| The concept of sinus headaches runs so deep in the | | | | moderate to severe intensity |
| public mind that many people with pain in the fronts | | | | the pain is aggravated by exertion |
| of their heads (and even some people with pain in | | | | Attacks also have at least one of the two following |
| the backs of their heads) automatically assume that | | | | features: |
| it is caused by their sinuses. Moreover, their diagnosis | | | | the pain is worsened by light and noise |
| seems confirmed when any of the following occurs: | | | | there is nausea or vomitingIf that system seems |
| | | | too complicated, then here are a couple of screening |
| The headache is caused by a change in weather. | | | | questions you can substitute. Do you suffer from |
| The headache includes nasal congestion or sinus | | | | recurrent, disabling headaches? When you have your |
| pressure. | | | | usual headache, would you like to lie down? A "yes" |
| A "sinus" medication helps resolve the headache. | | | | answer to either question makes migraine likely (and |
| Yet most headache experts feel that sinus | | | | sinus headaches unlikely).Researchers at the |
| headaches are way over-diagnosed as a cause of | | | | Headache Care Center of Springfield, Missouri, |
| recurring head pain. In fact, the author attended a | | | | screened 2991 clinic patients for individuals who |
| conference of headache experts at which one | | | | believed they had sinus headaches and who had |
| seasoned physician stood up and said, "Everything I | | | | never previously been diagnosed as having migraine. |
| know about sinus headaches I learned from | | | | The researchers excluded people with signs of |
| television!" So what gives?The speaker's point was | | | | infection. Using the system of diagnosis we already |
| that we have all been brain-washed by years of | | | | discussed, 80% had definite migraine and another 8% |
| pharmaceutical advertising to associate pain in the | | | | had probable migraine.So what about those three |
| front of the head with sinus disease. Do you | | | | items that seemed to confirm that a headache was |
| remember all those little triangles pasted around | | | | due to sinuses? It turns out that a change of |
| someone's nose, eyes and forehead in | | | | weather can trigger a migraine, probably via a drop |
| advertisements for Dristan(R) sinus pills? These | | | | or rise in barometric pressure. It also turns out that |
| pictures appeared for years not just in the media, | | | | nasal congestion or pressure in the sinuses can be |
| but on buses and subways, as well. The company's | | | | the effect of a migraine attack rather than its cause. |
| marketing department did their job well.Certainly, an | | | | Finally, it is always chancy to diagnose a condition |
| acutely infected sinus can cause substantial pain. But | | | | based on what treatment works for it, because a |
| in the far more typical circumstance of mere | | | | single treatment might help more than one condition. |
| congestion of the nasal passageways and sinuses, | | | | In the case of sinus pills there are usually multiple |
| usually there is either no pain or just mild discomfort. | | | | ingredients, one of which is a painkiller. For example, in |
| So if that's the case, what accounts for more | | | | the various Dristan(R) formulations, aspirin, |
| significant pains in the front of the head? The most | | | | acetaminophen or ibuprofen is present. Sometimes |
| frequent causes are migraine and tension-type | | | | caffeine is also included in the pills which can resolve |
| headaches. And when the pain is bad enough to | | | | migraine headaches, too.The confusion between sinus |
| interfere with or even prevent usual activities, | | | | and migraine headaches has an ironic component. |
| migraine is the most common culprit.An internationally | | | | While the drug companies used to work hard to |
| agreed-upon system for diagnosing the most | | | | convince people they had sinus headaches, now that |
| common form of migraine includes the following: | | | | some decent migraine medicines are available, the |
| | | | drug companies that sell them are just as intent on |
| Untreated or unsuccessfully treated attacks last for | | | | persuading people they have migraines.I guess it |
| 4-72 hours each. | | | | should go without saying that you shouldn't let the |
| Attacks have at least two of the four following | | | | marketing department of a drug company diagnose |
| features: | | | | your headaches.(C) 2005 by Gary CordingleyGary |
| present on just one side of the head | | | | Cordingley, MD, PhD, is a clinical neurologist, teacher |
| pulsating quality | | | | and researcher who works in Athens, Ohio. |