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   I respond to questions in the order I receive them, 

usually within 1-3 business days.  My responses are for

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advice for specific medical treatment or diagnosis

.   For appointments, please call my office at: (757) 631-9799.  

     Your email address or other information is confidential; I will never share it with anyone, nor will it be used for any form of solicitation.   I look forward to your questions! 

​Donald K. Liebell, DC, BCAO

477 Viking Drive Suite 170

Virginia Beach VA 23452 
8:30AM - 6:30PM M,W,F 

(By Appointment Tu, Sat) 


The Liebell Clinic: Chronic Pain & Wellness Solutions

Natural & holistic, whole-person, wellness-based Healthcare - Drug-Free & Non-Surgical Pain Relief


 Medical Journal Paper

Sinus Headaches: 
Avoiding Over-and


"Contrary to popular belief, sinus headaches are uncommon...

The International Headache Society classification is robust in qualifying the term sinus headache and says that "chronic sinusitis  is not validated as a cause of headache and facial pain unless relapsing into an acute stage...

The vast majority of people who present with a symmetrical frontal or temporal headache, sometimes with an occipital component, have tension-type headache... When these patients are asked to attend a clinic when they are symptomatic, the vast majority are found not to have a sinus infection. 

Sinusitis rarely causes headache, let alone facial pain,

except when there is an acute bacterial infection when

the sinus in question cannot drain, and it is usually

unilateral due to increased pressure and inflammation

caused by pus trapped within the sinus cavity… 

Headaches are rarely due to sinusitis."

Expert Review of Neurotherapeutics. 2009 
"Sinus headaches: avoiding over- and mis-diagnosis"

Dr. N.S. Jones   
Department of Otorhinolaryngology, 
Head and Neck Surgery, University of Nottingham, UK.  

"Sinusitis is over-diagnosed as a cause of headache because of the belief that pain over the sinuses must be related to the sinuses. In fact, frontal head pain more

often is caused by migraine and

tension-type headache."

Journal: Neurology Clinics 2004 
Headaches due to nasal and paranasal sinus disease 
- Dr. S.D. Silberstein - Thomas Jefferson University Hospital, Jefferson Headache Center, Philadelphia, PA  

Sinus Headache is NOT a 
Medically-Recognized Diagnosis!

Sinus headache is not a recognized entity by allergy, otolaryngology, or neurological organizations. Headache

is a minor feature in the diagnosis of acute rhinosinusitis

and is not validated as a symptom in chronic sinusitis. 

Sinus headaches are self-diagnosed due to weather triggers, bilateral and frontomaxillary location, and the presence

of vasomotor signs and symptoms, all of which can

accompany the migraine. 

Over 90% of self-diagnosed and doctor-diagnosed

sinus headaches meet the International Headache Society criteria for migraines… Sinus headaches are usually

severely disabling migraines, misdiagnosed and mistreated, with 61% of patients receiving antibiotic prescriptions for noninfectious causes, thus failing the patients and, in addition, contributing to a serious public health problem.

Allergy Asthma Proceedings . 2004 
New thoughts on sinus headache.  
Dr. S.J. Tepper, New England Center

for Headache, Stamford, CT

Suffer Sinus Headaches? 
Your Sinuses May NOT

Actually Be the Problem!

   By Dr. Donald Liebell

   The pain across your forehead, nose, and cheekbones are driving you mad.  It’s even worse if you bend forward.  You’re all plugged up, and maybe your eyes get red and puffy too.  You’ve tried all kinds of sinus medications—both prescription and over-the-counter for this ongoing misery… but nothing seems to really make a difference.

                                                               And there’s a really good reason why…

                                                               You probably don’t have a true sinus headache!

                                                               That’s right.  Most of the time the apparent sinus                                                                      headaches are actually misdiagnosed migraine or                                                                      tension headaches.  You (or even your doctors) may                                                                  feel certain that it’s your sinuses.  After all, changes                                                                  in the weather make it worse… and sinus medications                                                                help to some degree.  Plus, you have congestion or                                                                    some allergies.   It “must be” the sinuses.

   In reality, true sinus headaches are quite rare.  Sure, you may have pain around your sinuses… but odds are these symptoms are not directly caused by congestion or infection in your sinuses.  They are the result of irritation to the trigeminal nerve that originates in your brain.  The nerve can send pain signals to your face and sinus areas, as well as your head.  Inflammation to the trigeminal nerve can result in a wide variety of pain patterns.  It is involved in headaches stemming from various causes. 

   Misinformation and Misdiagnosis?

