A recent study showed no correlations between sinus infection severity
and facial pain.

Here's a link:
http://www.sinusnews.com/Articles2003/facialpainsinusseverity.html

Study: Correlation Between Facial Pain and Sinus Severity
This article first appeared in the July 15, 2003 issue of Sinus News:

The June edition of Larnygoscope features a study on the "Correlation
Between Facial Pain or Headache and Computed Tomography in
Rhinosinusitis in Canadian and U.S. Subjects." Here is the abstract
from that study:

Objectives:

1) To determine whether a correlation exists between facial pain or
headache and sinus disease severity by computed tomography (CT) scan
in patients with rhinosinusitis and

2) To compare disease severity and pain perception in two
geographically diverse North American patient populations.

Study Design:
Prospective patient questionnaire before CT scan of the paranasal
sinuses.

Methods:
Patients with refractory rhinosinusitis were recruited at the
University of Texas Medical Branch (Galveston, TX) and the University
of Alberta (Edmonton, Alberta, Canada). Before CT scanning, patients
completed a pain questionnaire. All scans were interpreted by one
neuroradiologist and were scored using the Lund-McKay, Harvard, and
Kennedy staging systems for rhinosinusitis.

Results:
Fifty-one patients completed questionnaires (27 were Canadian). There
was no correlation between pain severity and disease severity
reflected by any of the three staging systems used (P >.05). The mean
pain score for the U.S. patients was 7.3, and for Canadian patients,
5.2. The mean CT scores for U.S. versus Canadian patients were as
follows: Lund-McKay, 2.6 versus 6.6; Harvard, 0.7 versus 1.0; and
Kennedy, 1.4 versus 2.2. The Canadian patients had more severe disease
on CT scan (Lund-McKay, P =.001; Harvard, P =.005; and Kennedy, P
=.007) while reporting less severe pain (P =.004).

Conclusions:
There was no correlation between pain severity and disease severity by
sinus CT scan as graded by the Lund-McKay, Harvard, or Kennedy staging
system. Facial pain and headache, although frequent complaints of
patients with rhinosinusitis, are not useful predictors of sinus
disease severity. There appears to be a difference in pain perception
between the two North American populations.

Gordon Shields, MD; Hadi Seikaly, MD; Matthew LeBoeuf; Faustino
Guinto, MD; Herve LeBoeuf, MD; Thomas Pincus, MD; Karen Calhoun, MD

Yes, allergies could cause enlarged membranes without pain.

-O