Dr. Denis Grillo, Ear, Nose & Throat, 07/24/12

As an otolaryngologist (ear, nose and throat doctor), many people come to my practice with questions about their headaches.

In many instances, they have seen lots of other physicians, taken lots of pills and they come to the conclusion that sinuses could be causing their headaches.

In many instances, they are right. It is the sinuses, but also something that is overlooked is an allergic headache. Just like a sinus headache, an allergy headache can cause nasal pain or sinus pressure.

Some experts think allergy headache is even more common and frequent than sinus headache. Headaches in the forehead area accompanied by pain in the eye or temple often signal an allergic nasal condition and headache.

Other conditions besides sinus and allergy can include deviation of the septum, which is a twisting of the nasal bone that separates the left and right side such that it stops normal air flow, and also generalized swelling of the nasal lining and its structures can also cause headaches.

Migraine headache is also confused with allergic nasal headaches. The confusion lies in that people are convinced that pressure or weather changes trigger the headache to start, and because of the nasal stuffiness that sometimes is associated with it, it can be confused for nasal sinus problems. But migraine sufferers have involuntary nervous system problems that will trigger those events, and it may not be allergy or sinus at all.

Migraines are typically distinct in that they last hours to days. They are one-sided. They are pulsating. The pain is intense, worsened by physical activity or exercise, and can be associated with nausea, vomiting and light and/or sound intolerance.

There is also a possibility you could have a headache that is allergic and migraine.

There is a significant percentage of people who suffer with both, and the exact reason is not clear.

One of the suspect causes is a product your body makes called histamine that is involved in allergic reactions and causes some tissue changes that could be also the first step to a migraine headache.

The use of antihistamines, both over-the-counter and prescription, work well for allergic type headaches and believe it or not, some migraine head­ache sufferers also get relief with an antihistamine.

So, you can see why it is still quite confusing for researchers and scientists and so there is constant research going on, trying to decipher these problems so as to create better treatment.

So, what we know for sure is allergies can cause headaches, and the exact cause and relationship between allergic rhinitis and headaches is not clear, but is being explored.

So, if you do suffer from headaches that you think is related to your nose, sinuses or allergies, talk to your doctor. If simple antihistamine therapy works well for you, you can continue to utilize that just as long as it does not become an everyday problem.

If your headaches are protracted, you might need to see your general practitioner or neurologist and determine if you’re not having a migraine-type problem.

Denis Grillo, D.O., FOCOO, is an ear, nose and throat specialist in Crystal River. Call him at 352-795-0011 or visit CrystalCommunityENT.com.