This happens due to the connections between the nerves in your sinus and the area in your brainstem that is the “doorway” for all headache conditions.
The lining of the sinus has a nerve supply from the maxillary nerve, a branch of the Trigeminal nerve. The Trigemeinal nerve “terminates” in the brainstem in the upper part of the neck (C1-3).
The maxillary nerve has (obviously) a close relationship with other branches of the trigeminal nerve, such as the opthalmic nerve (pathway for pain “behind” or “around” the eye), the mandibular nerve, possibly involving facial pain and jaw ache, but also the spinal nerves C1-3 which provide pain feedback around the base of the skull and to the apex of the head.
If you look at this dermatome chart the V1-3 all over the front of the face is Trigeminal nerve (Cranial nerve V).
This anatomical connection not only explains why your sinus can give you referred pain to your head, but also why your neck can give you headache and migraine.
As an interesting side note, I have suffered chronic sinus for years and up until a few years ago was on the verge of having holes drilled in it until my neck was examined during a headache course. Pressure on C2 reproduced my typical sinus “throb” or “swollen” type feeling I get when they are bad.
So this can work via all pathways.
With the number of people I see with chronic headache and migraine who also, just so happen to have chronic sinus problems……the evidence is too strong to ignore.
With appropriate treatment and regular stretching, not only have I avoided surgery, but I haven't required anitbiotics which I usually had twice a year.
Hope this is useful.
Director - Melbourne Headache Centre
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