Deviated Septum and Headaches: Cause, Diagnosis & Treatment

In this complete guide we answer the question “Can a deviated septum cause headache?” (short answer: yes), and we also explain:

The connection between a deviated septum and headaches or migraines; and
Treatments for headaches caused by a deviated septum

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Can a Deviated Septum Cause Headaches (or Migraines)?

Can Fixing Deviated Septum Help Migraines (and Headaches)?

Alternative Remedies for Deviated Septum & Headaches?

Can a Deviated Septum Cause Headaches (or Migraines)?

Yes, the presence of deviated septum can cause headaches.

The deviated nasal septum may cause blockage of the sinus opening (which aids in the drainage of mucus). This could lead to the accumulation of mucus (a slimy substance produced by the inner lining of nose and sinus) and the built-up of pressure within the sinuses. An increase in pressure and reduced oxygen supply due to poor ventilation of the sinuses (hypoxia) causes headache and facial pain in the region of the affected sinuses.¹Low WK, Willatt DJ. Headaches associated with nasal obstruction due to deviated nasal septum. Headache. 1995;35(7):404-406.

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However, some patients with a deviated septum and no apparent nasal symptoms experience migraine-type headaches. This is also known as a contact point headache.

This occurs when the inner skin (mucosa) of structures present on the sidewall of the nose comes in contact with the deviated nasal septum. The mucosal contacts stimulate nerve receptors present on the nasal mucosa (inner skin of nose) and release chemicals (e.g., substance P) which transmit pain and cause migraine-like headache.²Kwon SH, Lee EJ, Yeo CD, et al. Is septal deviation associated with headache?: A nationwide 10-year follow-up cohort study. Medicine (Baltimore). 2020;99(20).

Can Fixing Deviated Septum Help Migraines (and Headaches)?

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Fixing deviated septum is considered one of the possible treatments to relieve headaches, but not a definitive treatment.

Headaches are usually caused by multiple factors. Research suggests that headaches can be classified into the following groups:

One where headaches are caused by sinus problems or infections
One where headaches are related to causes other than sinus such as seasonal allergies, migraine, nerve pain, or vascular problems
One where cause is unknown

It may be challenging for the otolaryngologist (ENT doctor) to identify the origin of headaches.

In cases where the cause is unknown, the headache could be related to contact point headaches. In such cases, correction of the deviated septum and that of the structural abnormalities on the sidewall of the nose is important. This helps avoid mucosal contacts and subsequent headache.³Tosun F, Gerek M, Ozkaptan Y. Nasal surgery for contact point headaches. Headache. 2000 Mar;40(3):237-240. DOI: 10.1046/j.1526-4610.2000.00034.x.

In cases with abnormalities related to nose and sinus, septoplasty (deviated septum surgery) is sufficient to relieve the symptoms of the sinus infection.⁴Bayiz U, Dursun E, Islam A, et al. Is septoplasty alone adequate for the treatment of chronic rhinosinusitis with septal deviation?. Am J Rhinol. 2005;19(6):612-616

Complete history taking, preoperative evaluations, multidisciplinary consultations, initial medical therapy, long observations, are essential steps for the correct diagnosis of the cause and better surgical outcomes.⁵Huang HH, Lee TJ, Huang CC, Chang PH, Huang SF. Non-sinusitis-related rhinogenous headache: a ten-year experience. Am J Otolaryngol. 2008;29(5):326-332.

Alternative Remedies for Deviated Septum & Headaches?

If your headaches are caused by a deviated septum, but you’re unable to get septoplasty surgery (also known as deviated septum surgery), here are some things you can do at home to help reduce your headaches:

Medical therapy

If the headache is caused by sinus infection, it may be treated medically with nasal decongestants and steroid sprays. In cases of allergic sources, antihistamines (or anti-allergics) can be prescribed. The doctor may also prescribe antibiotics. Medicines such as Triptan (serotonin) are known to lessen migraine-type headaches.⁶Evans, K. L. (1998). Recognition and Management of Sinusitis. Drugs, 56(1), 59–71.
Inhalation of steam twice daily helps in clearing mucus accumulation and moistens the dried nasal mucosa (inner lining).⁷Evans, K. L. (1998). Recognition and Management of Sinusitis. Drugs, 56(1), 59–71.
The use of saline (salt water) irrigation or flushing of nose helps in mucociliary clearance (draining of mucus embedded with foreign particles), which eases congestion.⁸Egan M, Hickner J. Saline irrigation spells relief for sinusitis sufferers. J Fam Pract. 2009;58(1):29-32

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Acupressure techniques may provide relief by massaging one or more acupressure points for 1-2 minutes.

Joining of valleys: Massaging the point in the space between the thumb and the index finger can reduce headache.⁹Hendrich, S., Kahanov, L., & Eberman, L. E. (2011). Acupressure for Tension Headache. International Journal of Athletic Therapy and Training, 16(3), 37–40.

