Sinusitis: When to Call the Doctor
Many people have learned to recognize the onset of sinusitis. At first, the coughing and sneezing make you think you might be getting a cold. Then your face starts hurting. Could it be a bad tooth? The headache and fatigue might point to the flu. The pain starts to combine with a dizzy, off-center feeling. Then comes the “balloon head,” and you know – that combination of intense pain, floating, and throbbing pressure tell you it’s probably your sinuses.
There are four pairs of facial sinuses, which are basically just hollow spaces that drain mucus into the nose. The frontal sinuses are over the eyes, the maxillary sinuses are inside the cheekbones, the ethmoid sinuses are behind the bridge of the nose between the eyes, and the sphenoid sinuses are behind the nose and eyes, a bit higher than the ethmoids. If all the sinuses are infected that’s called Pansinusitis that you can find more on the symptoms and treatments.
Sinuses are normally sterile and self-cleaning. But a common cold, allergies, or anything else that causes swelling in the nose can also affect the sinuses. Air, mucus, or pus trapped in a blocked sinus causes pain and pressure through all the sinuses, since they are connected. Similarly, when air is blocked from getting in to a sinus by swelling, a vacuum can be created that also causes pain.
Symptoms of sinusitis can include fever, weakness, fatigue, cough, and congestion. People with sinusitis often have a headache as soon as they wake up in the morning. Parts of the face might feel tender to the touch or look swollen. Nasal congestion and discharge might be green, yellow, or blood-tinged. The mucus can drain down the back of the throat, an annoying symptom called postnasal drip.
Although you can’t cure a sinus infection with home remedies, you can use them to lessen your discomfort. Inhaling steam from a vaporizer or a hot cup of water might soothe inflamed sinus cavities. A hot water bottle or wet compresses applied over the inflamed area also can be comforting.
Drink plenty of liquids, and use over-the-counter medications to reduce pain. Avoid non-prescription nose drops or sprays-they can interfere with normal nasal and sinus function and can be addictive, triggering more symptoms when you stop using them.
Acute or Chronic?
Acute sinusitis usually lasts about 3 weeks and is associated with colds or sore throats which turn into bacterial infections. It’s easy to confuse simple nasal congestion with sinusitis, but infections like the common cold usually last about a week and go away without treatment. Acute sinusitis lasts longer than a week and usually does not go away on its own.
Chronic sinusitis lasts longer, often 3 months or more, and is associated with allergies, anatomical abnormalities and repeated or untreated acute infections.
Health experts estimate 37 million Americans are affected by sinusitis every year, and spend $5.8 billion on healthcare costs related to sinusitis.
Some infections will eventually go away, but others need treatment from your health care provider. Call your doctor or health care provider if:
- You have a temperature higher than 102 degrees
- Your symptoms continue for 2 weeks or longer
- Your condition keeps getting worse instead of better
- You develop blurred vision.
Your health care provider can prescribe a course of treatment that will clear up the source of the inflammation and relieve the symptoms.
Doctors generally recommend decongestants to reduce the congestion, antibiotics to control a bacterial infection, if present, and pain relievers to reduce the pain.
If you are given a prescription, take the medication as directed and finish the entire prescription, even if you start to feel better.
Over-the-counter and prescription decongestant nose drops and sprays, however, should not be used for more than a few days. When used for longer periods, these drugs can lead to even more congestion and swelling of the nasal passages. To avoid complications, use them only for the amount of time recommended. Discard them after treatment, and don’t share the drops with others.
For patients with severe chronic sinusitis, a doctor may prescribe oral steroids, such as prednisone. Because oral steroids can have significant side effects, they are prescribed only when other medications have not been effective.
If you have an allergic disease along with sinusitis, you may also need medicine to control allergies. This may include a nasal steroid spray that reduces the swelling around the sinus passages and allows the sinuses to drain. If you already have asthma and then get sinusitis, your asthma may worsen. You should stay in close touch with your healthcare provider to modify your asthma treatment if needed.
For some people with chronic sinusitis, health care providers might decide that surgery is the only way to prevent ongoing episodes. The goal of surgery, which is done through the nose, is to improve sinus drainage and reduce blockage of the nasal passages.
In children, problems often are eliminated by removing the adenoids, pieces of tissue at the back of the throat that can obstruct the nasal sinus passages.
Adults who have had allergic and infectious conditions over the years sometimes develop polyps that interfere with drainage. Removing these polyps or repairing a deviated septum to ensure an open airway often provides noticeable relief from sinus symptoms. The most common surgery done today is called “functional endoscopic sinus surgery,” in which the natural openings from the sinuses are enlarged to allow drainage.
Although a substantial number of patients will still have some problems after surgery, most people have fewer symptoms and better quality of life.
This article includes information from the CDC and the National Institute of Allergy and Infectious Diseases.