Chronic And Acute Sinusitis

Sinusitis is a condition resulting from inflammation of the paranasal sinuses. This may be a result of infection from one of the following issues:
Bacterial
Fungal
Viral
Allergic
Impaired immune system
The newest classification of sinusitis refers to it as rhinosinusitis (rhinology is the medical specialty that deals with the nose and its diseases). The logic behind this choice is that inflammation of the sinuses cannot occur without some inflammation of the nose as well.

Differences Between Chronic and Acute Sinusitis

If you suffer from a quickly occurring and short but acute sinus infection lasting anywhere up to eight weeks, then that is probably an acute attack. Chronic sinusitis on the other hand usually recurs and is a long lasting condition. So any attack over eight weeks duration or repeat attacks would be classified as chronic sinusitis.  That said, the symptoms of the chronic condition are usually less severe than those of acute sinusitis, but it may lead to complications requiring prolonged treatment and sometimes surgery. An attack which lasts up to  12 weeks but just a one off will more likely than not be classified as subacute.

Chronic Sinus Headache

Whereas a person suffering from acute sinusitis is almost guaranteed a sinus headache, this is not the case with chronic sinusitis. In other words, a chronic sufferer will occasionally develop a chronic sinus headache due to internal pressure, however this is not a recognized characteristic of the disease. Sinus headache symptoms, which include facial discomfort and a dull, aching pain over the infected sinus, are common to both acute and chronic sinus infections.
The pain is nearly always localized over the infected sinus and often starts on one side and spreads over to the other. In addition, it is usually accompanied by a thick, yellow/green purulent nasal discharge, together with a hacking cough and a sore throat. The headache typically intensifies when the patient bends forward or lies down. If one or both of the maxillary sinuses are infected, a dull, achy toothache in the upper jaw is common.
Migraine misdiagnosis
It is difficult to tell the difference between sinus related headaches, pressure headaches and migraine headaches because many of their symptoms overlap. In fact, recent studies show that approximately 90% of so called “sinus headaches” turn out to be migraines. Migraine headache symptoms mimic sinus headaches because:
With a migraine, the trigeminal nerve innervates both the sinuses and the meninges surrounding the brain. This makes it almost impossible to isolate the origins of the pain.
A migraine often triggers nasal congestion
Autonomic nerve stimulation causes a runny nose and watery eyes

How to Tell the Difference

Whereas a migraine headache will respond to triptan medication, decongestants and antibiotics only serve to intensify the pain… and vice versa.
Sinus headaches do not display “auras” or visionary disturbances, which are common in migraines.
Unlike migraines, there is no sensitivity to bright light and loud noises with a chronic sinus headache.

A migraine lasts for a day or two, whereas a sinus headache can drag on for a week or more
A migraine typically produces a throbbing headache as opposed to the dull, constant pain experienced with a sinus headache
Without specialized medical training. it is extremely difficult to accurately diagnose the different classes of headache. Do not attempt to diagnose your own symptoms… it is unwise to treat yourself without consulting a physician. Dosing yourself with the wrong medication will only serve to intensify your headache.