Gates of consciousness: Massaging at the base of the skull above the nape of the neck

Temporal region: Massaging the center of the temporal region, or temple

Mind-Body Techniques

Biofeedback: This process allows patients to gain greater awareness and control over their body by using electronic or other instruments, with the goal of being able to manipulate all the body's systems at will.The patient is asked to control bodily processes that are involuntary, such as muscle tension, blood pressure, or heart rate by observing these metrics. This allows many patients to reduce their stress levels, resulting in fewer headaches.¹⁰Mauskop, A. (2001). ALTERNATIVE THERAPIES IN HEADACHE. Medical Clinics of North America, 85(4), 1077–1084.

Yoga: Yoga is another form of mind-body therapy. This includes physical exercise with breathing and relaxation. This may help individuals to deal with the emotional aspects of chronic pain.¹¹John PJ, Sharma N, Sharma CM, Kankane A. Effectiveness of yoga therapy in the treatment of migraine without aura: a randomized controlled trial. Headache. 2007;47(5):654-661. You can learn more from the video below.

Regular and frequent aerobic and neck stretching exercises can help decrease headaches.¹²Mauskop, A. (2001). ALTERNATIVE THERAPIES IN HEADACHE. Medical Clinics of North America, 85(4), 1077–1084.

Dietary approaches

Skipping meals and intake of some food additives and sugar substitutes may induce headaches. In those cases, a more regular and balanced diet is likely to help¹³Mauskop, A. (2001). ALTERNATIVE THERAPIES IN HEADACHE. Medical Clinics of North America, 85(4), 1077–1084.
Research suggests that reduced magnesium levels in the body can aggravate headaches. So, the inclusion of a magnesium-rich foods (Black-eyed peas, soy nuts, cooked beans, tofu, almonds, cashews, flaxseed) can help. Riboflavin or vitamin B2 (found in milk, cheese, eggs, leaf vegetables, liver, kidneys, lean meats, and legumes) are also effective in relieving headaches¹⁴Mauskop, A. (2001). ALTERNATIVE THERAPIES IN HEADACHE. Medical Clinics of North America, 85(4), 1077–1084.
Not drinking enough water is a well-known migraine and headache trigger, and it is advisable to increase the frequency of your water intake¹⁵Mauskop, A. (2001). ALTERNATIVE THERAPIES IN HEADACHE. Medical Clinics of North America, 85(4), 1077–1084.

Herbal approaches

Intake of herbs such as Feverfew (Tanaceturn parthenium), Butterbur root (Petasites hybridus), Guarana (Paullinia cupana) and Ginger (Zingiber oficinale), Gingko (Gingko biloba), and Valerian root (Valeriana oficinalis) may help some patients with headaches¹⁶Mauskop, A. (2001). ALTERNATIVE THERAPIES IN HEADACHE. Medical Clinics of North America, 85(4), 1077–1084.
External application of peppermint extract and eucalyptus have relaxing effects. Aroma of lavender oil and clove can also help reduce headache¹⁷Mauskop, A. (2001). ALTERNATIVE THERAPIES IN HEADACHE. Medical Clinics of North America, 85(4), 1077–1084.

Sources:

1
Low WK, Willatt DJ. Headaches associated with nasal obstruction due to deviated nasal septum. Headache. 1995;35(7):404-406.
2
Kwon SH, Lee EJ, Yeo CD, et al. Is septal deviation associated with headache?: A nationwide 10-year follow-up cohort study. Medicine (Baltimore). 2020;99(20).
3
Tosun F, Gerek M, Ozkaptan Y. Nasal surgery for contact point headaches. Headache. 2000 Mar;40(3):237-240. DOI: 10.1046/j.1526-4610.2000.00034.x.
4
Bayiz U, Dursun E, Islam A, et al. Is septoplasty alone adequate for the treatment of chronic rhinosinusitis with septal deviation?. Am J Rhinol. 2005;19(6):612-616.
5
Huang HH, Lee TJ, Huang CC, Chang PH, Huang SF. Non-sinusitis-related rhinogenous headache: a ten-year experience. Am J Otolaryngol. 2008;29(5):326-332.
6
Evans, K. L. (1998). Recognition and Management of Sinusitis. Drugs, 56(1), 59–71.
7
Egan M, Hickner J. Saline irrigation spells relief for sinusitis sufferers. J Fam Pract. 2009;58(1):29-32
8
Hendrich, S., Kahanov, L., & Eberman, L. E. (2011). Acupressure for Tension Headache. International Journal of Athletic Therapy and Training, 16(3), 37–40.
9
Mauskop, A. (2001). ALTERNATIVE THERAPIES IN HEADACHE. Medical Clinics of North America, 85(4), 1077–1084.
10
John PJ, Sharma N, Sharma CM, Kankane A. Effectiveness of yoga therapy in the treatment of migraine without aura: a randomized controlled trial. Headache. 2007;47(5):654-661.