It’s commonly understood that pressure on nerves can contribute to migraine headaches. Whether the pressure is a primary cause or a secondary condition that exacerbates the pain differs from patient to patient, but many find that relieving the pressure helps relieve both frequency and severity of migraine headaches.

The role played by the trigeminal nerve is well documented, and there are various treatments and procedures commonly recommended to relieve pressure in this area. A less commonly considered cause of migraine pain originates in the nose, when the septum becomes deviated.

What is a Deviated Septum?

The septum is the narrow wall of cartilage that divides the nostrils. Ideally this is nice and straight, equally dividing the nostrils and allowing equal air flow through both. Sometimes though, it becomes displaced and shifts to one side or the other. When this happens, not only can breathing become difficult because of the blockage, but pressure from the deviation can set up a pain chain reaction that mimics the pain levels of migraine caused by pressure elsewhere.

Some ear, nose and throat specialists claim impressive success rates among migraine patients who undergo surgery to correct their deviated septum. Indeed, one surgeon claims an 88% success rate, with 40% of those experiencing a complete cure from migraine type pain. The remaining percentage reported more effective pain control from over the counter medications, leading to the conclusion that their pain levels were significantly reduced.

The Common Route to Migraine Diagnosis

Deviated septum isn’t high on the list of possible migraine causes when you first seek diagnosis. You may be referred to a neurologist who may order MRI scans to look at your brain, but few doctors will consider checking your nose. A CT scan of the nasal passages and sinuses could reveal a septum that’s bent or crooked, providing vital clues to the cause of the headache pain.

Signs and Symptoms of Deviated Septum

If you have any of the following symptoms, it’s possible your septum is out of alignment. Bear in mind that often, you’ll not get any symptoms at all, so absence doesn’t necessarily mean you don’t have it.

• Facial Pain — Severely deviated septum can result in facial pain when the deviation impacts the nasal wall.
• Nosebleeds — One-sided breathing can lead to unnatural dryness of the nasal septum, leading to an increased risk of nosebleeds.
• Blocked Nostrils — So it’s more difficult to breathe through one nostril than the other. It can be caused by infections to the upper respiratory tract when you have a cold, or by allergies.
• Nasal Cycle Awareness — Most of us are not aware that we go through a nasal cycle since it’s natural. Being aware of first one nostril, then the other being clear could indicate an unnatural obstruction in one nostril.
• Sleeping Positions — While it’s natural to have a preferred sleeping position, if you find your preference is dictated by how easy it is to breathe, this could indicate a deviated septum.
• Noisy Breathing When Asleep — You’ll have to ask a partner about this so it’s hard to self-diagnose. Parents often observe this phenomenon in small children or babies.

Will Septoplasty Cure Your Migraine?

Septoplasty, the name given to the surgical procedure that corrects a deviated septum won’t cure everyone’s migraine headaches. Those it will help most are those with a high degree of sinus headache along with traditional migraine causes. Sinus headache can mimic true migraine both in pain position in the head and in severity. In people with a deviated septum, the headache will likely manifest on the same side of the head as the deviation.

According to one plastic surgeon, migraine pain may be attributed to the septum deviation when:

• Medication doesn’t relieve the headache.
• There has been facial trauma.
• MRI or CT scans show nothing unusual.
• Either one or both nostrils are blocked, making breathing difficult.
• Traditional migraine treatments have failed.

Septoplasty is a relatively quick operation, taking up to an hour to perform. During the procedure, the surgeon will cut and remove parts of the septum in order to straighten and reposition it correctly in the center of the nose. How much relief patients experience depends on the severity of the deviation.

Nasal obstruction caused by the deviation is often completely resolved, but other symptoms such as allergies that affect the lining of the nose or sinuses are not. These still need medication for treatment.

The good news is that because surgery to correct a deviated septum is not a cosmetic procedure (the shape of the nose is not normally altered), it’s covered by many health insurance policies.

When you’ve tried everything else and still found no relief from migraine pain, maybe it’s coming from the last place you’d expect, and is worth investigating.