   Millions of Americans suffer apparent sinus headaches costing billions of dollars each year in medical care.  But a study presented at a conference for the Annual Scientific Meeting of the American Headache Society revealed that around 90 percent of people suffering “sinus headache” symptoms actually had migraines.  Not all migraines are accompanied by nausea or vomiting, plus not all migraines are severe headaches.

   True sinus headaches are those that are the result of a sinus infection—swelling in the sinuses, which are small air spaces in your skull, behind your cheeks, eyes, and nose, which become blocked from due to excessive mucous, due to infection from viruses, fungi, or bacteria.  This creates a pressure buildup inside the sinuses. 

   True sinus headaches—those due to sinus infection, are typically accompanied by fever, green or yellow discharge from the nose, and swollen lymph nodes.  Odds are, if you do not have these symptoms in addition to your headaches, you probably don’t have a sinus headache.  Consider the headaches you may have when you have a cold.  The cold eventually gets better, and any associated headaches go away.

What about my allergies?  Don’t they cause sinus headaches?

   Sure, you can have sinus congestion from allergies.  And that could cause some headache.  However, unless the underlying causes are addressed; treatment will not be effective, nor will it ever be preventative.  There may be several separate problems that combine together, with overlapping symptoms.  Airborne allergies rarely are the direct cause of headaches.

   Part of the confusion comes from the fact that some people receive temporary relief benefit from a variety of medications including those geared towards allergy, sinus, migraine, or tension headaches. 

“But what if I actually DO get lots of Sinus Infections… with headaches?”

   It is essential that the causes of true sinus headaches are addressed. 

   But how often are they?    If you get frequent sinus infections,

or you’ve been diagnosed with chronic sinusitis… and you’ve had many

rounds of antibiotics… your doctor may be barking up the wrong tree!

Why? It is quite likely that your sinus infections are not from bacteria… they could be from several types of FUNGUS!

   A 1999 Mayo Clinic study revealed that FUNGI were the cause of MOST chronic sinusitis!  Up until the time this study was released, the cause was unknown.  Yet, prescriptions for antibiotics—completely incapable of killing fungi have continued to be written by the millions… do, despite this medically published knowledge!

  The public has been given a raw deal regarding sinus headaches and sinusitis.  We have essentially been brainwashed by advertising from pharmaceutical companies to believe that pain in the front of the head is a sinus problem. 

   It usually is not.

   Both doctors and patients have been woefully confused about the differences and similarities of migraines and sinus headaches.  In the past, drug companies used to focus a lot of their efforts on convincing the public they had “sinus headaches” to sell their products.  Then, some fairly effective migraine medicines were developed… and they changed their tune, and have tried to con people into believing they have migraines!

   It’s no coincidence.  Either way, it is not advisable to let the pharmaceutical companies influence diagnosis of the cause your headaches or sinusitis.  The bigger problem goes far beyond whether or not the diagnosis of migraine or sinus headache is correct.  What about the treatment?

Conventional Medical Treatment for “Sinus Headaches”

   Whether it is headache or sinus pain (or both) that you’re suffering… it can be caused by many sources.  There are approximately 200 different medically classified types of headaches (described in my separate article. Considering this, it is mind-boggling how the treatment of headaches can be done in such a broad or generic manner.  The conventional medical approach is still the same: drugs, drugs, and more drugs.  Treatment is geared towards relieving symptoms—not correcting the causes.  This may include antibiotics for supposed infection, or antihistamines and decongestants, pain relievers, and steroids.

“Can Natural Treatment Methods Work as Well... or Better?”

   In my opinion, helping people is not a competition between natural treatment methods versus conventional pharmaceutical; it is a matter of correcting the causes… however it is accomplished.  If a drug can be safely utilized to eliminate a problem—because it addresses the causes… and it doesn’t need to be continued indefinitely… I’m all for it. 

   But how often is this the case?  

   Most patients I encounter have been taking both prescription and over-the-counter headache medications for years prior to consulting with me.  Clearly the causes of their alleged sinus headaches (or other diagnosed types) have not been addressed by the conventional pharmaceutical approach.

   My patients agree they are glad the treatment methods I use are safe and natural.  But that is not the main reason they have pursued my care.  They are most happy because treatment worked for them!  It is the results that count.  When your body naturally eliminates your headaches, and they stop coming on, or at least drastically reduce… it’s the real deal.

   I have spent over 20 years investigating the causes of headaches, and successfully treating patients.  In my I have developed a comprehensive, safe, natural, and effective approach, which does not involve any pharmaceutical medications at all.  The difference is that I do NOT the headache; I treat the PERSON—to correct various causes of the headaches, naturally.

-Dr. Donald Liebell