Sinus, Facial & Headaches - James Rockwell MD

Many of the patients I see complain of facial pain and headaches. A large number of these patients have seen multiple physicians over the years and have been incorrectly diagnosed with migraine headaches, tension headaches and various other incorrect labels.Patients often tell me that they experience “sinus” or “frontal” headaches with associated facial pain and pressure. These are headaches that have a “butterfly” distribution where the headache is centered across the forehead between the eyes and on the mid face.

These types of headaches can be associated with sinus infections but more often than not, they are associated with nasal obstruction (inability to breath through the nose). This nasal obstruction problem is due to a deviated septum.

How do I treat facial pain and headaches?

First and foremost, we need to rule out a current sinus infection. Through a detailed medical history, a review of all of the patient’s current symptoms and a thorough nasal exam I will determine whether we are dealing with an active sinus infection or nasal obstruction problem. A sinus x-ray may also be done to truly assess the sinus status. If I determine that there is a nasal obstruction problem a course of nasal steroid sprays is prescribed. Those that do not respond to this treatment are offered sinus surgery options.

Symptoms of Nasal Obstruction

-Facial Pain and Headaches
-Excessive Snoring and Sleep Apnea
-Recurrent Ear Infections, Dizziness
-Sinus Infections
-Chronic fatigue

Facial pain & headaches
Snoring
Ear Symptoms
Chronic Sinusitis
are all due to nasal obstruction issues

Sinus Infections- Diagnosis and Treatment

The most common patient problem I deal with on a daily basis are patients that believe they have a sinus infection. While this can often be the fact, I often discover that after evaluating their history they ultimately do not have a problem with their sinuses but have nasal obstruction issues (ongoing problems breathing through their nose). Patients come to see me after having been treated for months and years with multiple courses of antibiotics only to see their symptoms reoccur and are at a loss as to why.

What does sinus treatment include?

Initially I review a patient’s symptoms, take a detailed medical history and do a nasal exam. I often also do a sinus x-ray. A sinus x-ray is the only way to definitively assess a patient’s sinus status. Patients that have sinus infection symptoms but totally normal sinus x-rays often do not have a sinusitis but have nasal obstruction problems. In the event there is a current sinus infection I prescribe a course of sinus specific antibiotics and decongestants. Sinus infections can be very difficult to cure and I carefully follow up with my patients to make sure there has been total resolution of their symptoms.

Do you have a sinus infection or a nasal obstruction problem?

True sinus infections and nasal obstruction problems can be difficult for a patient to diagnose on their own and you can indeed have both of these problems at the same time. The most common patient complaint I hear from those people who are diagnosed with sinus infections are cold symptoms that don’t go away. Please consult the boxes below to see if you could have one or both of these problems.

Possible Sinus Infection Symptoms

Nasal Obstruction Problem Symptoms

	Excess nasal drainage
	Coughing & hoarseness
	Facial pain & headaches
	Ear pressure & fullness
	Nasal congestion
	Ongoing cold symptoms

	Recurrent sinus infections
	Snoring & Sleep Apnea
	Facial pain & headaches
	Recurrent ear infections, dizziness
	Chronic, fatigue

I have treated patients for both of these conditions very successfully. If either of these sound like you please call me for an appointment.