Pain at the bridge of your nose most often comes from sinus inflammation, particularly in the ethmoid sinuses, which sit directly behind the nasal bridge. But sinusitis is far from the only explanation. Eyeglasses, migraines, injuries, and even nerve irritation can all produce that same focused ache between your eyes.
Ethmoid Sinus Inflammation
The ethmoid sinuses are a honeycomb of small air pockets nestled between your eye sockets, right behind the bridge of your nose. When they become inflamed or infected, the hallmark symptom is pain or pressure at the nasal bridge. You may also notice congestion, a reduced sense of smell, postnasal drip, or a low-grade fever.
What surprises many people is how often sinus problems get blamed for facial pain when they aren’t actually the cause. Among patients referred to ear, nose, and throat specialists with a suspected sinus diagnosis, only a small fraction turn out to have pain truly attributable to sinus disease. If you don’t have congestion, discolored nasal discharge, or fever alongside the bridge pain, sinusitis is less likely than you might think.
Migraines and Tension Headaches
Migraine is actually the most common diagnosis found in patients whose facial pain was initially chalked up to sinusitis. While migraines typically involve throbbing pain on one side of the head, in some cases the pain localizes to the cheek and nose or the area around the orbit. These “sinus migraines” can fool you with accompanying congestion and watery eyes, but they respond to migraine treatment rather than antibiotics or decongestants.
Tension-type headaches are even more widespread, affecting over 70% of some populations at some point. They produce a dull, pressing sensation that can wrap around the forehead and settle into the nasal bridge area. If your bridge pain comes with a band-like tightness across your head and tends to worsen with stress or screen time, tension headache is a strong possibility.
Eyeglass Pressure
This is the most overlooked cause, and one of the easiest to fix. Glasses that are too tight pinch the sides of your nose and create focused pressure points right on the bridge. Glasses that are too loose slide forward, producing friction and irritation in the same spot. Over hours of wear, either problem can leave you with a deep, aching soreness that lingers even after you take the frames off.
A few practical fixes: look for lightweight frames made of titanium or acetate, which reduce the load on your nose. Frames with adjustable nose pads let you customize the fit to your face. Even a small change to the angle of the temple arms can redistribute pressure significantly. Most opticians will make these adjustments for free, and it’s worth a visit if you notice the pain tracks with how long you’ve been wearing your glasses.
Nasal Injury or Fracture
If your bridge pain started after a blow to the face, a fall, or a sports collision, the nasal bones themselves may be bruised or fractured. The nasal bones are thin and sit right at the surface, making them vulnerable to even moderate impacts. Signs that suggest a fracture rather than a simple bruise include a visible step-off or bump along the bridge, a crunchy sensation when you touch the area (called crepitus), swelling that spreads under the eyes, and bruising around the eye sockets.
A soft tissue bruise typically improves steadily over a week with ice and anti-inflammatory pain relief. A fracture needs evaluation, especially if the nose looks crooked or if swelling makes it hard to breathe through one side. Any blood collecting under the cartilage inside the nose (a septal hematoma) needs prompt drainage to prevent permanent damage to the septum.
Contact Points Inside the Nose
Some people have structural variations inside the nose where tissues press against each other. The middle turbinate, a shelf-like structure inside the nasal cavity, can impinge on the septum or the side wall of the nose, creating a deep, localized ache at the bridge. This condition, sometimes called contact point headache or rhinogenic headache, produces pain that worsens with congestion (when the tissues swell further) and improves with topical decongestant sprays. If a decongestant spray temporarily relieves your bridge pain, a structural contact point may be the culprit.
Nerve-Related Pain
A single nerve, the nasociliary nerve, is responsible for carrying pain signals from your eyes, the skin of your nose, and the nasal bridge area to your brain. Irritation of this nerve can produce sharp, stabbing bursts of pain that radiate from around the eye into the forehead and down the nose. This is uncommon, but worth knowing about if your pain comes in sudden, intense flashes rather than a steady ache.
Other nerve-related conditions like trigeminal neuralgia (the most common facial nerve pain syndrome) can also refer pain to the nasal region. Trigeminal neuralgia typically causes brief, electric-shock-like jolts triggered by touching the face, chewing, or speaking.
Skin and Soft Tissue Infections
Infections of the skin on or near the nasal bridge can cause localized pain, redness, and swelling. A boil inside the nostril can progress to cellulitis, a spreading bacterial infection that may move from the nasal tip up toward the bridge and cheeks. You’ll typically see redness that expands over hours, skin that feels warm and tender to the touch, and sometimes fever. Cellulitis on the nose warrants prompt medical treatment because the veins in this area drain toward the brain, and untreated infections can spread to the bloodstream.
Rare Inflammatory Diseases
Two uncommon conditions deserve mention because they both target the nasal cartilage and can start with nothing more than unexplained bridge pain.
Relapsing polychondritis is an autoimmune disease that attacks cartilage throughout the body. In about 24% of patients, nasal cartilage inflammation is present at diagnosis, and over half develop it at some point. One documented case began with an abnormal sensation around the nasal bridge that progressed to worsening pain over a month, with tenderness on examination and inflamed, swollen septum cartilage on imaging. This condition usually also affects the ears (causing red, swollen outer ears) or the joints.
Granulomatosis with polyangiitis (GPA) is a form of blood vessel inflammation that affects the upper airway in over 90% of patients. It typically starts with crusting inside the nose, chronic runny nose, and recurrent sinusitis. Over time, it can destroy the nasal septum cartilage, with about 33% of patients developing a hole in the septum and roughly 30% developing a visible collapse of the nasal bridge called saddle nose deformity. This collapse can happen even with appropriate medical treatment, and sometimes occurs without a large septal perforation.
Both conditions are rare, but if your nasal bridge pain persists for weeks without an obvious cause, is accompanied by joint pain or ear inflammation, or you notice your nose shape changing, these possibilities are worth raising with a doctor.
Red Flags That Need Urgent Attention
Most nasal bridge pain resolves on its own or with simple measures. But certain accompanying symptoms signal something more serious: pain, swelling, or redness spreading around the eyes; high fever; double vision or other vision changes; confusion; or a stiff neck. These combinations can indicate an infection spreading beyond the sinuses toward the eye socket or brain, and they need same-day medical evaluation.