*3.4.1 Exercise*

*Sino-Nasal and Olfactory System Disorders*

**3.1 Prevalence, causes and risk factors**

**3.2 Symptoms**

and teeth [49].

**3.3 Diagnosis**

tests include:

*3.3.1 CT-scan*

radio waves.

Headache is a symptom produced by the nervous system in response to disturbance or any threat. Hence it is the physiologically protective symptom of nervous system. About 90% are the life time incidents of the headache [44]. Headache may be primary or secondary as well, depending upon the underlying cause of the pain. When no definite pathological cause is identified then the headache is considered as **primary headache syndrome**. The most common primary headache disorders are migraine, tension type headache, cluster headache and probable migraine. When the cause of headache can be definable under pathological conditions, this type of headache is known as **secondary headache.** Causes of secondary headache include neoplastic, immunologic, metabolic, infectious, traumatic, inflammatory, endocrinologic and sinusitis [45]. Patients visited to the otolaryngologist because of their chronic headache, it is difficult to diagnose depending on the patients' presentation whether the headache is because of sinusitis or may be the other reason. Endoscopic techniques have been well developed for the diagnosis of underlying diseases and their associated symptoms. Sinus headaches are headache in which individual may feel pain and pressure around his eyes, cheeks and forehead. Due to differential diagnosis sometimes migraine and tension headaches may mistakenly consider as sinus headache [46, 47].

Sinus headaches are mostly associated with other chronic secondary headaches. It may cause pain and pressure around facial area and in sinuses and progress the sino nasal disorders. Sinus headaches are not related with the sinus infections therefore they should not be treated with antibiotics. Sinus headaches may affect any individual but they are more prone to those patients who have family history or even previous history of migraine or primary headache disorders. It also affects those patients who have sinusitis and they also suffered with headaches related with hormonal changes [48].

Symptoms of sinus headache exclusive of causes may include pressure, pain and tension around eyes cheeks and forehead, stuffy filled nose, fatigue, fever, pain may worsen upon bending forward or even lie down and pain sensations in upper jaw

Headache is pathological disorder of nervous system and it is difficult to diagnose the exact cause of headache. After physical examination medical practitioner may perform imaging diagnostic test to find out the real cause of headache. Imaging

Cross sectional images of brain, spinal cord and sinuses are obtained by X-ray

Cross sectional images of the brain and sinuses are made with magnetic field and

which rotates around the body and displayed on the computer.

*3.3.2 Magnetic resonance imaging (MRI)*

**3. Sinus headache**

**34**

Regular aerobic exercise helps in reduction of tension and prevention of headache. Aerobic exercises include swimming, cycling and walking. Before starting intense exercise one should warm up his body because sudden exercise also initiate headache. One of the causes of headache is obesity, in that case obese patients need to exercise daily in order to reduce headache [51].
