“Every head has its own headache”

April 1, 2009 9:24 AM

I am woken up each and every night with a pounding sinus headache. What remedies can you suggest?

I would love to hear any ideas/remedies to get this taken care of.

A little background info on me - I am a 33 yr old female. In relatively good health. I exercise at least an hour every day. I am at a normal weight. I eat a healthy diet. I went to an allergist a few years back. I do have some mild environmental allergies, but not enough that I would have qualified for allergy shots. I don't know if this is what is causing my sinus headaches anyway. I have had these headaches since in my teens.

About once a year (some time between October and February) they get so bad that they cannot be ignored and I take a trip to the doctor. He prescribes antibiotics, thinking I have a sinus infection. The antibiotics lessen the severity of my headaches to where they are tolerable, but it doesn't get rid of them all together.

In conjunction with your remedies for me, if you could let me know (if you know) of the time your remedy would take to have an effect, I'd be most grateful.

posted by Sassyfras to health & fitness (26 comments total)

I think you should go see an ear, nose & throat doctor. My husband had awful sinus headaches and constant sinus infections. It turned out to be caused by a deviated septum. He had surgery for it and is now MUCH better.

I have a lot of sinus pressure and headaches when my allergies are bad. The remedies that work for me are (1) Claritin when needed, (2) Nightly saline nasal rinses (nasal RINSES not sprays) ... I recommend Ayr Saline Nasal Rinse kit which you can buy in most drugstores, and (3) Running a HEPA air filter in my bedroom at night.
posted by tastybrains at 9:29 AM on April 1

Are you using a humidifier?

I was also on the antibiotic train last year, and finally said "enough" after three back-to-back courses. I went to an ENT who recommend surgery, but I'm really reluctant to do it. For right now, decongestants (the kind you have to sign the form for) and OTC allergy meds seem to be working well enough.
posted by JoanArkham at 9:29 AM on April 1

Neti Pot. I get sinus headaches all the time and this gives nearly instant relief.

It's a bit of a teeth-gritter though. Here, watch this and be amused.
posted by unixrat at 9:35 AM on April 1 [1 favorite]

Holy cow, I missed the most important tool: pseudoephedrine. It's a 'behind-the-counter' OTC in almost every state. DO NOT ACCEPT SUBSTITUTES, they're crap.

Go to the pharmacy, ask for it, sign the book. Take these as soon as you feel the sinus problems coming on. Fight fire with fire, but shoot early and often.
posted by unixrat at 9:37 AM on April 1

Dry, cold air in the winter has caused me the same sort of problem. For a while I lived in a rural community where the number one crop was... hay, and once again had similar problems.

For several years we lived in a house with forced air heating, and I was constantly sick in the winter. The dry air makes it easy for your throat and nose to dry out and become damaged, making it easy for infection to start. Office air conditioning can do the same thing.

Pollution and house dust can do the same thing to me. Everything, including my ears (the inner part) can become inflamed in the winter.

Going to a nose, ear and throat specialist has worked.
posted by KokuRyu at 9:38 AM on April 1

I feel for you -- I have had sinus issues since high school. I have even tried surgery, which changed things but didn't fix them. The only thing that has provided any lasting benefit for me is steroid shots every three months. I think the best advise is to go see someone good.

There are two things that work in the short term for me. First as tastybrains mentions nasel rinses help alot. I use a waterpik with a sinus tip and it works wonders. The other think that helps immensely is to drink a lot of water -- I start with about 1.5 liters and push it from there. I think it helps loosen things up.
posted by rtimmel at 9:43 AM on April 1

Pulsatile irrigation has worked well for me and was effective almost immediately.

I had chronic sinus problems for years, to the point of being unwilling to ever get on a plane again due to the certainty of extreme pain from the pressure changes. That happened to me several times during the climb up to cruising altitude and lasted until tears caused the blockage to loosen up enough to let the pressure out with a little squeak, at which point relief was immediate.

That clued me in that my problem might be solved by getting some additional moisture in there and thinning things out. So I ordered one of these special attachments for a water pik. Several weeks of daily use got rid of the chronic problem for good, and now I just use it if I have a bad cold or something.

