Symptoms include pain and pressure in the face along with a stuffy or blocked nose. Other symptoms include drainage from the nose or down the back of the throat. Leaning forward or moving your head may increase the pain in your face.

Other common symptoms of sinusitis may include:

• A headache (Figure 1).
• Pain or pressure in the ears.
• A cough.
• A fever.
• Tooth pain.
• A reduced sense of smell.
• Bad breath.

Figure 1 - Sinusitis: Areas of pain

Sinusitis may cause pain in the forehead, in the cheeks, and around the eyes. It can be caused by an infection (bacterial or viral) or from allergies.

Current as of: September 27, 2023

Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

There are two main types of sinusitis: acute (short-term) and chronic (long-term). Acute sinusitis often develops after a cold or viral infection. Swelling, inflammation, and a buildup of mucus caused by the cold can block the normal drainage of the nose and sinuses. This makes it easier for germs like viruses and bacteria to grow in the sinuses. Most sinus infections get better on their own. But antibiotics may be needed if there is a bacterial infection.

When inflammation in the sinuses lasts 12 weeks or longer, it is called chronic sinusitis. Anything that causes the sinuses to become inflamed and stay inflamed can lead to chronic sinusitis. This includes nasal allergies and nasal polyps that block the nasal passages or reduce drainage from the nose and sinuses. A deviated nasal septum can also make it worse.

Call your doctor now or seek immediate medical care if:

• You have new or worse swelling, redness, or pain in your face or around one or both of your eyes.
• You have double vision or a change in your vision.
• You have a high fever.
• You have a severe headache and a stiff neck.
• You have mental changes, such as feeling confused or much less alert.

Call your doctor if:

• Your symptoms of acute sinusitis do not improve after 10 days of home treatment.
• Your acute sinusitis symptoms start to get better within 10 days but then get worse again.
• You are not feeling any better within 5 to 7 days after starting antibiotics for a sinus infection.
• You have chronic sinusitis and you are not getting better as expected, or you have new symptoms of an acute sinus infection.

Watchful waiting

Watchful waiting is okay if you have symptoms of an early sinus infection (such as pain and pressure in your head along with a stuffy or runny nose). An early sinus infection can often be treated at home. If you develop symptoms of a sinus infection, start home treatment. This includes drinking lots of fluids and using saline nasal washes. Check the symptoms above to decide whether you need to call a doctor.

Check your symptoms

Your doctor can tell if you have sinusitis by asking questions about your current symptoms and how long you've had them. The doctor will also do a physical exam. You probably won't need any other tests. But you may need more tests if medicine doesn't help or your symptoms are chronic (long-term). More tests are also needed if you have problems caused by an infection. Tests may include an endoscopic sinus exam (nasal endoscopy) or CT scan.

Your doctor may refer you to an ear, nose, and throat (ENT) specialist. This may be needed if you don't get better over time. An ENT specialist will take a closer look at your nasal passages and upper throat. If allergies could be causing your sinus problems, you may need to see an allergist (immunologist).

Watch

Treatment depends on if you have acute or chronic sinusitis. A steroid nose spray along with a saline nose wash may relieve your symptoms. If needed, over-the-counter medicine can help with pain and pressure. If you have a bacterial infection, you may also get antibiotics. Other medicines may also be used.

Surgery may be needed when sinusitis is chronic or severe and doesn't get better with medicines.

Learn more

• Use saline (saltwater) nasal washes. This can help keep your nasal passages open and wash out mucus and allergens.
  • You can buy saline nose washes at a grocery store or drugstore. Follow the instructions on the package.
  • You can make your own at home. Add 1 teaspoon (5 millilitres) of non-iodized salt and 1 teaspoon (5 millilitres) of baking soda to 2 cups (500 millilitres) of distilled or boiled and cooled water. Fill a squeeze bottle with the nasal wash. Then put the tip into your nostril, and lean over the sink. With your mouth open, gently squirt the liquid. Repeat on the other side.
• Try a steroid nasal spray. This is especially good for chronic sinusitis.
• If needed, take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Read and follow all instructions on the label.
• For acute sinusitis, try a decongestant nasal spray like oxymetazoline (Claritin). Do not use it for more than 3 days in a row. Using it for more than 3 days can make your congestion worse.
• If the doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• Be careful when taking over-the-counter cold or influenza medicines and Tylenol at the same time. Many of these medicines have acetaminophen, which is Tylenol. Read the labels to make sure that you are not taking more than the recommended dose. Too much acetaminophen (Tylenol) can be harmful.
• Breathe warm, moist air. You can use a steamy shower, a hot bath, or a sink filled with hot water. Avoid cold, dry air. Using a humidifier in your home may help. Follow the directions for cleaning the machine.

Learn more

Watch

Certain medicines may be used to treat acute or chronic sinusitis. Your doctor will let you know which medicine can help treat the type of sinusitis you have. You may use more than one medicine. Medicines may include:

• Corticosteroids. They reduce inflammation in the nasal passages. Examples include fluticason (Flonase) and mometasone (Nasonex). Most of the time, they are used as a nasal spray (Figure 2).
• Decongestants. They reduce the swelling of the mucous membranes in the nose. Some examples are oxymetazoline (such as Claritin) and phenylephrine (such as Dristan).
• Analgesics. They relieve pain. They include acetaminophen (such as Tylenol) and ibuprofen (such as Advil).
• Antibiotics. They are prescribed to treat sinusitis caused by bacteria if your symptoms don't go away with time and self-care. They may be prescribed when symptoms of acute sinusitis don't start to get better within 10 days or if symptoms get better before 10 days but then get worse again.
• Allergy medicines. They may be used to treat nasal allergies (allergic rhinitis) or nasal polyps.

Be safe with medicines. Read and follow all instructions on the label.

Learn more

Figure 2 - How to use a corticosteroid nasal spray

Corticosteroid nasal sprays (such as Flonase, Nasacort, and Nasonex) are used to help allergy symptoms like a runny or stuffy nose. They help reduce inflammation in the nose. They start working quickly, but it may be several weeks before you get the full effect. Here are some tips for using these sprays:

• You may need to prime the sprayer before you use it. This means spraying it into the air a few times to make sure you get the right amount of medicine. Follow the directions on the label.
• Blow your nose before you spray. This will help clear out your nostrils.
• Gently sniff the medicine into your nose as you spray. Don't snort, or the medicine will go all the way into your throat where it won't do much good.
• Aim the nozzle straight toward the outer wall of your nostril. This will help keep the medicine from irritating the inner walls of your nose, especially your septum (the wall that separates your left and right nostrils).
• Don't blow your nose for 10 minutes or so after you spray. And try not to sneeze.
• Clean your sprayer once a week. The label will tell you how.

Current as of: July 31, 2024

Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.