Question: My 25-year-old son in law has had severe pressure and pain in his eyes and head. He is finishing med school as has been to various doctors trying to alleviate his problem and they have ruled out Vacuum Sinusitis as well as other obstructions. He does have a polyp, but according to the doctors, nothing that would cause this pain. He is devastated with the pain for over 2 months. What do you suggest?
Answer: Headaches can be due to many different causes. While sinus problems can frequently cause headaches, unless caused by an acute (new severe) infection, sinus headaches tend to be dull and persistent. They are usually located over the area of the sinuses involved, except for headaches from the sphenoid sinus, which tends to cause a headache at the top or back of the head. There is some thought that contact points- that is when the septum touches the side wall of the nose, can cause severe headaches- but not all agree with this philosophy.
We would be happy to see your son in law at the NY Sinus Center, to help find a cause and treatment of his headaches. Imaging by CT scan should be done if he has not had this already and he should have a thorough neurologic examination as well. We work closely with headache specialists and others who can help, should the pain not be from his sinuses.
Robert L. Pincus MD
NY Sinus Center
Frequently Asked Questions
Headaches related to sinus issues often stem from inflammation or infection within the sinuses. These headaches are usually dull and persistent, located over the affected sinus area. However, acute infections may cause more severe pain, and certain sinuses like the sphenoid can cause headaches at the top or back of the head.
While nasal polyps can contribute to sinus problems, they do not always cause severe headaches or eye pain. Doctors may find polyps during examination, but unless they significantly obstruct sinus drainage or cause infection, they might not be responsible for severe pain symptoms.
For persistent severe headaches with eye pain, a CT scan is recommended to evaluate the sinuses thoroughly. Additionally, a thorough neurologic examination is important to rule out other potential causes. Collaboration with headache specialists can also be helpful if sinus issues are not the source of pain.
If sinus problems are ruled out, treatment should focus on other possible causes such as neurological or headache disorders. Working closely with headache specialists or neurologists can help identify and manage conditions like migraines or cluster headaches that might be causing the pain.
Some believe that contact points, where the nasal septum touches the sidewall of the nose, can cause severe headaches. However, this idea is controversial and not universally accepted among medical professionals. More research may be needed to clarify this relationship.
Sinus-related headaches can be dull and persistent, lasting for weeks or even months if not properly addressed. However, acute sinus infections usually present with more severe and sudden symptoms. Chronic inflammation may cause ongoing discomfort that requires medical evaluation and treatment.
A neurologic examination helps assess the nervous system to rule out neurological disorders that could be causing the headaches. This is important because some headache causes are unrelated to sinus issues and require different treatments or interventions.
