Pressure in Sinus But No Congestion: Causes and Treatments

Many patients with sinus pressure or sinus pain are misdiagnosed as to its cause. This occurs when there are no symptoms of congestion, an unusual circumstance. Yet there are still many possible causes to consider if you experience sinus pressure without congestion.


If you experience sinus pressure without congestion, consider the following conditions:

  • Do you have a deviated septum?

This deformity can affect breathing and mucus discharge. The septum, which is the central wall of the nose cavity, is somewhat slanted. Facial injuries and growth abnormalities can cause this deviation. Sinus pain is one of the most common symptoms.

  • Do you have nasal polyps?

Polyps are growths that vary in size. The bigger it gets, the more painful it becomes. If present, polyps can cause sinus pressure without congestion. If it is big enough, it can cause discomfort to the eye region.

  • Do you have an allergy?

Sinus pressure without congestion can result from hypersensitivity to something. A food allergy is the most common form. The allergic response induces a series of reactions that leads to swelling of the sinus and other parts of the nasal cavity.

  • Do you have sinusitis?

Surprisingly, not all cases of sinusitis are accompanied with congestion. This is a very common condition that can also lead to discomfort of the eyes, forehead, ears, or the head in general due to a buildup of pressure from inflamed sinuses.

  • Do you have a hormonal imbalance?

Women may experience swelling of their nasal passages simply because of hormonal shifts. During pregnancy and menstruation, certain hormones suddenly drop or rise and may lead to sinus pressure and discomfort. The good news is, the symptoms disappear after giving birth or at the end of the menstrual cycle.

  • Do you have TMJ?

TMJ is commonly caused bruxism (unconscious teeth grinding usually when at sleep), physical trauma to the jaw or nasal cavity, and even excessive gum chewing. Tinnitus and headache may accompany the sinus pain.


Most symptoms of sinus pain and pressure are usually treated initially with analgesics to relieve pain, corticosteroids to reduce inflammation, and if needed, antibiotics to fight any offending bacteria and decongestants to relieve decongestion. Otherwise, the doctor will treat the patient based on perceived cause; if the doctor suspects an allergy, then an antihistamine will be prescribed.

Some cases of sinus pressure without congestion may require alternative treatment options depending on cause. Nasal septum deviation has to be corrected by performing sinus surgery. Steroid sprays are used to limit the growth of nasal polyps, although surgery might be required if pharmacologic means aren't successful. For TMJ, pain relievers and tricyclic antidepressants are used to address acute to chronic symptoms, while surgery is only used as a last resort if other options have been exhausted.

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