Also helpful were long, hot showers and aerobic exercise in a fairly small room--the additional humidity being presumably the key thing there. Drinking plenty of water also helps keep the problem from coming back, and on days when I don't do that I can definitely feel the pressure returning. So if any of these things help you, then the irrigation thing might too.
posted by FishBike at 9:44 AM on April 1

Pseudoephedrine taken right when your sinuses start acting up can actually prevent them from getting worse. The stuff is magic. I also second the neti pot - no need to buy an actual pot, you can just use a paper cup in the shower - it helps a lot.
posted by The Light Fantastic at 9:44 AM on April 1

you can just use a paper cup in the shower - it helps a lot.

Damn you, now I'm going to have to try this. No salt? Does it make a difference?
posted by unixrat at 9:45 AM on April 1

I find that sleeping in a position with my head raised helps reduce the amount of congestion. Somethimes I sleep with one of those reading/tv watching pillows if it's really bad.
posted by mmf at 9:46 AM on April 1

Also, if you are in the middle of the headache, try sleeping in a partially reclined recliner. Going horizontal hurts - don't do it. Stay as vertical as you can.
posted by unixrat at 9:47 AM on April 1

I think it'd sting more without salt.

Get thee to an ENT pronto.

I had sinus surgery to correct a deviated septum and constant horrible sinus infections. It made an amazing difference. This may not be your best course - only your doc can advise you there.

In the meantime:

If you're in a dry climate or have forced hot air heating, especially in winter, have a humidifier running.

Buy some saline mist to squirt in your nose during the day (when a neti pot might not be practical.)

But if you're having an attack, pseudophedrine and one pill of Exedrin Migraine (which has caffeine) works for me. Also make sure you're properly hydrated - get dried out is a sure way of getting a nasty headache.
posted by canine epigram at 9:52 AM on April 1

Do you have your tonsils and/or adenoids? My daughter inherited my bad sinuses and was having a helluva time at age 5 with sinus headaches, constant stuffiness, that sleeping where you stop breathing and almost wake (lost for words today).

Anyways, the docs remove the tonsils and noids and she drained green snot for two days. (Vomited it back up, natch) She's like a new kid after that. I don't think she's had a true sinus problem in the four years since.
posted by unixrat at 9:57 AM on April 1

nthing an ENT doctor. They are magic. Or science. Mostly science.
posted by spec80 at 9:59 AM on April 1 [1 favorite]

I find that a Zyrtec + Mucinex cocktail a few hours before bed really helps to keep the sinuses open at night, and that in turn helps to prevent sinus problems from escalating.

You also might want to try cutting out dairy products from your diet; after I did this, my incidence of sinus infections went from 3 or 4 per year down to 1.
posted by qxntpqbbbqxl at 10:11 AM on April 1

Seconding the humidifier, or even just a vaporizer -- usually the vaporizer is way cheaper (I got mine at Target for about twelve bucks). My sinuses also go a little crazy when the air gets dry, and I've also had bad sinus headaches sometimes -- and this makes an enormous difference.

(I also cheat a little and add a few drops of essential oils to the water in the vaporizer tank, so the air doesn't just have steam, it also smells all pretty.)
posted by EmpressCallipygos at 10:14 AM on April 1

Damn you, now I'm going to have to try this. No salt? Does it make a difference?

You need to use a little bit of salt. Sea salt or non-iodized is best. Just throw a pinch in the cup before you hit the shower.
posted by The Light Fantastic at 10:25 AM on April 1

I am plagued by a stuffy nose and sinusy headaches year-round. The combination that works best for me is pseudoephedrine (agreeing with everyone who says to get the real stuff that's behind the pharmacy counter; the new substitutes are no better than a placebo) and a warm-steam vaporizer (cool-air humidifiers can sometimes harbor mold, and that just makes your situation worse).

I've also found that drinking something carbonated helps (I usually choose club soda so as not to consume a bunch of empty calories before bed) - the fizzy bubbles seem to stimulate my sinuses in a positive way, but I might just be imagining that part.

