Guide to Contact Point Headache What It
Discover what a contact point headache is, how nasal contact triggers debilitating pain, and the diagnostic and treatment options that offer lasting relief.
Written by Dr. Rohinipriyanka Pondugula
Reviewed by Dr. Vasanthasree Nair MBBS
Last updated on 21st Sep, 2025
Introduction
Do you suffer from a persistent, one-sided headache that feels like it's centred behind your eye or cheek? You might have tried every over-the-counter migraine pill and sinus medication, only to find temporary or no relief. The culprit could be hiding right inside your nose. This isn't a typical sinus infection or a migraine; it could be a contact point headache, a unique and often misdiagnosed condition where a simple, subtle touch within your nasal passage triggers a cascade of debilitating pain. This guide will walk you through everything you need to know—from what causes this pain and how to recognise it, to the definitive diagnostic tests and effective treatment paths that can finally offer you lasting relief.
What Exactly is a Contact Point Headache?
A contact point headache is a type of secondary headache, meaning the pain is directly caused by an underlying physical issue—in this case, inside the nasal cavity. It occurs when two opposing surfaces of the nasal mucosa (the soft tissue lining the nose) make contact and put pressure on each other. This constant, light touch irritates the incredibly sensitive nerves in the area, leading to referred pain that you feel as a headache or facial pain.
The Simple Explanation: When Your Nose Gives You a Headache
Think of it like a pebble in your shoe. The pebble itself is tiny, but the constant rubbing against your skin creates a blister and significant pain that affects your entire ability to walk. Similarly, a tiny septal spur or a slightly enlarged turbinate (structures inside your nose) can act like that pebble. The gentle, persistent contact doesn't hurt the nose itself in an obvious way, but it aggravates nerves that signal pain to your brain, which interprets it as a headache.
The Medical Definition: A Secondary Headache Disorder
The International Classification of Headache Disorders (ICHD-3) recognises this condition under "11.5.1 Headache attributed to disorder of the nose." The diagnosis is confirmed when the pain is caused by contact between opposing nasal mucosal surfaces, is felt in the same area as the contact point, and resolves completely after successful application of a local anaesthetic to the site or following surgical correction.
The Anatomy Behind the Pain: Your Nose's "Headache Cockpit"
To understand this headache, you need a quick lesson in nasal anatomy. Your nose isn't just an empty tunnel; it's
divided by a septum (a wall of cartilage and bone) and has bony, shelf-like structures on the sides called turbinates, which are covered in mucosa.
Common Culprits: Septal Spurs and Turbinate Hypertrophy
The most common causes of these painful contact points are:
- Septal Deviation or Spurs: A crooked septum (deviated) or a small, bony outgrowth on the septum (spur) can bend into the nasal passageway.
- Turbinate Hypertrophy: The turbinates, especially the middle turbinate, can become enlarged due to allergies, chronic inflammation, or environmental irritants.
When a deviated septum or spur presses against an enlarged turbinate, it creates the perfect conditions for a contact point headache.
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How Light Contact Triggers a Major Pain Response
The area where these structures often touch—typically the anterior ethmoid region—is so rich with nerves that it's often called the "headache cockpit." The trigeminal nerve, which provides sensation to your face, is stimulated by this contact. This triggers a neurogenic inflammatory response and activates the parasympathetic nervous system, leading to the classic symptoms of pain, watery eyes, and a runny nose—all on the same side as the contact.
Recognising the Signs: Symptoms of a Contact Point Headache
While symptoms can vary, they often follow a distinct pattern that helps differentiate them from other headache types.
Unilateral Pain: The One-Sided Headache
The hallmark sign is pain that is almost always one-sided. Patients typically point to a specific spot:
- Behind or around the eye (retro-orbital pain)
- In the cheekbone or maxillary area
- In the forehead or brow region
The pain is often described as a deep, dull, pressure-like ache that can sometimes become sharp or throbbing.
Beyond the Pain: Associated Nasal Symptoms
Crucially, the headache is often accompanied by ipsilateral (same-side) nasal symptoms, which is a key clue for doctors:
- A sense of nasal obstruction or congestion on the painful side.
