Overview
Diagnosis
Determining the cause of headaches can be challenging. Your healthcare provider will ask detailed questions about your headache patterns and perform a physical exam.
Imaging tests may be used to help identify the underlying cause:
-
CT scan: Combines X-ray images from multiple angles to create cross-sectional images of the brain and head, including the sinuses.
-
Magnetic resonance imaging (MRI): Uses a magnetic field and radio waves to produce detailed cross-sectional images of brain structures.
Treatment
Many people who think they have sinus headaches may actually have migraines or tension-type headaches. Treatment focuses on relieving symptoms and preventing future episodes.
Pain relievers
-
Over-the-counter medications such as acetaminophen, ibuprofen, or naproxen sodium may help reduce headache pain.
Triptans
-
Medications like sumatriptan, rizatriptan, almotriptan, naratriptan, zolmitriptan, frovatriptan, and eletriptan relieve migraine pain by blocking pain pathways in the brain.
-
Triptans can be taken as tablets, nasal sprays, or injections and should be avoided in people with heart disease or stroke.
-
A combination of sumatriptan and naproxen sodium has been shown to be more effective than either medication alone.
Ergots
-
Ergotamine with caffeine (Migergot) or dihydroergotamine (D.H.E. 45, Migranal) may be used if pain lasts longer than 72 hours.
-
These medications constrict blood vessels and can worsen nausea or cause medication-overuse headaches; they should be avoided in people with heart disease or stroke.
Newer therapies
-
Lasmiditan (Reyvow): Oral tablet for migraine with or without aura; blocks pain pathways without constricting blood vessels.
-
CGRP antagonists: Ubrogepant (Ubrelvy) and rimegepant (Nurtec ODT) for acute migraine treatment.
-
CGRP monoclonal antibodies: Erenumab, fremanezumab, galcanezumab, and eptinezumab are given monthly or quarterly by injection to prevent migraines.
Anti-nausea medications
-
Chlorpromazine, metoclopramide, or prochlorperazine may be used to control nausea often associated with migraines.
Glucocorticoids
-
Dexamethasone may be used alongside other medications for pain relief but should not be used frequently due to the risk of steroid toxicity.
Advertisement
