Does Sinus Headache cause Neck Pain?

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Written By Dr. Marcus Yu Bin Pai

MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

Have you ever experienced a throbbing headache accompanied by neck pain? If so, you’re not alone. Many of us have wondered whether our sinus headaches could be the culprit behind that nagging neck discomfort. With sinus infections and allergies being quite common, it’s important to understand the connection between these issues and how they may affect other parts of our body, such as the neck.

In this article, we’ll delve into whether sinus headaches can cause neck pain or not. We’ll explore how sinuses work, what triggers sinus headaches, and how this type of headache might relate to neck pain.

Can sinus headaches cause neck pain?

Yes, sinus headaches can cause neck pain in some cases. The two main mechanisms are:

  • Referred pain from the sinuses to the neck region. The sphenoid sinuses located behind the eyes have nerve connections to the upper neck area. Sinus inflammation can cause pain signals to be transmitted to the neck.
  • Tension headaches triggered by sinus headaches. The facial pain from sinus pressure can activate neck and shoulder muscles, leading to a tension headache that radiates into the neck.

The Anatomy Of Sinuses

The sinuses are air-filled spaces located in the skull, specifically within the bones of the face and around the nasal cavity. They are connected to the nasal passages and help filter, warm, and moisturize the air we breathe. There are four pairs of sinuses, including the frontal sinuses (located above the eyes), maxillary sinuses (situated in the cheekbones), ethmoid sinuses (found between the eyes), and sphenoid sinuses (located behind the nose).

When inflammation or infection occurs in these sinus cavities, it can lead to a condition called sinusitis. Sinusitis may cause various symptoms such as facial pain or pressure, nasal congestion, headaches, and even neck pain. The connection between sinus headache and neck pain can be attributed to their shared nerve pathways and muscles that are affected during sinus inflammation.

Typical Symptoms of Sinus Headaches

  • Pain, pressure, and feeling of fullness in the face, especially around the sinus areas like cheeks, forehead, brow, and bridge of nose. The pain often gets worse when bending forward.
  • Headache that worsens with sudden head movement or straining. The location depends on the sinus(es) affected – behind the eyes, in the cheeks, forehead, or bridge of nose.
  • Congestion and blockage of the nasal passages, causing difficulty breathing through the nose.
  • Runny nose, often with thick, discolored (yellow, green) nasal discharge. 
  • Decreased or lost sense of smell.
  • Sore throat, cough, fever, fatigue.
  • Pain or pressure in the ears and upper teeth. 
  • Symptoms get worse in the morning after mucus has collected overnight. 
  • Symptoms worsen with sudden temperature changes.
  • Symptoms last 7-10 days or more without improvement.

Differentiating from Migraines

While migraines can have similar symptoms, they typically have nausea, vomiting, sensitivity to light/sound. Sinus headaches due to infection have thick nasal discharge and last longer.


  • Acute sinusitis – inflammation and congestion of the sinus cavities often due to a viral infection like a cold. This blocks sinus drainage leading to pressure buildup.
  • Allergies – can cause chronic sinus inflammation, congestion and recurrent sinus headaches. 
  • Structural issues like neck arthritis or injuries may also contribute to neck pain

Common Sinus Headache Triggers

The main reason behind this connection lies in the inflammation and congestion within the sinuses, which puts pressure on various nerves and blood vessels in the head and neck regions.

This can cause tension, muscle strain, and overall discomfort in the neck area. Additionally, drainage from congested sinuses can lead to post-nasal drip, which may result in soreness or stiffness in the throat and neck muscles as well.

Prevention And Treatment Strategies

By understanding the strategies for prevention and treatment, individuals can avoid the complications that may arise from these conditions and achieve a higher quality of life.

One effective approach to prevent sinus headaches and neck pain is maintaining proper posture. This means keeping your head well-aligned with your spine, which helps in reducing muscle tension in your neck.

Regular stretching exercises targeting the neck and shoulder muscles can also be beneficial in improving flexibility and reducing stiffness. Additionally, staying hydrated, consuming a balanced diet, managing stress levels, and getting enough sleep are all crucial factors that contribute to overall health and well-being.

For those already dealing with sinus headaches or neck pain, seeking medical advice is always recommended.

Treatment options

  • Over-the-counter medications like decongestants, antihistamines, pain relievers to treat the sinus symptoms and pain.
  • Saline irrigation with neti pot can help clear congestion.
  • Rest, hydration, warm compresses. Avoiding irritants or allergens.
  • See a doctor if symptoms persist or get severe, to check for underlying infection or structural causes.
  • Physiotherapy, massage, chiropractic adjustment may help for musculoskeletal causes of neck pain.
  • Preventative treatment of allergies or neck injuries may reduce recurrence.

Pharmacological options


  • Work by constricting blood vessels in the nasal passages, reducing swelling and congestion.
  • Available over-the-counter as pills, liquids, and nasal sprays containing pseudoephedrine or phenylephrine.
  • Oral decongestants like Sudafed provide broader relief. Nasal sprays like Afrin target the nasal area directly.
  • Start providing relief within 30-60 minutes. Effects last 4-6 hours.
  • Should not be used for more than 3 days in a row as they can cause rebound congestion.
  • Side effects may include insomnia, increased blood pressure/heart rate, dizziness, restlessness.
  • Not suitable for people with heart disease, high blood pressure, thyroid problems, diabetes.
  • Avoid taking close to bedtime as decongestants are stimulants.


Antihistamines are medications that can help relieve allergy symptoms, which may contribute to sinus headaches. They work by blocking the action of histamine, a chemical released during an allergic reaction that causes swelling of the mucous membranes and mucus production.

Some common over-the-counter (OTC) antihistamines include:

  1. Loratadine (Claritin)
  2. Cetirizine (Zyrtec)
  3. Fexofenadine (Allegra)

These second-generation antihistamines are less likely to cause drowsiness and other side effects compared to first-generation antihistamine

They are effective for about 24 hours, and a person should only take one dose per day.

When To Seek Medical Attention

It’s important to know when your sinus headache and neck pain may require medical attention. Although these symptoms can often be managed with over-the-counter medications and home remedies, there are instances when it’s necessary to consult a healthcare professional. If your sinus headache persists for more than a week despite self-care measures, or if the pain becomes severe and is accompanied by a fever, it could be indicative of an infection that requires antibiotic treatment.

Additionally, if you’re experiencing neck pain that doesn’t improve with rest and pain relief medication, or if the pain is severe enough to limit your daily activities, it may be time to see a doctor. Neck pain can be caused by various conditions, such as muscle strain, herniated disc, or even meningitis – some of which might necessitate medical intervention. By seeking professional assistance when needed, you can ensure that any underlying issues are promptly identified and treated before they worsen or cause further complications.


In conclusion, it’s clear that sinus headaches can indeed cause neck pain, as well as discomfort in the shoulders and upper back. The duration of this pain may vary, but incorporating specific stretches, exercises, and addressing lifestyle factors can help alleviate the discomfort.

Don’t hesitate to explore alternative therapies like acupuncture or massage if you’re struggling with neck pain caused by sinus headaches. Remember, taking care of your overall health and well-being is essential in preventing and managing these painful symptoms.

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MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

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