- A runny nose (rhinorrhoea) or post-nasal drip.
- Watering of the eye on the affected side.
Importantly, these symptoms are not caused by a sinus infection, so you typically won't have discoloured mucus or a fever.
How is a Contact Point Headache Diagnosed?
Proper diagnosis is critical, as mistaking this for a migraine or sinusitis can lead to years of ineffective treatment. If your symptoms suggest a rhinogenic headache, an ENT specialist will follow a specific process.
The Crucial Role of the Nasal Endoscopy
The first step is a nasal endoscopy. A thin, flexible tube with a light and camera is inserted into the nose. This allows the doctor to visually identify any anatomical abnormalities, inflammation, and—most importantly—see if there is actual mucosal contact between structures. They can pinpoint the exact "headache cockpit."
The Diagnostic Anaesthetic Test: The Key to Confirmation
The definitive diagnostic test is the application of a topical anaesthetic (like lidocaine) directly to the identified contact point. If the application completely resolves your headache within a few minutes, it confirms the diagnosis. This is a powerful tool because it not only diagnoses the problem but also predicts a high success rate for surgical intervention.
Effective Treatment Options for Relief
Treatment is aimed at separating the contacting surfaces, either by reducing inflammation or physically correcting the anatomy.
Conservative (Non-Surgical) Management
For milder cases or those driven primarily by inflammation (e.g., from allergies), non-surgical options are tried first.
Nasal Corticosteroid Sprays
Sprays like fluticasone or mometasone can reduce turbinate swelling and inflammation, potentially decreasing contact and relieving pain. They require consistent use over several weeks to be effective.
Saline Irrigation and Antihistamines
Nasal saline rinses help clear irritants and reduce inflammation. If allergies are a trigger, oral or nasal antihistamines can be very effective in managing underlying turbinate hypertrophy.
Surgical Intervention: When is it Necessary?
If conservative measures fail and the diagnostic anaesthetic test was positive, surgery is a highly effective option with success rates often cited between 70–90%.
Septoplasty and Turbinate Reduction
The goal of surgery is to remove the point of contact. This is typically done through:
- Septoplasty: Straightening a deviated septum.
- Turbinate Reduction: Gently reducing the size of the enlarged turbinate using various techniques (radiofrequency ablation, microdebrider resection, or outfracture).
These are often performed together in a minimally invasive procedure.
What to Expect from Surgery and Success Rates
Surgery is usually performed under general anaesthesia and is often an outpatient procedure. Recovery involves some nasal congestion and crusting for a few weeks. The most significant outcome for patients is the dramatic reduction or complete elimination of their chronic headaches, often improving their quality of life substantially. If your condition does not improve after trying conservative methods, consult an ENT specialist online with Apollo24|7 to discuss if a surgical evaluation is right for you.
Contact Point Headache vs. Other Headache Types
It's easy to confuse this with other common headaches. Here’s how to tell them apart:
Contact Point Headache vs. Migraine
- Contact Point: Pain is strictly unilateral and localised. Triggered by physical contact. Often has ipsilateral nasal
symptoms. Responds to nasal anaesthetic. - Migraine: Pain can be one-sided or throbbing but often shifts sides. Triggered by hormones, stress, food. Associated with nausea, light/sound sensitivity. Responds to triptans or migraine-specific meds.
Contact Point Headache vs. Sinus Headache
- Contact Point: No infection present. Nasal discharge is typically clear. Pain is focused and constant.
- Sinus Headache: Caused by acute sinus infection (sinusitis). Accompanied by thick, yellow/green mucus, fever, and dental pain. Pain is often more widespread and improves with antibiotics.
When to See a Doctor: Don't Ignore Persistent Pain
If you experience a persistent, one-sided headache that hasn't responded to standard treatments, it's time to seek a professional opinion. This is especially true if it's accompanied by nasal symptoms on the same side. Start with your primary care physician, but be prepared for a referral to an Otolaryngologist (ENT specialist) who has the expertise and tools (like an endoscope) to properly diagnose a nasal contact point headache. Booking a physical visit to a doctor with Apollo24|7 ensures you get the in-person examination and potential endoscopic evaluation needed for an accurate diagnosis.
