For a bunch of empty space, sinuses sure do cause a lot of problems. Sinuses are a trait shared with many animals, which means we probably have a common ancestor who had sinuses, or it is a useful enough bit of anatomy to evolve independently many times over—like the eye. There are a lot of theories as to what their evolutionary purpose is, and here are a few likely candidates: a humidifier/filter for your nasal passage, facial crumple zones, a way to reduce skull weight, and resonators for our voice.
Whatever the case, our sinuses have a fairly major design flaw: The passageways between our nose and sinuses, called ostia, are small, easily clogged, and on the top of the empty space instead of the bottom to allow easy, gravity-fed drainage. I read a study not too long ago that stated that the ostia haven't changed since our ancestors walked with their spines oriented more horizontally than vertically. When hominids started living their lives in a more upright manner, the sinus problems began. That means that we have literally been suffering from sinus headaches for millions of years. Thankfully, we have developed some better medical practices over the years which can help us get rid of sinus headaches. I hate to think of the frustrating lack of relief one could get from banging your head against the cave wall.
Getting Rid of Sinus Headaches
Sinus headache treatment should be specific to what is causing it. Sinus headaches are caused by sinusitis, an infection of the tissues in the sinus cavity. As mentioned above, these infections are fairly common. Those pesky passageways are susceptible to irritation and inflammation, which causes them to block the ordinary drainage of the sinuses. That irritation can be caused by several factors, but is most commonly linked to a prior upper respiratory event, such as a cold, influenza, or seasonal allergies. If you can determine what is causing the irritation, finding the proper method for evicting the sinus headache becomes a whole lot easier.
Viral infections are very common cause of sinus headaches. Sinus headaches are most often linked to a prior run-in with a respiratory virus, such as the common cold (rhinovirus) or the flu (influenza). Viruses like this have no immediate cure, but will usually run their course within a few weeks. The way to get rid of sinus headaches caused by viral infection is to treat the symptoms and patiently wait it out. Symptoms such as facial tenderness, dizziness, migraine-like headaches, mucous discharge, and congestion can all be treated with a combination of an analgesic (ibuprofen) and a decongestant (pseudoephedrine). The analgesic will ease the pain and reduce swelling, while the decongestant will help thin out the mucous and open up the blockages causing the problem in the first place.
Allergies and fungal infections are also a problem that may lead to sinus headaches. The irritation and inflammation caused by pollen or dust allergies can start the sinus headache train rolling towards misery. Allergies don't cause an infection, but they can make a person more susceptible to an infection by clogging those drainage sites. An antihistamine will help prevent allergic reactions and cut down on potential inflammation.
Fungal infections of the sinus can be divided into two basic groups, non-invasive and invasive—both are really scary:
Non-invasive. Allergic fungal sinusitis and mycetoma (fungus balls) can happen to people with normal immune systems, but are more common in people with asthma and nasal polyps. It's a pretty horrendous state of affairs that involves a lot of puss, mucous, and a thick granular slop that forms in your sinuses. It is usually discovered by X-ray or CT scan after an extended, unrelenting bout with chronic sinus headaches. Surgery is necessary to clear everything out. An antifungal medicine and steroid regimen are given to help heal the area after surgery.
Invasive. Fungal sinusitis is very rare, but is more common in those who have problematic immune systems or diabetes. It is far more dramatic and persistent than its non-invasive cousin. The infection increases the pressure in the sinus cavity, allowing the fungal growth to eat through bone and expand into the eye cavity or into the brain. It can cause permanent disfiguring by killing tissue, and possibly impact your mental state. Treatment is going to require extensive surgery and antifungal treatments, along with treatment of the immune system problems that allowed the infection in the first place.
Bacterial infections are less common and easier to treat. Another possible cause of sinus infections is going to be bacteria. Though it is common for a physician to automatically prescribe an antibiotic for every sinus infection, this seems counter intuitive as most sinus infections are viral, and antibiotics have no effect on viruses. However, if sinusitis doesn't clear up after a week or two, it is reasonable to suspect that the cause is something other than a virus. Tests can determine the culprit. To save time while waiting for results, an antibiotic might be administered, just in case. I understand the logic, but the possibility of contributing to resistant bacteria does not justify such an action to me.
Chronic sinusitis is usually caused by a physical deformation. The term chronic is defined as ongoing for a long time or frequently occurring. If you have a sinus headache that lasts more than a few weeks, or comes back several times in a year, you have chronic sinusitis. It could be that you have a poor immune system or are in a bad environment for sinus health. People with nasal deformities, such as a deviated septum, cleft palette, or nasal polyps, are going to be far more susceptible to problems with their sinuses. I recommend that you make an appointment with an otolaryngologist, also known as ear, nose, and throat specialists. They should be able to help you out. There are even doctors who specialize beyond ENT to only deal with sinuses—if you can find them. It is quite likely that surgery will be necessary to correct any physical problem.
Over-The-Counter Medication for Sinus Headaches
OTC medications are usually sufficient, but there are other options. I have a coworker who uses a technique called Nasal Saline Irrigation (neti-potting) and swears that it has helped with her sinus congestion problems. Of course, this is the same coworker who kept a whole, unpeeled onion on her desk to ward off the swine flu. I gave the idea of dumping water down my nose about the same seriousness I gave the onion, until I did some research. It seems this is actually quite effective for relieving symptoms associated with sinusitis and nasal congestion. They are very often recommended by otolaryngologists for use by patients who have had surgeries because they help to clear out crusting mucous, allergens, and also help to keep cilia (the hairs in your nose) working properly.
They aren't hard to use and are seemingly available everywhere, these days. The mixture is one teaspoon of salt in one pint lukewarm water. Tipping your head over a sink, pour it in one nostril and out the other. Some might run into your throat, so be prepared for that awkward feeling of drowning. If done too often, there is a possibility of causing some irritation—don't get too wild with it. Also, be sure to keep your neti pot clean; otherwise, you'll just be dumping a bunch of bacteria or fungus into your nose—the opposite intention.