Sinus Headaches and Neck Pain: Can One Cause the Other?

Although many people complain of sinus headaches, a true sinus headache is less common than you might think. Even less common is a sinus headache with neck pain, but it can happen. Neck pain can also be from other types of headaches, such as migraine, or from its own unique type of headache.

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"If you have neck pain and a headache, you probably don't have a sinus headache," says Zubair Ahmed, MD, a neurologist and headache specialist at the Cleveland Clinic Center for Neuro-Restoration in Cleveland. "Neck pain is much more common with migraine or tension headaches."

"Studies show that most people who complain of sinus headaches really have migraine headaches," he says. "Sinus pain gets confused with migraine because migraine headaches cause nasal congestion and facial pain."

According to the American Migraine Foundation, a very famous study of 30,000 people diagnosed with migraine, called the American Migraine Study II, found that when migraine was misdiagnosed, the most common diagnosis was sinus headache. Yet another study evaluated almost 3,000 people with at least six episodes of what they thought were sinus headaches. In close to 90 percent of these people, the real diagnosis turned out to be migraine.

Sinus infections are caused by viruses or bacteria that infect one or more of the sinuses in your head, explains the American Academy of Otolaryngology‒Head and Neck Surgery. Your sinuses connect to your nose through drainage tubes. When a sinus gets infected, it can fill up with pus and mucus. A sinus infection typically lasts for 10 days or more. You may have headache pain, but you will also have some of these common symptoms:

• Fever
• Stuffy nose
• Loss of smell
• Discolored and thick nasal mucous
• Pain around your eyes or over your teeth

There is one type of sinus infection that may cause neck pain: an infection of the sphenoid sinus, which is located behind your nose, almost in the middle of your skull. Sphenoid sinusitis may cause pain in the middle of your head, behind your eyes, or pain that shoots down into your neck. Yet according to a June 2006 review in ​Emergency Medicine Journal​, less than 3 percent of sinus infections affect the sphenoid sinus.

Your doctor will diagnose a sinus infection from your symptoms and sometimes an X-ray of your sinuses. Treatment of viral infections includes decongestant medications to break up mucous and nasal sprays to clear the nose and sinuses. For a bacterial infection, you'll need antibiotics as well. For a long-term sinus infection or inflammation, called chronic sinusitis, you may need saltwater nasal irrigation, nasal steroid sprays or a medical procedure to open and drain the infected sinus.

​Read more:​ The 9 Best Natural Remedies for Sinus Infections, and 3 to Skip

"Neck pain can be its own headache, called a cervicogenic headache," says Dr. Ahmed. According to the National Headache Society, cervicogenic headaches come from a source in your neck. The pain starts in the spine of your neck, called your cervical spine, and travels up to your head. The problem in your cervical spine could be due to pressure on a nerve or blood vessel from a cervical vertebra, one of the bones in your neck. Headaches can be traced to neck trauma or arthritis of the cervical spine.

Cervicogenic headaches can be severe. They usually cause pain and a stiff neck, and typically the pain gets worse when you move your neck. Pain can shoot into your shoulders, arms, face, head and eyes. Pain can mimic a migraine and be only on one side. Treatment of these headaches depends on the cause, but it may include physical therapy, nerve block injections, pain medication and sometimes surgery.

"A severe headache with neck pain could be a migraine or cervicogenic headache," Dr. Ahmed says. "The most important thing to do is get the right diagnosis so you can get the right treatment."

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