Top 5 Causes of Sinus Pain
What is sinus pain?
Sinuses are pockets of air behind your nose, cheekbones, eyes, and forehead. They are lined with cells that produce mucus, which traps foreign substances like allergens, irritants, and viruses. Normally, these invaders are carried out of the body through the nose or swallowed.
Sometimes viruses are able to bypass this protective barrier, causing the lining of the sinuses to become inflamed and sometimes infected. The inflammation causes swelling that blocks mucus from draining (congestion). It creates sinus pain and pressure or a sinus headache.
Treatments for sinus pain include home remedies like nasal rinses, warm compresses, and over-the-counter medications. For more serious problems, you may need antibiotics, allergy medications, or surgery.
1. Acute viral sinusitis
The sinuses are lined with millions of tiny hair-like cells called cilia, which actively move mucus through the sinuses. There are small openings where that mucus eventually drains through. If the cilia aren’t able to move mucus effectively, or if the drainage pathways get inflamed and close off, that can lead to sinusitis. —Dr. Amrita Khokhar
- Facial pain and pressure, usually over the cheeks or forehead
- Nasal congestion
- Nasal discharge that can be thick and colored
- Post nasal drip
Acute viral sinusitis occurs when the sinuses are infected with a virus, like the common cold. Symptoms can be severe when the sinuses are involved. Viruses attack the lining of the sinuses, creating inflammation and damage that leads to congestion and pain.
Viral sinusitis usually goes away on its own in about a week. Treatments can include saline sprays or rinses to remove mucus from the nasal passages, or using a nasal decongestant medication to help the mucus drain. Antibiotics will not help viral sinusitis.
2. Acute bacterial sinusitis
- Facial pain, often more severe than in viral sinusitis
- Thick, green, or yellow nasal discharge
- Nasal congestion
Acute bacterial sinusitis is an infection of both your nasal cavity and sinuses. It is usually a complication of viral sinusitis. When sinusitis symptoms last longer than 10 days, or if the symptoms are getting worse, it may be a bacterial infection.
The main treatment for bacterial sinusitis is taking antibiotics.
3. Chronic sinusitis
- Chronic facial pressure or pain
- Nasal congestion
- Loss of smell or taste
Chronic sinusitis is a form of sinusitis where symptoms occur for longer than 12 weeks. It can be caused by a long-standing infection, nasal polyps (non-cancerous growths in the nose), or swelling of the lining of your sinuses.
Nasal polyps can lead to significant congestion, loss of smell and taste, and nasal discharge. If polyps are the cause, treatment may be surgery to clear out the sinus passages.
If allergies are the reason, treatment would be allergy medications. Sometimes, there isn’t a known cause. In these cases, surgery to clear out the sinuses and nasal steroids can help.
4. Temporomandibular joint (TMJ) dysfunction disorder
- Pain in the jaw
- Pain may occur in other areas of the face
- Restricted movement
- Clicking sounds in jaw
Temporomandibular joint dysfunction (TMJ) is often caused by a variety of factors, including daily habits, your teeth alignment, and even stress. People with TMJ typically experience pain on one side of the face that is worse when chewing, yawning, or other movements of the jaw. In some cases, TMJ pain can be confused with sinus pain, but it does not involve the sinuses.
With some simple changes in daily habits and other at-home treatments, most people with TMJ find relief within weeks.
5. Tooth infection
- Severe, persistent tooth pain that can radiate to the jawbone, neck, or ear
- Swelling in face or cheek
- Swollen and painful lymph nodes under the jaw or in the neck
A tooth infection is caused by bacteria invading the inside of a tooth, usually because of cavities or a crack in the tooth. An infection can cause sinus pain if it is in the upper molars. It can also cause an abscess, which is a pocket of pus.
Tooth abscesses need prompt treatment by a dentist to drain the pus and clean the affected area. A root canal, which removes the infected area of the tooth, may be needed. But in some cases, the entire tooth may have to be taken out.
When to call the doctor
In some instances where the diagnosis isn’t completely obvious, you might be referred to an ear, nose, and throat specialist to have a nasal endoscopy, which is where a thin, flexible camera is placed in your nasal passages to get a better look. If the diagnosis still remains unclear, you may need a CT scan to look inside of the sinuses. —Dr. Khokhar
Sinus pain is often a sign of an infection. Most often, sinus infections are due to a virus. These will eventually resolve on their own. However, you should contact a doctor if you begin to experience the following:
- Sinus symptoms last for longer than 7 to 10 days and are not improving or are worsening.
- Severe sinus pain.
- Nasal discharge turns thick, foul-smelling, or colored when it was previously clear.
- Loss of smell.
Should I go to the ER for sinus pain?
You should go to the emergency room for evaluation if you are experiencing the following:
- Vision changes
- Pain or restricted movement in your neck
Sinus pain treatments
It’s important to know the steps that might be taken to diagnose the underlying cause of your sinus pain. First, your doctor will take a history, focusing on qualities like where the pain is located, how severe it is, and if you’re experiencing fevers or nasal drainage. Next, he or she will inspect your nasal passages and press on your face to identify the location of the pain. —Dr. Khokhar
- Moisturize the sinuses. Breathing in warm, moist air (such as steam from a shower) can loosen secretions and help them drain.
- Use nasal saline rinses to help clear mucus from your nasal passages.
- Place a warm, moist towel or heating pad on the cheek area.
- Keep your head elevated during sleep. This reduces congestion and allows the nose to drain.
- Use over-the-counter pain relievers to reduce the pain.
- Use over-the-counter decongestant sprays or pills for a few days to reduce congestion and help mucus drain.
Other treatment options
- Antibiotics may be necessary for bacterial infections.
- If you have structural problems with your nasal passages, like polyps, your doctor may refer you to a specialist to discuss surgery.
- If allergies are contributing to your sinusitis, you may be prescribed allergy medications to take on a daily basis to help reduce inflammation.
How to do a nasal rinse
Nasal saline rinses are a good way to treat discomfort and congestion. They can help flush out mucus, debris, and irritants, and soothe nasal passages.
A neti pot can be used to do this. You fill a pot with a saline rinse that you can buy. (If you want to make your own saline rinse, here is a recipe from the American Academy of Allergy Asthma & Immunology.)
- Place the spout of the pot against one nostril.
- Tilt your head to the side.
- The saline will pour out of the lower nostril—thanks to gravity.
- Repeat steps with the other nostril.
Dr. Khokhar is a board-certified Allergist and Immunologist. She received her undergraduate degree in Biology from Stony Brook University in 2008 and graduated from the Renaissance School of Medicine at Stony Brook University in 2012. She completed a residency in Internal Medicine at Northwell Health in 2015, followed by a fellowship in Allergy and Immunology at the University of California, Irvine in 2017. She then spent two years as an attending physician in Allergy and Immunology at Tufts Medical Center in Boston, MA before moving back to her home state of New York. She recognizes the overwhelming obstacles in medical literacy and education that patients face while navigating healthcare, now the focus of her career. She joined Buoy as a medical writer in 2020.