Also, make sure that you are washing your bed linens regularly and that you remove possible allergy triggers from your bedroom (plants, flowers, candles, air fresheners, etc) and keep a bottle of water on your nightstand so that you can take little sips and rehydrate your throat if you wake up feeling dried out.
posted by amyms at 10:39 AM on April 1

I've had real bad allergy headaches for almost a year now. I went to the doctor for something else and he thought I had an infection, so I took the antibiotics and I was cured!
posted by RussHy at 11:01 AM on April 1

Another vote for pulsitile irrigation. It is like a Neti pot but even more effective. You don't need to buy the fancy saline preps they sell, just use non-iodized salt. The correct proportions are in the manual. If the price puts you off, try a Neti pot; they are cheap and available at your pharmacy. Of course, you also want to stay well hydrated.
posted by caddis at 11:12 AM on April 1

Even though your allergies aren't severe, it would be worth your while to find out if your pillow is making things worse. Latex is inhospitable to dust mites, but other 'hypoallergenic' stuffings can harbor them. You can buy a dust-mite cover, or just use a folded-up towel or blanket instead of a pillow. A cover intended just for bed-bugs won't be fine enough.
posted by wryly at 11:44 AM on April 1

see a neurologist...what you described sounds a lot like my cluster headaches.
posted by plungerjoke at 12:09 PM on April 1

A personal technique that I can only recommend gently as it is a very homemade remedy is using a neti pot or sinus rinse with a small amount of hard alcohol, like vodka or ouzo, instead of salt. About a quarter of a shot for every 8 ounces. Vodka works the best as it's generally unflavored and contains no sugar or other additives.

It does burn, but it also provides immediate relief. The salt mixture never seems to work for me. Then a quick gargle at the back of the throat to kill anything growing there.

Again, completely a home remedy that I made myself, but I still use it every time.
posted by destro at 2:47 PM on April 1

It looks like nobody else mentioned it, so I'll say that a prescription steroid nose spray (Flonase, etc) did the trick for me when Claritin and Neti Pot still didn't quite cut it--although I'll agree with everybody that they're amazing. It doesn't work for everybody, and some people get nosebleeds or other unpleasant side effects. It sounds like you have general inflammation up there that's causing the problem and that's what these drugs treat.
posted by hydropsyche at 3:19 PM on April 1

If you have any kind of heart condition or high blood pressure, call your doctor before you take pseudoephedrine the first time. Seriously. It landed me in the hospital, and all I had was (what I was told were) benign heart palpitations.
posted by IndigoRain at 8:29 PM on April 1

Same thing happens to me, and sometimes the headaches are so bad I throw up. But if I take pseudoephedrine I can't sleep, and it takes a couple of hours to kick in.

I told my doc this. He looked at me like he was talking to someone a bit slow and said, "You have heard of Afrin, right?"

So, I got a bottle of Afrin Sinus. I would happily pay whomever invented it a thousand dollars. It's awesome. Within a few minutes your sinuses are clear and the headache is gone.

But you can't take it for more than a few days. My doctor is really vehement about this. You could tell him you've taken up smoking, intravenous drug use, and cooking with trans fats and his response would be, "But you don't use Afrin more than three days in a row, right?"

For me the answer was: a) keep a bottle of Afrin handy and then b) take a 24 hour Claritin D (extended release pseudoephedrine) tablet first thing in the morning, to wean off the Afrin. For me, taking one anytime after 10 am means no sleep that night.

On preview - I agree with IndigoRain about asking your doctor before taking pseudoephedrine. I wear a heart rate monitor when I work out and on days that I take Claritin D (even the 24 hour type), my heart rate is 15 bpm or so higher than normal - I slow down my workout to compensate. Why not see your doctor or an ENT and ask them for something a bit more proactive than antibiotics? The takeaway from this thread seems to be that everyone has something a bit different that works for them, your doc should be able to help find a solution that works for you without endangering your health.
posted by txvtchick at 8:51 PM on April 1