Cures for your aching head

There are many potential etiologies for headaches. The three most common types of headache are tension headaches, migraine headaches, and sinus headaches.

Tension headaches are obviously caused by tension and stress. These are the most common type of headache and are typically well treated with nonsteroidal anti-inflammatory medications such as ibuprofen. Reducing stress as well as relaxation techniques and massage will also help.

Migraine headaches are not quite as common as tension headaches, but are often times considered to be more severe. Patients will often describe unilateral headaches with nausea and light sensitivity. Over-the-counter medications will typically include caffeine to help alleviate these vascular based headaches. Patients with severe migraines may end up on stronger medications through their physician.

Sinus headaches will cause sinus pressure most commonly in the sinuses above or below the eyes, but may affect any sinus. Patients will typically note increased symptoms with congestion, allergies, and barometric changes. Allergy treatments and decongestants are the mainstay of medical therapy.

Two less known treatment options for headaches that are becoming much more popular include Botox and balloon sinus dilation.

Botox injections help to decrease muscular tension in certain areas. Botox has been successful in tension headache treatment, but many patients with migraine headaches also obtain benefit. This simple treatment can be performed in the clinic in five minutes and if benefits are obtained, they typically last for four months.

Balloon Sinuplasty is a new innovative sinus treatment technique to improve sinus drainage. Many patients with both tension and migraine headaches will have sinus pressure as their headache triggers. By using a small balloon to dilate the natural sinus drainage pathways in a simple clinic procedure, sinus pressure can be alleviated. This alleviates sinus pressure headaches and any secondary headaches that patients may have that are related to the sinus triggers. Studies have shown excellent long-term results in resolution of patient’s sinus complaints as well as sinus related headaches.

Zachary Wassmuth, MD

Why am I so Congested?

Many people suffer from chronic nasal congestion. One of the main contributors to nasal congestion is the inferior turbinate. The inferior turbinate is a vascular structure in the nose that swells from allergies or irritation. The inferior turbinate can also be chronically enlarged without an identifiable cause.

Patients that have allergies are treated with allergy medications or allergy shots in an effort to decrease their reactivity to allergens. One of the main tissues that benefits from this treatment is the inferior turbinate. Unfortunately, some patients with allergies continue to have nasal congestion or nasal obstruction despite appropriate treatments.

Many people also take oral decongestants or topical nasal decongestants such as phenylephrine and oxymetazoline.  These medications directly shrink the blood vessels of the nose decreasing the nasal congestion. Unfortunately, these medicines are not intended to be long-term treatments and can have significant side effects.

A very effective treatment that many patients do not know about is a simple procedure called inferior turbinate reduction. The inferior turbinate reduction is performed under local anesthesia in the clinic and takes about five minutes. The inferior turbinate vasculature is directly reduced with a special instrument. By directly reducing the size and vasculature of the inferior turbinate, turbinate enlargement from any etiology is significantly reduced and symptoms of nasal congestion are therefore significantly reduced as well.    Patient satisfaction rate is well over 90%.

Although inferior turbinate reduction does not cure allergies, it will most times resolve the nasal congestion symptoms that most allergy patients experience.

A simple physical exam will help the physician determine whether you are a candidate for clinic turbinate reduction and a lifetime of improved breathing.

Zachary Wassmuth, MD

Why is my nose plugged?

Nasal congestion is one of the most common medical complaints, especially in Austin. There are quite a few things that will plug up a nose, but with a little knowledge, you can usually narrow down the possibilities.

The first thing to consider is how often you experience the problem. If your nose is always blocked, then you probably have a structural problem. These include deviated septum, polyps, tumors and enlarged turbinates (these are the humidifiers in your nose). If you can breathe normally through your nose at times without using nasal decongestant spray, you probably have an inflammatory problem. Something is causing the lining of your nose to swell, plugging your breathing passages.

Inflammatory conditions include allergies, sinus infections, non-allergic rhinitis and rare diseases. Allergies are usually associated with sneezing, watery/itchy eyes, post-nasal drainage, fatigue and clear nasal discharge. Sinus infections can be acute (sudden) or chronic (long-lasting). The acute version causes discolored nasal discharge, facial pressure/headache, loss of smell, post-nasal drainage and sometimes fever. Chronic infections are harder to diagnose because patients often get used to the symptoms. They usually cause post-nasal drainage, bad breath, facial pressure and headaches.

Every type of nasal blockage has a potential solution. Once a diagnosis is made, treatment can begin and you can begin to breathe once again.

Dr. Christopher Thompson is board-certified in Otolaryngology with a subspecialty in sleep medicine.