A deviated septum, a common anatomical variation, can contribute to headaches for some individuals, though not everyone with the condition experiences them. This structural irregularity can lead to head pain through specific mechanisms. This article explores the link between a deviated septum and headaches, its recognition, diagnosis, and management.
Understanding a Deviated Septum
The nasal septum is a thin wall of cartilage and bone that divides the nose into two chambers. It normally runs down the center, creating two passages for airflow. A deviated septum occurs when this wall is off-center or crooked, making one nasal passage smaller than the other.
This condition is common, with estimates suggesting up to 80% of the population has some degree of septal deviation, though many experience no symptoms. A deviated septum can be present from birth due to developmental factors or birth trauma. It can also result from an injury or trauma to the nose, such as contact sports, car accidents, or falls.
The Connection Between Deviated Septum and Headaches
A deviated septum can lead to headaches through several interconnected pathways. One primary mechanism involves nasal obstruction, where the crooked septum significantly blocks airflow. This reduced airflow can lead to pressure changes within the nasal cavity and sinuses, manifesting as pain or pressure in the head and face. The discomfort often feels like a dull, constant ache in areas such as the forehead, cheekbones, or the bridge of the nose, and it can worsen with sudden head movements or straining.
Another significant factor is the formation of mucosal contact points. In severe deviation, the septum can press directly against other sensitive structures within the nasal cavity, such as the turbinates. This constant contact can irritate the mucosal lining and trigger sensory nerves, particularly branches of the trigeminal nerve. The irritation of these nerves can lead to referred pain, where the pain is felt in the head rather than directly in the nose. Some experts refer to these as “contact point headaches.”
A deviated septum can also interfere with proper sinus drainage. When nasal passages are narrowed, mucus can become trapped, creating an environment conducive to sinus infections or chronic sinusitis. Inflammation and pressure buildup within the sinuses are well-known causes of headaches and facial pain. These headaches are often described as pressure-like and can be accompanied by other sinus symptoms like congestion, discolored mucus, or a feeling of fullness in the ears. The chronic discomfort and breathing difficulties can also contribute to muscle tension in the head and neck, potentially triggering tension-type headaches or exacerbating migraines.
Recognizing and Diagnosing a Deviated Septum
Recognizing a deviated septum often begins with persistent nasal symptoms. While headaches can be a symptom, other common indicators include difficulty breathing through one or both nostrils, which may worsen during colds or allergy seasons. Individuals might also experience frequent nosebleeds, facial pain or pressure, noisy breathing during sleep, or recurrent sinus infections. Some people may notice a change in the external shape of their nose.
If symptoms are chronic or significantly affect quality of life, seeking medical attention is advisable. A doctor, typically an Ear, Nose, and Throat (ENT) specialist, will conduct a physical examination of the nose. This usually involves using a nasal speculum and a bright light to visualize the inside of the nostrils. In some cases, a long, thin scope (nasoscope or endoscope) may be used to examine deeper parts of the nasal cavity. The doctor will also ask about the nature and duration of symptoms, past nasal injuries, and any medications.
Managing and Treating a Deviated Septum
Managing symptoms can involve non-surgical and surgical approaches. For mild symptoms, non-surgical options focus on alleviating discomfort. These may include nasal decongestants to reduce swelling and improve airflow, antihistamines if allergies contribute to congestion, and saline nasal sprays or irrigation to clear nasal passages and moisturize the lining. Humidifiers can also help by keeping nasal passages moist. While these methods provide temporary relief, they do not fix the underlying anatomical issue.
For individuals experiencing significant symptoms, such as persistent headaches, chronic breathing difficulties, or recurrent sinus infections due to a deviated septum, surgical correction, often called septoplasty, is the primary treatment. During septoplasty, a surgeon straightens the nasal septum and repositions it in the center of the nose. This may involve trimming, reshaping, or removing parts of the cartilage and bone. The goal of septoplasty is to improve nasal airflow and alleviate symptoms caused by the deviation. Many patients report significant improvement in headaches, breathing, and overall quality of life after successful septoplasty.