Evodia (Evodia rutaecarpa), known as Wu Zhu Yu in Traditional Chinese Medicine (TCM), has been historically used for a variety of ailments, including headaches associated with sinus congestion or "cold" headaches. In TCM, Evodia is believed to disperse cold, alleviate pain, and promote the flow of Qi, making it a common ingredient in herbal formulas aimed at relieving headaches with a cold or damp component, which may include sinus-related headaches. Its use is commonly documented in classical texts such as the "Shennong Bencao Jing" and "Compendium of Materia Medica."

However, scientific validation for Evodia's efficacy specifically in treating sinus headaches is limited. Some laboratory and animal studies have identified anti-inflammatory and analgesic properties in certain alkaloids found within Evodia, such as evodiamine and rutaecarpine, which may theoretically contribute to its pain-relieving effects. Despite these findings, there is a lack of high-quality clinical trials or systematic reviews supporting its use for sinus headaches or any headache subtype in modern medical literature. Therefore, while Evodia is traditionally used for headache and sinus-related symptoms in TCM, the current evidence base from scientific research is weak, and its use for this purpose is primarily justified by historical rather than modern clinical or pharmacological data.