A sinus headache feels like deep, constant pressure behind your forehead, cheeks, or the bridge of your nose. Unlike the throbbing pulse of a migraine, the sensation is more like something pushing outward from inside your face. The pain typically gets worse when you bend forward or lie down, and it often comes with a stuffy nose and thick, discolored mucus.
Where the Pain Shows Up
The location of your pain depends on which sinuses are inflamed. You have four pairs of sinuses in your skull, and each one produces a distinct pain pattern. The frontal sinuses sit above your eyes, so inflammation there creates a band of pressure across your forehead. The maxillary sinuses, the largest pair, sit inside your cheekbones on either side of your nose. When these flare up, you feel an aching heaviness in your mid-face that can radiate into your upper teeth. The ethmoid sinuses are tucked between your eyes and behind the bridge of your nose, producing pain that feels like it’s deep inside your head.
Most people describe the sensation as pressure rather than sharp pain. It’s a fullness, like your face is swollen from the inside. Pressing on the skin over an inflamed sinus often makes the pain spike, which is one way doctors confirm the diagnosis during an exam.
Movements That Make It Worse
One of the most reliable hallmarks of a sinus headache is that bending forward intensifies the pain noticeably. Tying your shoes, picking something up off the floor, or looking down at your phone can send a wave of pressure through your face. Lying flat often makes things worse too, which is why many people with sinus headaches sleep propped up on pillows. Sudden head movements, like turning quickly to check a blind spot while driving, can also trigger a sharp flare.
This positional worsening happens because fluid and pressure shift inside the inflamed sinus cavities when you change the angle of your head. It’s a useful clue when you’re trying to figure out what kind of headache you’re dealing with.
Symptoms That Come Along With It
A true sinus headache rarely shows up alone. Because it’s caused by inflammation or infection of the sinuses, it almost always arrives with nasal symptoms. The most common ones include:
- Thick, discolored mucus. Yellow or greenish discharge from your nose, or dripping down the back of your throat (postnasal drip), is a strong indicator of sinusitis.
- Nasal congestion. Breathing through your nose becomes difficult or impossible on one or both sides.
- Reduced sense of smell. Swollen sinus tissues block the receptors that detect odors.
- Upper tooth pain. The roots of your upper back teeth sit very close to the floor of the maxillary sinuses, sometimes even extending into the sinus cavity. When those sinuses are inflamed, the pressure can make your teeth ache as if you have a dental problem.
You may also have a low-grade fever, fatigue, and a general feeling of being unwell. The facial pain often feels worse in the morning because mucus has pooled in your sinuses overnight.
How It Differs From a Migraine
This distinction matters more than most people realize. Research pooling data from multiple studies found that roughly 55 to 65 percent of people who believe they have sinus headaches actually have migraines. The confusion happens because migraines can cause nasal congestion and even a runny nose, mimicking sinus symptoms.
A simple three-question screening tool developed at Albert Einstein College of Medicine can help sort this out. Ask yourself: Does the headache limit your daily activities? Do you feel nauseous during the headache? Do you become sensitive to light? If you answer yes to two of those three questions, there’s a 93 percent chance you’re experiencing a migraine, not a sinus headache. Yes to all three pushes that to 98 percent. People with genuine sinus headaches are far less likely to have nausea or light sensitivity.
Migraines also tend to throb or pulse, often on one side of the head, while sinus headaches produce steady, bilateral pressure centered on the face. If your headaches keep coming back without clear signs of infection (no fever, no discolored mucus, no congestion), a migraine diagnosis is worth exploring with your doctor.
How Long Sinus Headaches Last
The duration tracks with the underlying sinus problem. Acute sinusitis, often triggered by a cold, typically runs its course in two to four weeks. Your headache will generally persist as long as the sinuses remain inflamed, though it may fluctuate in intensity throughout the day. Chronic sinusitis, defined as symptoms lasting 12 weeks or longer, can produce a low-level version of the same facial pressure that lingers for months. The pain in chronic cases tends to be milder but more persistent, a dull ache rather than the intense pressure of an acute infection.
If your sinus headache follows a cold and resolves within a few weeks, that’s a typical pattern. Pain that keeps returning in the same locations, especially without other sinus symptoms, is worth investigating further since it may point to migraines or another headache type entirely.