How to Avoid Unnecessary Sinus Surgery for Your Headache or Migraine

July 6, 2009 by dean · Leave a Comment 

True sinus headache is rare.

Clinical studies have demonstrated that nearly 90 per cent of patients with a diagnosis of ‘sinus’ headache have migraine or tension headache and therefore it is not surprising that recent research has shown that the ‘triptans’, medication developed specifically for migraine and which has been shown to be effective in tension headache, also relieved ‘sinus’ headache – if this happens then clearly it is not a sinus headache!

However we also know that Cervicogenic (neck-related) headache is often misdiagnosed as migraine or tension headache and that the ‘triptans’ are effective in cervicogenic headache (that is why there is a misdiagnosis!). This suggests that the mechanisms of migraine, tension headache and neck-related headache are similar and that a neck disorder is capable of referring pain into the facial region, raising the possibility that ‘sinus’ headache may actually be referred pain from a neck disorder.

Indeed my experience is (and a significant body of research demonstrates) that facial pain and pressure is often a referred pain from a neck disorder. A very aware Ear, Nose and Throat surgeon sends me patients with ‘sinus’ headache to determine if it is referred from the neck before embarking on surgery, thus avoiding unnecessary and the not insignificant surgery!



(Cady RK, Schreiber CP. Sinus headache: a clinical conundrum. Otolaryngol Clin North Am 2004 Apr;37(2):267-88

Kari E, DelGaudio JM. treatment of sinus headache as migraine: the diagnostic utility of triptans. Larygoscope 2008 Dec;118(12) :2235-9

Pavese N, Bibbiani F, Nuti A, Bonuccelli U. Sumatriptan in cervicogenic headache. Proceedings European Headache Federation 2nd International Conference 1994; Abstract 131

Tepper SJ. New thoughts on sinus headache. Allergy Asthma Proc 2004 Mar-Apr;25(2):95-96 ;

Yi X et al Cervicogenic headache in patients with presumed migraine: missed diagnosis or misdiagnosis? J Pain. 2005 Oct;6(10):700-3)

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.

About dean
Consultant Headache & Migraine Physiotherapist; International Teacher; Director, The Headache Clinic & Watson Headache Institute; PhD Candidate Murdoch University, Western Australia; Adjunct Lecturer, Masters Program, Physiotherapy School, University of South Australia; MAppSc(Res) GradDipAdvManipTher Experienced health practitioners trained in the Watson Headache Approach perform the examination and treatment techniques developed by Dean Watson. These techniques are based on his extensive experience of 7000 headache patients (21,000 hours) over 21 years and are now taught internationally. For your nearest practitioner who has completed training in the ‘Watson Headache Approach’ please refer to the ‘Practitioner Directory’.

Speak Your Mind

Tell us what you're thinking...
and oh, if you want a pic to show with your comment, go get a gravatar!