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Sinusitis: Pressure and face pain from sinus infection

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By Louis Neipris, M.D., Staff Writer, myOptumHealth  

NATIONAL - Your sinuses produce mucus, which filters and moisturizes the air you breathe. Like sticky fly paper, mucus traps dust and germs from inhaled air as it moves across a delicate tissue lining. Normally, the mucus moves from the sinuses down to the throat, where it's swallowed and eliminated from the body. Inflammation, often from a bad cold or allergies, can cause the lining of the sinuses to swell. This traps the germy debris, where it can fester into an infection.

What is sinusitis?

Each year, more than 30 million people in the U.S. get sinus infections, also called sinusitis.

Most sinus infections are caused by viruses, often the same ones that cause the common cold. Although not common, sometimes a secondary bacterial infection can develop. Rarely, sinusitis can be caused by a fungal infection.

You may have a sinus infection if:

  • You still have symptoms of nasal congestion 10 days after the start of a cold, or
  • Your nasal congestion starts to get worse again within the first week or so after having improved

Things that can increase your risk for sinus problems include:

  • Nasal polyps (noncancerous growths inside the nose)
  • Deviated septum (shift in nasal cavity)
  • Allergies to airborne substances like molds
  • Smoking or exposure to secondhand smoke

Ongoing sinus infection called chronic sinusitis is more common in people who have:

  • Asthma
  • Cystic fibrosis
  • Weakened immune system

What are the symptoms?

  • Facial pain/pressure, especially near the nose and above the eyes. Pain can also occur behind the cheekbones or the upper teeth.
  • Pain often gets worse when you bend forward or lay back, whichever increases pressure on the affected sinuses.
  • Nasal discharge that could be thick and with pus, more on one side of the nose. Mucus may also drip down the throat behind the nose. This is called postnasal drip and can cause sore throat.
  • Loss of smell.
  • Cough.

Additional symptoms may include:

  • Fatigue
  • Bad breath
  • Fever

How is sinusitis treated?

Sinusitis usually doesn't require antibiotics, because most of the time a virus is to blame. Various medications are used to reduce swelling, remove blockage and thin mucus.

  • Decongestants. These drugs reduce the swelling of tissue inside the sinuses. They include over-the-counter pills (Sudafed) or nasal sprays with phenylephrine (Neo-Synephrine) or oxymetazoline (Afrin). Don't use these sprays for more than a few days, though, or the congestion can get worse. This is called "rebound congestion."
  • Antihistamines. These drugs may help if your sinusitis is due to allergies.
  • Mucolytics or expectorants (such as guaifenesin). These drugs may help to loosen and clear mucus from the sinuses.
  • Pain relievers, such as acetaminophen or ibuprofen to relieve any pain.
  • Antibiotics. Antibiotics are reserved for sinus infection caused by bacteria.
  • Nasal steroid sprays. These are prescription medications that may help with chronic sinus infections. They may reduce inflammation.

These medications are not for everyone. Depending on your symptoms, general health and other medicines you might be taking, your doctor can help decide what medicine is right for you. Always be sure to follow all directions on the label closely.

Surgery for chronic sinusitis may be an option if medical therapy isn't enough. Endoscopic techniques allow doctors to see and drain the sinuses and remove obstructions using a thin, lighted tube connected to an eyepiece or video camera.

What can I do at home for sinusitis?

Drink plenty of fluids to help thin the mucus. Cool, moist air may help reduce sinus congestion:

  • Set up a cool mist humidifier in your bedroom. Check to be sure that all filters are clean. Follow all manufacturer's instructions for keeping the humidifier clean.

Warm, moist air may also be helpful. Stand or sit in the bathroom while you run hot water in the shower. The steam may help with the congestion. Always be sure that the water is not so hot that it would burn someone reaching into the shower.

You can also:

  • Apply warm compresses to your nose and face
  • Use saline nose drops to moisturize the nasal passages
  • Gently irrigate the nasal cavity with salt water, most helpful for sinusitis caused by allergies

To help prevent future infections, avoid allergens, get a yearly flu shot and practice good handwashing.

View the original Sinusitis: Pressure and face pain from sinus infection article on myOptumHealth.com 

SOURCES:
  • Leung RS, Katial R. The diagnosis and management of acute and chronic sinusitis. Primary Care: Clinics in Office Practice. 2008;35(1):11-24.
  • Orlandi RR. Sinusitis. In: Rakel RE, Bope ET, eds. Rakel: Conn's Current Therapy 2008, 60th ed. Philadelphia, PA: Saunders-Elsevier; 2008.
  • American Academy of Otolaryngology-Head and Neck Surgery. Fact sheet: 20 questions about
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