain signals that are perceived as a headache. Studies indicate that correcting these contact points can significantly improve such headaches.
Another way a deviated septum can contribute to head pain is by obstructing normal sinus drainage. A severe deviation can block the natural pathways for mucus to exit the sinuses, leading to a buildup of fluid and creating an environment where bacteria can thrive. This can result in recurrent or chronic sinus infections, known as sinusitis, which commonly cause pressure and pain in the face and head, often referred to as sinus headaches. These headaches typically present as a dull ache behind the eyes, in the cheekbones, forehead, or at the bridge of the nose, often worsening with head movement.
Altered airflow patterns due to a deviated septum might also contribute to discomfort. Disrupted airflow can lead to nasal dryness or irritation of the nasal lining, potentially triggering or exacerbating headaches. Any structural abnormality affecting nasal function can create an environment conducive to various types of head pain, including contact point headaches and, in some cases, migraine, particularly if related to sinus issues or sleep disturbances.
Associated Nasal Symptoms and Conditions
Beyond headaches, a deviated septum can cause other nasal symptoms. Difficulty breathing through one or both nostrils, often feeling like chronic nasal congestion, is common. This obstruction can worsen during colds or allergies.
Some individuals may experience frequent nosebleeds, as altered airflow can dry out the nasal lining. Snoring and noisy breathing during sleep are also common due to restricted airflow. In severe cases, a deviated septum can contribute to obstructive sleep apnea. Additionally, some people report facial pain or pressure and a persistent postnasal drip.
Diagnosis and Management
Diagnosing a deviated septum typically begins with a physical examination by an ear, nose, and throat (ENT) specialist. The doctor examines the septum and nasal passages using a nasal speculum. A lighted scope (nasal endoscope) may be used for a more detailed view. Imaging, such as a CT scan, may also be performed to evaluate the deviation and identify any associated sinus issues. It is important to rule out other potential causes for headaches before attributing them solely to a deviated septum.
Management depends on symptom severity. For mild symptoms, non-surgical approaches can provide relief, including nasal sprays (decongestants or corticosteroids) to reduce swelling and improve airflow, or pain relievers for discomfort. However, these medications only manage symptoms and do not correct the underlying structural deviation.
When symptoms are persistent, significantly impact breathing, or are linked to contact point headaches or recurrent sinus infections, surgical correction may be considered. The primary surgical procedure, septoplasty, involves reshaping or removing portions of the septum to straighten it. This procedure is typically performed through the nostrils, with no external incisions. The goal of septoplasty is to improve nasal breathing, alleviate related symptoms, and potentially resolve headaches if the deviated septum was the underlying cause, particularly for contact point or sinus-related headaches. While septoplasty can significantly improve these specific headache types, it is not typically a cure for migraines unrelated to nasal issues.