Sinusitis is an inflammation, or swelling, of the tissue lining the sinuses. Sinuses are hollow spaces within the bones between your eyes, behind your cheekbones, and in your forehead. They make mucus, which keeps the inside of your nose moist. That, in turn, helps protect against dust, allergens, and pollutants.
Healthy sinuses are filled with air. But when they become blocked and filled with fluid, germs can grow and cause an infection.
Conditions that can cause sinus blockage include:
- The common cold
- Allergic rhinitis, which is swelling of the lining of the nose caused by allergens
- Small growths in the lining of the nose called nasal polyps
- A deviated septum, which is a shift in the nasal cavity
Types
You may hear your doctor use these terms:
- Acute sinusitis usually starts with cold-like symptoms such as a runny, stuffy nose and facial pain. It may start suddenly and last 2 to 4 weeks.
- Subacute sinusitis usually lasts 4 to 12 weeks.
- Chronic sinusitis symptoms last 12 weeks or longer.
- Recurrent sinusitis happens several times a year.
- Pansinusitis affects all the sinuses in your head – not just the common one or two.
Who Gets Sinusitis?
Lots of people. About 35 million Americans have sinusitis at least once each year. It’s more likely if you have:
- Swelling inside the nose like from a common cold
- Blocked drainage ducts
- Structural differences that narrow those ducts
- Nasal polyps
- Immune system deficiencies or medications that suppress the immune system
For children, things that can cause sinusitis include:
- Allergies
- Illnesses from other kids at day care or school
- Pacifiers
- Bottle drinking while lying on the back
- Smoke in the environment
The main things that make sinusitis more likely for adults are infections and smoking.
Common symptoms of sinusitis include:
- A stuffy or blocked nose
- A thick white, yellow, or green discharge from the nose
- Pain in the teeth
- Pain or pressure in the face. This often feels worse when a person bends forward.
You may also have:
- A fever
- Coughing
- Trouble smelling
- Ear pressure or fullness
- A headache
- Bad breath
- A tired feeling
Chronic Sinusitis Symptoms
You may have these symptoms for 12 weeks or more:
- A feeling of congestion or fullness in your face
- A nasal obstruction or nasal blockage
- Pus in the nasal cavity
- A fever
- A runny nose or discolored postnasal drainage
You may also have headaches, bad breath, and tooth pain. You may feel tired a lot.
Lots of things can cause symptoms like these. You'll need to see your doctor to find out if you have sinusitis.
What Is Pansinusitis?
Normally, a sinus infection doesn’t affect all four pairs of sinuses in your head; it only affects one or two. But sometimes, all four can become infected at once. This is known as pansinusitis.
Sinusitis Treatment
Sinusitis Medication
Antibiotics. If your doctor thinks a bacterial infection is to blame, they may prescribe antibiotics. For acute sinusitis, you typically take them for 10-14 days. For chronic sinusitis, it might be longer. Antibiotics only help with bacterial infections. They won’t help if your sinusitis is caused by viruses or other problems.
Painkillers. Many people with sinusitis take over-the-counter (OTC) pain medicines, like ibuprofen or acetaminophen, to ease discomfort. Follow the instructions on the label, and don't take them for more than 10 days. Check with your doctor to see which one is right for you.
Bioelectronic sinus device. This works by using microcurrents to stimulate nerve fibers in your sinuses. Sold over-the-counter, it helps reduce sinus inflammation, pain, and congestion.
Decongestants. These meds lower the amount of mucus in the sinuses. Some are available as nasal sprays. Others are pills. If you use decongestant nasal sprays for more than 3 days, they may actually make you more congested. Follow the instructions on the label.
Allergy medicines. Many cases of sinusitis are due to uncontrolled allergies. If you've never been diagnosed with allergies, it might be worth doing some allergy testing to see if you have them. If you do, medication (like antihistamines) and avoiding your triggers will help. Another option is to get allergy shots, a long-term treatment that gradually makes you less sensitive to the things that set off your symptoms.
Steroids. In some cases, your doctor may prescribe inhaled steroids to bring down the swelling in the sinus membranes. For tough cases of chronic sinusitis, you may need to take steroids by mouth.
Surgery. Occasionally, if you have chronic sinusitis or acute sinusitis that keeps coming back, an operation may be the best choice. The surgeon can remove blockages and enlarge the sinus passages, which makes it easier for them to drain.
Sinusitis Home Remedies
While medicines can help, many cases of sinusitis go away on their own, without any medical treatment. If you often get the condition, many of these same approaches will help you prevent it, too.
Humidify. Use a humidifier in rooms where you spend a lot of time. Follow the instructions for regular cleaning.
Breathe in steam vapors. You can either run the shower and sit in the bathroom, or breathe in steam from a bowl of warm (but not too hot) water. The steam vapors ease congested and swollen nasal passages.
Use warm heat. Put a warm, wet towel on your face. It can take off some of the pressure.
Try a nasal saline solution. While they don't contain medicine (saline is salt water), they can help keep your nasal passages moist.
Flush out your sinuses. Nasal irrigation with salt water can clear out mucus (and other debris) and keep your sinuses moist. You can use bulb syringes or neti pots, for example. Use distilled, sterile, or previously boiled water to make up the irrigation solution. Rinse the device after each use and let it air dry.
Drink lots of fluids. They'll help thin the mucus, which reduces the blockage in your sinuses. Cut down on alcohol, which makes the swelling worse.
Rest. When you've got a sinus infection, take it easier than normal. Get plenty of sleep, and give your body a chance to recover.
Chronic Sinusitis Treatment
There are some other things you can do yourself to help with chronic sinusitis:
- Warm compresses can ease pain in the nose and sinuses.
- Drink plenty of fluids to keep mucus thin.
- Saline nose drops are safe to use at home.
- Over-the-counter decongestant drops or sprays can help. Don’t take them longer than recommended.
Other Options
You also need to avoid any triggers linked to your sinusitis.
If you have allergies, your doctor may recommend an antihistamine.
If a fungus is to blame, you’ll get a prescription for an antifungal medicine.
If you have certain immune deficiencies, your doctor may give you immunoglobulin, which helps fight the things your body reacts to.
If your symptoms do not get better, talk with your doctor or nurse. They might order tests to figure out why you still have symptoms. These can include:
- A CT scan or other imaging tests. Imaging tests create pictures of the inside of the body.
- A test to look inside the sinuses. For this test, a doctor puts a thin tube with a camera on the end into the nose and up into the sinuses.
Can I Prevent Sinusitis?
There is no sure-fire way to prevent sinusitis. But there are some things that might help.
- Don’t smoke, and avoid other people's smoke.
- Wash your hands often, especially during cold and flu season, and try not to touch your face.
- Stay away from things you know you’re allergic to. Talk to your doctor to see if you need prescription medicines, allergy shots, or other forms of immunotherapy.
If your sinus problems keep coming back, ask your doctor about the pros and cons of surgery to clean and drain the sinuses.
What Happens if Sinusitis Isn’t Treated?
You’ll have pain and discomfort until it starts to clear up. In rare cases, untreated sinusitis can lead to meningitis, a brain abscess, or an infection of the bone. Talk to your doctor about your concerns.