Sinusitis

Sinusitis is an inflammation of the sinuses, which are air-filled spaces in your skull, next to your nasal cavity.  Sinusitis is often the fuel that stokes airway inflammation – in other words, asthma. Fix sinus infections and you often fix the asthma.

Sinus Symptoms

In adults, sinus headache and postnasal drip are the most common complaints from sinus congestion, but other  symptoms include:

  • Facial pressure or pain
  • Headache pain
  • Congestion or stuffy nose
  • Thick, yellow-green nasal discharge
  • Low fever (99˚-100˚F)
  • Bad breath
  • Pain in the upper teeth

Sinus infections in young children

Young children have immature immune systems and are more prone to infections of the nose, sinus and ears, especially in the first several years of life. Symptoms that may indicate your child has a sinus infection include:

  • A “cold” lasting more than 10-14 days, sometimes with a low-grade fever
  • Thick yellow-green nasal drainage
  • Postnasal drip, sometimes leading to or exhibited as sort throat, cough, bad breath, nausea and/or vomiting
  • Headache, usually in children age 6 or older
  • Irritability or fatigue
  • Swelling around the eyes

Cause of Sinus Pain

Sinuses become congested just like your nose does when reacting to allergens, irritants or respiratory infections: Tissues become swollen and produce extra mucus. If the cilia can’t move the thick mucus out, it begins to accumulate. Trapped mucus provides a safe haven for germs or fungi to grow. Infection sets in, causing sinus pressure and pain.

Differences in air pressure can also cause sinus pain. When your sinuses are clogged, air can’t pass in and out easily and any atmospheric changes in pressure – whether from driving through the mountains or flying in a plane – can create a painful pressure build-up.

Prevention: Simple Sinus Care

Taking care of your sinuses will help eliminate sinus infections that can cause asthma flares. You can prevent most sinus problems by avoiding illnesses and allergies that cause sinus inflammation, keeping nasal mucus thin and cilia moving and washing your nasal passages regularly.

Minimize allergy symptoms.

  • See a board-certified allergist for accurate diagnosis and an individualized management plan.
  • Start allergy medications well before your allergy season and continue as directed to control runny nose or inflammation that can lead to congestion.
  • Consider treating hard-to-control allergies with immunotherapy (allergy shots).

Stay away from smoke and air pollution.

  • Smoking cigarettes, cigars or pipes – or being around others who are smoking – can damage cilia and make them unable to sweep mucus efficiently. Secondhand smoke is as dangerous as smoking itself.
  • Ozone and other chemicals in the air can also damage cilia, so keep windows closed at home, school, work and in the car on bad air quality days.

Use moisture and heat to thin mucus and reduce sinus pressure.

  • Apply a warm, moist washcloth to your face, eyes and nose several times a day to soften mucus and warm the air inside your sinuses, which will relieve pressure.
  • Drink lots of fluids to keep your body (including your sinuses) hydrated; avoid alcohol and caffeine, which can have a drying effect.
  • Inhale steam to moisten and soften mucus. Do this in the shower or create your own mini-nasal-sauna by draping a towel over your head as you lean over a basin full of hot water. (Add a few drops of essential oils for custom-made aromatherapy.)
  • Keep nasal passages moist with saline (saltwater) sprays. The salt helps match the water to your body’s natural pH chemistry, but try to find sprays without BAC (benzalkonium chloride), a common preservative that many people find irritating.
  • Apply moisturizing gel inside your nostrils to relieve dry nasal passages – try ones with eucalyptus, menthol or essential oils like peppermint or clove.

Shrink swollen membranes.

  • Nonprescription nasal decongestant sprays will reduce swelling in nasal passages, allowing mucus to flow more easily. They should never be used for more than 3-5 days because long-term use can actually increase congestion.
  • Over-the-counter decongestant pills, capsules or liquids relieve nasal swelling and pressure but do not treat the cause of inflammation.
  • Prescription nasal corticosteroid sprays will reduce nasal inflammation and swelling caused by allergies or polyps (tissue growths that can block nasal passages). It will take 4-5 days of use for them to reach full effect; then they should be used daily as directed.
  • Use a saltwater nasal wash for the inside of your nose. Studies show that a mixture of concentrated salt water and baking soda (bicarbonate) helps the nose work better and move mucus out faster. Buy a nasal wash kit or premixed solution at pharmacies and allergy supply stores or make your own. 

Talk with your medical care team about making these steps part of your asthma and allergy management plan. 

Treatment of Sinusitis

A sinus headache does not necessarily mean you have an infection requiring a doctor’s care or prescription medication. Many cases of sinusitis will clear up by themselves within a week, especially if you follow the self-help treatments recommended above. However, the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) recommends adults see a doctor if any three of the above symptoms persist for 10 days or longer. 

Sinus symptoms that last 12 weeks or longer or recur 4-6 times during the year indicate chronic sinusitis, which often requires more complex treatment than short-term cases. Your doctor may use a CT scan or endoscope to check for a fungal infection or for polyps or structural abnormalities that are blocking your sinuses.