Can treating the neck help with sinus headaches?

Rhinosinusitis a group of disorders characterized by inflammation of the mucosa of the nose and paranasal sinuses.  Many of us feel symptoms in the facial tissues and head due to the sinuses but in many times, the diagnosis is not always “just a sinus headache”, but could be contributed to overlap from other areas, such as the neck or cervical spine.  

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There could be local cervical musculoskeletal dysfunction and certain findings could suggest that neck dysfunction may be a comorbid or contributing factor to your headaches.

In fact, it has been shown in research that up to 84% of persons with sinus headaches have neck pain (Peterson et al 2019)

The diagnosis of sinus headaches whether by a physician or self-diagnosis, is often given to people who actually have migraine or tension-type headaches.  This is due do symptoms that appear rhinosinusitis-related such as facial pain and pressure can also be reported by patients with tension-type headache.  We see many times that people who have sinus headaches actually do have neck pain with a temporal relationship between the two.

Some of us may not recognize the neck as a possible cause or contributing factor to headaches.  There are ways to determine if the neck is involved other than simply feeling “pain” in the neck.  For persons with “sinus headaches” who also have impaired neck function demonstrate: 

  1. Less neck flexor muscle endurance

  2. Less ROM in the sagittal and transverse planes

  3. Greater frequency of painful segmental dysfunction in the upper cervical region.

Here is a video showing you where you SHOULD feel exercises to strengthen the neck and just as important, where you should NOT feel exercises!

We show you ways that you can determine if there are neck (cervical) joint, movement and muscle dysfunction on your own.  We do this through our “Feel it to Heal it Physio Approach” —- one that can determine if certain areas are moving like they should, which translates to a “feeling” to the person! 

Research has shown several factors specific to someone who has sinus headaches with neck dysfunction and the pictures below indicate if you are feeling movement like you should.  You would just need a skilled clinician to determine if you have painful and limited segmental dysfunction in the upper cervical spine. 

  • Less neck flexor muscle endurance

deep cervical flexor strength
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  • Less ROM in the sagittal and transverse planes

Cervical Extension Range of Motion - Normal is 70 degrees

Cervical Extension Range of Motion - Normal is 70 degrees

Cervical Flexion Range of Motion - Normal is 80 to 90 degrees

Cervical Flexion Range of Motion - Normal is 80 to 90 degrees

Cervical Spine Rotation - Normal is up to 90 degrees each direction

Cervical Spine Rotation - Normal is up to 90 degrees each direction

Cervical Spine Rotation Range of Motion - Normal is up to 90 degrees both directions

Cervical Spine Rotation Range of Motion - Normal is up to 90 degrees both directions

Headaches can be a challenge to diagnose and treat.  What is shown in this blog is just a glimpse of what can be assessed by a physical therapist to determine how or whether any pain from the neck dysfunction is contributing to sinus headache pain.  

If you are currently being treated for sinus headaches but not getting the relief you need, additional treatment might include treatment of the neck if it is determined the neck is a contributing factor to the headaches.  Feel free to contact us to see if we can help you.