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Sinusitis is more common than heart disease and causes more absenteeism than back pain. The painful, cold-like ailment afflicts more than 30 million people in the United States annually, generating 16 million visits to medical providers. Sufferers spend $150 million yearly on prescriptions and $1 billion on over-the-counter medications for symptom relief.
Understanding the anatomy of your sinuses, why they get infected and how to protect them can help keep you out of the doctor’s office and on the job.
Sinuses are air-filled spaces lined with tissue that produces thin mucus. The mucus drains into the nose through tiny ducts, washing away germs and debris. If the linings become inflamed, the tiny ducts become blocked and quickly fill with mucus. Viruses and bacteria flourish in this fluid, leading to infection.
Acute sinusitis is a short-term inflammation of the sinus tissue caused by a previous cold, seasonal allergies or smoking. Symptoms can last 10 days or more and can include nasal congestion, thick yellow or greenish nasal discharge, aching teeth, frontal headaches and low-grade fever.
Sometimes it’s hard to distinguish the difference between a cold, seasonal allergies and an acute sinus infection. They all involve runny noses, but a cold is usually mild and lasts less than a week; allergies tend to result in sneezing as well as itchy eyes and nose.
Only 5% of acute sinus infections are viral, meaning they do not get better with antibiotics. Sufferers can use saline nasal spray or rinse, warm facial compresses and acupuncture or massage. Acetaminophen or ibuprofen help with pain.
You may have a possible bacterial sinus infection if your symptoms worsen by the end of seven days. Other symptoms include a fever of 102 degrees or higher, bad breath, uncontrollable coughing, or simply being ill longer than 10 days. If you experience any of those symptoms, you’ll need to see your medical provider, who may prescribe antibiotics.
Chronic sinusitis lasts 12 weeks or longer and is associated with chronic allergies. Other causes include nasal polyps and nasal deformities, such as a deviated septum, which can block sinus ducts. Symptoms are similar to acute sinusitis but with no fever and a loss of sense of smell. (Fortunately, it’s reversible.) Treatments include nasal steroid spray, nasal saline and decongestants, though they should be used sparingly due to drying side effects. It may be necessary to consult with an ear, nose and throat specialist.
Both acute and chronic sinus infections can be avoided, and moisture is the key. Irrigate your nasal passages twice daily, after brushing your teeth (the so-called brush and flush). Make your own saline solution—a half teaspoon of non-iodized salt with a half teaspoon of baking soda in two cups of lukewarm distilled or previously boiled water—for use with a small bulb syringe or neti pot.
Steaming in a hot shower can help, or you can boil water and inhale the steam with a towel over your head, keeping a distance to avoid getting burned. Consider buying a personal sinus steamer. (It’s like a facemask with a steam reservoir.) Sleep with a humidifier at your bedside. Avoid decongestants, and only take antihistamines if they’re prescribed by your doctor.
Sleeping with your head elevated aids sinus drainage. Don’t blow your nose forcefully, as that can irritate nasal passages, causing them to swell. Wash your hands regularly and avoid contact with sick people. Help your immune system by getting a flu shot and, if appropriate, a pneumonia vaccine.
These preventive measures will not only minimize your risk of sinus infections, they will protect you from other viral illnesses, including Covid.
Mary Jenkins is recently retired after nearly 40 years as a family practice physician in New York state.