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Sinus pressure or pain? It may not be a sinus infection.


I recently had the opportunity to spend time in an ENT or ear, nose and throat specialist's clinic. The client we saw together was someone with sinus pressure as well as headaches and dizziness. Reviewing the MRI the sinuses were clear. No signs of infection with open spaces. This helped in the diagnosis and prevented unnecessary antibiotic treatment that would not have helped. Testing the upper neck showed a reproduction of headaches as well as pain referral into the face and sinus area.


Can you have sinus pain and normal sinuses?


Here is an example of two cone beam CT's of two different patients with sinus pain. The one on the left had sinus pain and pressure but the cone beam CT showed normal maxillary sinuses.

The image on the right had the same symptoms but the left maxillary sinus is completely filled and there is a suspected sinus cyst or mucocele present in the right maxillary sinus.


These cases will be treated much differently.




The patient on the left was treated with manual therapy, or hands on treatment of the neck joints and muscles, and his symptoms improved. We avoided antibiotics because our evaluation was clear that the sinus pain was not because of an infection.


The patient on the right was referred to an ENT specialist for further evaluation.


A cone beam CT scan gives us a lot of information. It is an amazing resource to clear the sinuses when an infection is suspected or to refer to a specialist. Specialists take time to get an appointment, they can be expensive, and without imaging the diagnosis of a sinus infection is less sure.


Sinus infection? Get a cone beam CT scan


This can be ordered by your physician, dentist or through Cornerstone Physical Therapy.






  • You have continued sinus pain and have tried different antibiotics but your sinus pain does not get better.


  • You have headaches and may even have eye pain.


  • Your jaw is tense and you have jaw sounds with opening and closing.


You may need to have a clinical evaluation by a specialist at Cornerstone. They can decide if a Cone Beam CT is right for you. You can call 719-596-5000 or email us at with any questions or to book an evaluation.




Sinus pressure or pain? It may not be a sinus infection.