Conclusion
Living with a chronic headache can be debilitating, but hope exists. A contact point headache, while less known, is a very real and treatable condition. The key is recognising its unique pattern—unilateral pain paired with same-sided nasal congestion—and pursuing the correct diagnostic path with an ENT specialist. The simple anaesthetic test can be a life-changing moment, offering both answers and a clear path to relief, whether through targeted medication or a straightforward surgical procedure. Don't resign yourself to a life of pain; the solution might literally be right under your nose.
Consult a Specialist for Personalised Advice
Consult a Specialist for Personalised Advice
Dr. Suvadeep Sen
Critical Care Specialist
12 Years • MBBS, MD, FNB (CRITICAL CARE MEDICINE), EDIC
Mumbai
Apollo Hospitals CBD Belapur, Mumbai
Dr. G Daya Sagar
General Practitioner
3 Years • MBBS
Hyderabad
Apollo 24|7 Virtual Clinic - Telangana, Hyderabad
Dr. Gaddam Manoj
General Practitioner
1 Years • MBBS
Hyderabad
Aaradhya clinic, Hyderabad
Dr. Mainak Baksi
General Practitioner
13 Years • MBBS , MD (MPH)
Howrah
Mainak Baksi Clinic, Howrah
(50+ Patients)
Dr. Rohinipriyanka Reddy
General Practitioner
9 Years • MBBS
Hyderabad
Apollo 24|7 Clinic, Hyderabad
Consult a Specialist for Personalised Advice
Dr. Suvadeep Sen
Critical Care Specialist
12 Years • MBBS, MD, FNB (CRITICAL CARE MEDICINE), EDIC
Mumbai
Apollo Hospitals CBD Belapur, Mumbai
Dr. G Daya Sagar
General Practitioner
3 Years • MBBS
Hyderabad
Apollo 24|7 Virtual Clinic - Telangana, Hyderabad
Dr. Gaddam Manoj
General Practitioner
1 Years • MBBS
Hyderabad
Aaradhya clinic, Hyderabad
Dr. Mainak Baksi
General Practitioner
13 Years • MBBS , MD (MPH)
Howrah
Mainak Baksi Clinic, Howrah
(50+ Patients)
Dr. Rohinipriyanka Reddy
General Practitioner
9 Years • MBBS
Hyderabad
Apollo 24|7 Clinic, Hyderabad
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Frequently Asked Questions
Can a contact point headache cause pain on both sides?
While possible, it is exceedingly rare. The defining characteristic of a contact point headache is its unilateral (one-sided) nature. Bilateral pain should lead a doctor to investigate other primary headache disorders like migraines or tension-type headaches.
Is surgery the only permanent cure?
For structural issues like a septal spur or significant deviation, surgery is the only permanent solution to remove the physical point of contact. However, if the contact is solely due to allergic inflammation, consistent management with steroid sprays and allergy control can provide long-term relief without surgery.
How long does it take to recover from surgery for this?
Most people return to non-strenuous work within a week. The initial congestion and crusting inside the nose improve significantly within 2–3 weeks, but full healing and the final result can take up to 3–6 months as all swelling subsides. Headache relief, however, is often almost immediate after the initial healing phase.
Can this type of headache cause dizziness or brain fog?
Yes, indirectly. Chronic pain of any kind can be exhausting and lead to difficulties with concentration, often described as 'brain fog.' While the contact itself doesn't directly cause dizziness, the interconnected sinus and ear systems mean significant nasal congestion and pressure can sometimes contribute to feelings of unsteadiness.
Are there any risks to the diagnostic anaesthetic test?
The test is considered very safe. The main risk is a rare allergic reaction to the local anaesthetic. The doctor uses a very small amount applied topically, which minimises any systemic effects. You might temporarily taste the anaesthetic in the back of your throat.