Ask Dr. John

Headaches & Sinus Pain

Gary writes: "What are the best and fastest ways to relieve sinus pain and dryness?"

This time of year sinus problems are very common. With our changing temperatures, one day sunny and warm, the next day a near blizzard, your sinuses have a hard time keeping up. The pain from your sinuses can be in your forehead or face. It might also go into your ears or even your upper teeth. The best way to relieve the dryness is by using a cool mist humidifier in your house, especially while sleeping. Also, simple over-the-counter saline nasal sprays can keep the area moist. Neti pots look like small tea pots, but are used as a type of sinus rinse. Using them with a warm water saline solution is usually safe. One recent study found that if the Neti pot is used only sparingly it can help clear the sinuses and avoid a sinus infection. Otherwise, over-the-counter decongestants can help reduce any mucus buildup in your sinuses. For very temporary relief, nasal sprays like Afrin or Neosynephrine can be used, but they must be used correctly. You'll want to limit them to just three days. Using them longer than this can result in what's known as a "rebound" effect, meaning the mucus membrane lining the nose and sinuses gets used to the Afrin or Neosynephrine and you'll have a hard time stopping their use.

Kathy from Trinidad: "I have had headaches for the past two years and they have gotten worse in the last six months. I had a MRI and a CT, which came back normal. My father had a tumor on his brain caused by cancer and it took a year for doctors to find it. I am concerned this is something similar. I just had an EEG and am waiting for the results. If the EEG does not show anything, what is my next course of action?"

Thankfully the MRI and CT scan didn't find any evidence of a tumor. So now, there are other types of headaches to look into. One type is migraines, which can cause severe headaches. These are usually accompanied by what's known as photophobia, or sensitivity to light. They can also cause nausea and vomiting and like your symptoms, get worse with time. Another type is tension headaches. People with these types of headaches describe a tight band of pain around their head. We used to think these came about because of tension in the muscles of the head and particularly the neck, but we aren't so sure that's the cause anymore. More experts think it has to do with changes in brain chemicals. A third type of headaches is cluster headaches. These headaches can also be severe and tend to come in groups, or clusters, thus the name. Triggers for all of these types of headaches vary, but most seem to come about because of stress and can be worsened by alcohol or certain medications. Your next course of action, if you haven't already done so, is probably to see a Neurologist, a doctor specializing in these types of headaches. There are a variety of medications and lifestyle changes that can help, but not everyone responds the same way, so you'll need to work with a doctor that can follow you to see how well you respond to various treatments. Over the last few years doctors have been using Botox injections with mixed results, but that might be one type of treatment to consider.

Ronn from Colorado Springs: "I have been having some severe sinus pain and pressure that goes to the back of my head and into my neck, making me feel nauseous and dizzy. I already had sinus surgery and tubes in my ears. What course of action should I take?"

Depending on how long ago your sinus surgery was, you might benefit from revisiting your ENT doctor to find out if your sinuses have redeveloped polyps or if scar tissue has formed, requiring another surgery. The other thing to consider, especially if your sinus infections happen at the same time every year, is to get tested for allergies. Allergies, whether to dogs, cats, trees or grass, can precipitate a sinus infection. If skin testing shows you have allergies, treatment, whether with medication or allergy immunotherapy shots, might help get your sinus infections back under control.

Crystal from Fountain: "What does it mean when you always have headaches or migraines and pain and numbness in your arms and legs, as well as swelling and occasional nose bleeds?

There are a variety of different types of headaches anyone can have. These include anything from the headaches we all get from time-to-time, usually due to stress, dehydration or some minor illness. But they can also include migraines, tension headaches and cluster headaches. These types of headaches occur more frequently and although we aren't sure what exactly causes them, there are different medications or treatments that can help get them under control. In your case, the worrisome thing is the numbness and swelling in your arms and legs along with occasional nosebleeds. None of these symptoms are commonly associated with the types of headaches I described above. Anytime you have headaches along with neurological findings like numbness or tingling, you should be seen by a health care provider.

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