What Are the Symptoms of Sinusitis?

Symptoms of a cold (runny nose and low fever) often give way to pain and pressure in the sinuses, which are usually the first signs of sinusitis. Other symptoms of sinusitis include pain or puffiness around the eyes; a bad-smelling, yellow-green discharge from the nose; bad breath; a headache in the morning; aching in the upper jaw and the back teeth; weakness or extreme tiredness; and coughing, especially at night. People with sinusitis occasionally develop earaches, neck pain, or a sore throat caused by mucus draining into the throat.

Some other conditions have similar symptoms to sinusitis, but they are not the same condition. Many people confuse nasal congestion with sinusitis. In addition, considerable confusion exists about people call "sinus headaches," and some studies have indicated that up to 90 percent of these headaches are actually not related to the sinuses.

How Is Sinusitis Diagnosed?

To diagnose sinusitis, doctors look for the signs and symptoms of the condition in the patient. They suspect sinusitis if a patient has cold symptoms that last for more than 10 days, or if the patient has other sinusitis symptoms. A doctor may, for example, tap the patient's face to determine if sinuses are tender. If a patient has complicated or repeated cases of sinusitis, a doctor may order x-rays or a computerized tomography (CT) scan to determine whether the sinuses are inflamed.

How Is Sinusitis Treated?

Bacterial sinusitis usually clears up after treatment with antibiotics. Most cases of acute sinusitis, however, result from viruses. Because antibiotics have no effect on viruses, the initial treatment of acute sinusitis generally does not involve antibiotics. Rather, it includes decongestants and pain medications. However, some patients still demand antibiotics. Such overuse of antibiotics is ill-advised because it can contribute significantly to antibiotic resistance. Medical professionals typically only consider antibiotic use in treating acute sinusitis if the patient has no improvement in 48 hours after using decongestants and pain medications.

Beyond these treatments, individuals can try to relieve the symptoms of sinusitis in several ways. They can take acetaminophen to help ease the pain and use nonprescription decongestants (dee-kon-JES-tents), taken by mouth or in sprays, to lessen stuffiness. Using a decongestant nasal spray for more than a few days, however, may itself cause swelling of the sinuses and slow recovery. Saline or salt sprays may also reduce swelling in the sinuses. Some patients find relief by placing a warm compress over the infected sinuses, using a steam vaporizer, or sitting in a warm, steamy bathroom. Doctors may prescribe special nasal sprays or oral (by mouth) medications for people with chronic sinusitis who have allergies that contribute to the infection. Chronic sinusitis sufferers often benefit from sinus irrigation or flushing, and many different devices are available for this purpose. For chronic or recurrent sinusitis, doctors may refer the patient to an ear, nose, and throat specialist.

In some cases, people with severe chronic sinusitis may undergo surgery to enlarge their sinus passages, to remove a polyp, or to fix a deviated septum that might be blocking sinus drainage.

Does Sinusitis Have Complications?

Complications of sinusitis are rare, but they do occur. Sinusitis can cause osteomyelitis when the infection from the sinus spreads into the bones of the face or skull. Sinusitis can also lead to an infection of brain tissue or meningitis (inflammation of the meninges"). In addition, a sinus infection can spread to invade the tissues surrounding the eyes.

Can Sinusitis Be Prevented?

Because no practical way exists to prevent all colds or to eliminate all allergies, sinusitis is not entirely preventable. People can limit their exposure to the viruses and bacteria that cause the infections by washing their hands thoroughly and frequently, and by only using their own, rather than sharing, eating or drinking utensils. Individuals should also avoid smoking as well as exposure to tobacco smoke to help limit the risk of sinusitis. People with allergies should avoid whatever triggers their allergy symptoms and control their allergies with the treatment recommended by their doctors. Drinking plenty of fluids and keeping the air in the house moist by using a vaporizer can help thin mucus and prevent its buildup in the sinuses. Limiting alcohol consumption also may help, because alcohol can cause nasal membranes to swell. In addition, air travel and underwater diving can cause significant discomfort in individuals with acute or chronic sinusitis, so they may consider using decongestants prior to these activities.

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