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Suggest treatment for headaches and sinus infection

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Posted on Mon, 11 May 2015
Question: Hi I have a question about headaches and a possible sinus infection.

8 Months ago I developed a persistent, non-stop headache that has not responded to any treatment so far. I've been treated for Lyme disease after testing positive for it, but was later told by an Infectious Disease doctor that I don't have Lyme disease.

I've consistently had "mild mucousal thickening" present in all of my CT Scans/X-Rays, etc..in ever sinus, even as recently as last week. I also have a constant post-nasal drip and clear discharge. No color to it.

My question is..would this kind of persistent, dull pain that's usually under a 3 on a 1-10 scale, usually present in the forhead above the eyebrows, and often on the top of the head, be caused by my sinus problems. Please note, that the pain is unremitting.

One last kicker though...2 months after I developed my headache, my girlfriend also developed an identical, persistent headache with the same presentation. However, hers is more often a 1-2 than a 3 like mine and she also had "reactive arthritis" (presumably) in her right wrist that lasted several months. Consequently, we assume that it isn't a coincidence that we both have the same persistent headache and it must be from something that's infectious/contagious but her CT scan came back clear.


Thoughts?
doctor
Answered by Dr. Krunal Karade (29 minutes later)
Brief Answer:
In my opinion , your headache is most likely because of sinus infection .

Detailed Answer:
Hi,
Thanks for the query.

I have read your query , reviewed your medications and understand your concern.

As per your clinical history it appears that you are most probably having chronic rhinosinusitis with associated allergy .

In my opinion , your headache is most likely because of sinus infection .

Your girlfriend headache is just coincidence might because of other reason since CT scan came clear . It is also of low severity which is common in most person .

To help you better kindly upload your latest CT scan report here .

If I were your treating Doctor for this case , I would advice you
Continue using a neti-pot 2x daily ,
Fluctinasol nasal spray 2x daily, make it 2 puff each nostril twice daily &
Tab paracetamol 500 mg twice daily for headache .

Gargle with water 20 mins after nasal spray use to remove any spray coming to throat .

You will get relief .

Hope it is helpful to you . If you have any further questions I will be happy to help.

Regards.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Krunal Karade (17 minutes later)
Hi Doctor, thank you for your response.

I'm curious as to how you could assume my girlfriend's headache is just a coincidence. Neither of us have ever had a headache that's lasted longer than a few hours, then within two months of each other, we both develop one that's lasted 6+ months...that doesn't seem very coincidental to me.

She had an "osteoma versus sinolith" appear in her frontal sinuses according to the report. What does that mean? could that be causing her headache?
doctor
Answered by Dr. Krunal Karade (18 minutes later)
Brief Answer:
Since she is having osteoma or sinolith ,it could be cause for her headache

Detailed Answer:
Hi,
Thanks for the follow up query.

As you write earlier that her CT scan was clear possibility of sinus headache was less likely .

Since she is having osteoma or sinolith , it could be cause for her headache .

Osteoma is a is a benign bone tumor.

Sinolith means a stone formation in the sinuses .

To help you both about headache kindly upload CT scan reports of both here .

Regards.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Krunal Karade (1 hour later)
While I can't upload the reports themselves...here's what they say.

Mine:
Frontal: Mild mucosal thickening in left frontal and inferior right frontal sinus with partial opacification of frontal recesses.

Maxillary: retention cysts versus polyps within inferior maxillary left sinus. Mild mucosal thickening in right XXXXXXX sinus. Maxillary ostia and infundibula remain patent bilaterally.

Ethmoid: Mild mucosal thickening throghout ethmoid air cells

Spehnoid: Mild mucosal thickening within sinuses. Partial mucosal opacification of sphenoethmoidal recesses.

Impression: Mild pansinus mucosal thickening and several retention cysts versus polyps within the left maxillary sinus.

Hers:
Frontal: Normal. There is a 7 mm osteoma versus sinolith within the left frontal sinus.
XXXXXXX Eth, Sphen: Normal

No significant soft tissue findings.

Impressions: No active sinus disease.
doctor
Answered by Dr. Krunal Karade (7 hours later)
Brief Answer:
Your headache is because of sinus infection .

Detailed Answer:
Hi,
Thanks for the follow up query.

After reading your CT Scan report , You are having chronic rhinosinusitis with associated allergy .Your headache is because of sinus infection . Follow treatment plan as advised , you will get relief .

Your girlfriend headache could be because of osteoma or sinolith .When headache is more she can use tab paracetamol 500 mg .

Regards.


Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Krunal Karade (15 hours later)
Thanks for your reply doctor.

Out of curiosity...could both of these conditions, my "chronic rhinosinusitis" (which, if you could provide a brief explanation of the difference between sinusitis and rhinosinusitis..I'd appreciate it) and her osteoma or sinolith present with the symptoms I've described? In other words...can both of these give a *persistent* headache that lasts for months with pain that waxes and wanes and migrates around the head?

Thanks again
doctor
Answered by Dr. Krunal Karade (29 minutes later)
Brief Answer:
Rhinosinusitis is a broader term now use.

Detailed Answer:
Hi,
Thanks for the follow up query.

Rhinosinusitis is a inflammation of the mucous membranes of the nose and one or more paranasal sinuses. It is a broader term now use.

Sinusitis is a inflammation of the mucous membranes one or more paranasal sinuses .

In your case it is most likely your headache is because chronic rhinosinusitis .

In her case , headache can be persistent but low intensity due osteoma or sinolith.

Regards.


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Krunal Karade (32 minutes later)
But both of those causes can cause persistent dull headaches that last for months at a time until treated...?
doctor
Answered by Dr. Krunal Karade (13 hours later)
Brief Answer:
Yes both condition can give rise to persistent dull headaches .

Detailed Answer:
Thanks for the follow up query.

Yes both condition can give rise to persistent dull headaches .

Osteoma is a benign bone tumor . It grow very slowly giving rise to persistent dull headaches of low intensity .

Sinolith causes localized inflammation leading to persistent dull headaches of low intensity.

Chronic rhinosinusitis also give rise to persistent headaches that lasts for months with waxes and wanes and migrates around the head.

Regards.



Above answer was peer-reviewed by : Dr. Pradeep Vitta
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Answered by
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Dr. Krunal Karade

ENT Specialist

Practicing since :2009

Answered : 1000 Questions

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Suggest treatment for headaches and sinus infection

Brief Answer: In my opinion , your headache is most likely because of sinus infection . Detailed Answer: Hi, Thanks for the query. I have read your query , reviewed your medications and understand your concern. As per your clinical history it appears that you are most probably having chronic rhinosinusitis with associated allergy . In my opinion , your headache is most likely because of sinus infection . Your girlfriend headache is just coincidence might because of other reason since CT scan came clear . It is also of low severity which is common in most person . To help you better kindly upload your latest CT scan report here . If I were your treating Doctor for this case , I would advice you Continue using a neti-pot 2x daily , Fluctinasol nasal spray 2x daily, make it 2 puff each nostril twice daily & Tab paracetamol 500 mg twice daily for headache . Gargle with water 20 mins after nasal spray use to remove any spray coming to throat . You will get relief . Hope it is helpful to you . If you have any further questions I will be happy to help. Regards.