Many people get sinus infections, or rhinosinusitis, each year. Most of the time, the symptoms — including nasal congestion and drainage, facial pain or pressure, and a bad smell in your nose (halitosis) — go away on their own or with medication. But for some, they become chronic, and can have a serious impact on work and life. In fact, a recent Harvard University study found that people with persistent sinus problems had less energy than others, and were more likely to be depressed.
Your sinuses drain through small openings called ostia, which can become blocked by a swollen sinus lining (exacerbated by viral infection or allergies), structural components like a deviated septum (a crook in the line of tissue that divides your nostrils) or polyps, or from environmental and genetic factors such as thin airways, obesity, smoking, or family history of sinus trouble. Sinusitis can also be caused by fungus.
Symptoms of sinusitis can be divided into three categories: acute, subacute and chronic. Acute sinusitis symptoms — including nasal congestion and drainage, and facial pain or pressure — last less than four weeks and are usually caused by viruses. Subacute symptoms — which last four to 12 weeks — are often caused by bacteria. Chronic sinusitis occurs when symptoms recur four or more times per year, and are usually caused by bacterial infection.
In most cases, your healthcare provider will make a diagnosis based on your symptoms and health history. They may feel for tenderness in your nose and face and use a light-directed tool, such as a nasal endoscope, to check for swelling, draining or blockage. They may also order a CT scan, which provides detailed images of your sinuses and nose area.
Treatment of sinusitis includes over-the-counter and prescription medications, such as analgesics (acetaminophen, ibuprofen) and decongestants (oxymetazoline (Afrin), neosynephrine) to reduce congestion; a mucus-thinning agent, such as guaifenesin (Mucinex); and nasal irrigation with saline solution. Your provider may prescribe antibiotics to help clear up an infection causing your sinusitis, and antihistamines if allergy is a trigger.
In addition to medical treatments, complementary and alternative therapies can help reduce symptoms, such as acupuncture, nasal irrigation with a Neti pot or saline spray, and facial massage. Some individuals report that aromatherapy and warm compresses can also relieve sinus symptoms, but more research is needed. Getting enough sleep and avoiding tobacco smoke are important, as well. In some cases, your healthcare provider may recommend surgery to remove a sinus polyp or other structural issues that cause your sinuses to be clogged. Surgical options include endoscopic sinus surgery, balloon sinus dilation, and sinus drainage. Depending on the type of surgery and your needs, your provider will discuss what the best option is for you. Follow-up care with your primary care provider or an ear, nose and throat specialist (otolaryngologist) is important to ensure that your sinuses stay healthy.