How to distinguish between sinusitis and other possible causes for long-lasting pain in between the eyebrows?

Doctor's Answers (1)

Thank you for your enquiry. There are many causes of facial pain. However, some possible causes of pain in between the eyebrows include:

Sinus headache

Sinuses are air-filled hollow spaces that surround the nasal cavity. The four major pair of sinuses are:

  1. Maxillary sinus (below your eyes)
  2. Frontal sinus (above your eyes)
  3. Ethmoid sinus (in between your eyes)
  4. Sphenoid sinus (behind your eyes)

The lining of your sinuses produces mucous that drains into the nasal cavity. When the drainage pathway of the sinuses is blocked, you can experience pressure in these sinuses. Hence, sinus headaches are often felt in the forehead region, in between the eyes, in the cheek area and at the top/back of your head. Most of the time if you have a sinus headache, you may also experience nasal blockage, coloured or thick mucous from your nose or in your phlegm, reduced or loss of sense of smell and postnasal drip (mucous flowing from the back of your nose down to your throat).

Primary headache

The common primary headaches include tension headache (band-like or pressure like feeling around the head), migraine (usually one-sided throbbing headache which may be associated with nausea and vomiting), and cluster headache (pain in and around the eye region). 

Trigeminal neuralgia

This refers to nerve pain in the face region caused by impairment of the trigeminal nerve. The reason for the nerve pain is often unknown but sometimes an MRI may show a nearby blood vessel that may be pressing on the nerve.

I would suggest that you visit an ENT specialist for an assessment. A nasoendoscopy and possibly CT/MRI scan may be required to ascertain a diagnosis. If the cause of your pain is unlikely to be sinugenic, your ENT specialist may refer you to a neurologist (brain specialist) for further assessment. Hope this helps and all the best!

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