Sinusitis

Overview

Sinusitis is inflammation of the sinuses—the air-filled spaces in your skull around your nose and eyes. This swelling can block mucus drainage, causing pressure, pain, and congestion. It's often called a sinus infection and usually follows a cold.

Yes, sinusitis is very common. Many people have at least one episode in their lifetime.

Sinusitis can affect anyone, but it's more common in people with allergies, asthma, nasal polyps, or those who smoke. Children and older adults can also get sinusitis.

Symptoms

Common symptoms

• Blocked or runny nose
• Pain, tenderness, or pressure around your nose, eyes, or forehead
• Headache that gets worse when you bend forward
• Reduced sense of smell
• Yellow or green mucus from your nose or down the back of your throat
• Cough, especially at night
• Bad breath
• Mild fever (above 100.4°F or 38°C)

Symptoms in children

• Irritability or fussiness
• Cough that lasts more than a week
• Breathing through the mouth
• Ear pain or tugging at the ears
• Poor feeding or reduced appetite

Symptoms in older adults

• Less obvious fever, but may feel more tired or confused
• Milder facial pain, sometimes just a dull ache
• Increased risk of complications, so symptoms should be watched carefully

Causes

Main causes

• Viral infections (most common, often after a cold or flu)
• Bacterial infections (when sinuses are blocked and mucus builds up)
• Allergies that cause ongoing sinus inflammation
• Nasal polyps or a deviated septum that block sinus drainage

Risk factors

• Having a cold or flu
• Allergic rhinitis (hay fever)
• Smoking or exposure to second-hand smoke
• Asthma
• Weak immune system due to illness or medication
• Recent dental infection or tooth abscess

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency signs listed above (eye swelling, severe headache, vision changes).
• If you have a weakened immune system and develop sinusitis symptoms.

Book a routine appointment if:

• If your symptoms last more than 10 days without getting better.
• If you have a fever higher than 100.4°F (38°C) that lasts several days.
• If you have sinusitis episodes that come back often (more than 4 times a year).

Diagnosis

Your doctor will ask about your symptoms and examine your nose, ears, and face. They may press gently on your sinuses to check for tenderness.

Tests that may be done

• None usually needed for simple cases.
• Nasal endoscopy: a thin, flexible tube with a camera is used to look inside your nose and sinuses.
• Imaging tests like a CT scan (rarely, only if symptoms are complicated or chronic).
• Allergy testing if allergies are suspected as a cause.

What to expect at your appointment

The doctor will likely recommend self-care first. If they think you have a bacterial infection, they may prescribe antibiotics. They will explain what to do if symptoms get worse.

Treatment

Treatment depends on the cause and how long you've had symptoms. Most people improve with home care. If bacteria are suspected, antibiotics may be needed. The goal is to reduce inflammation, relieve pain, and help sinuses drain.

Self-care at home

• Rest and drink plenty of fluids like water or herbal tea.
• Use a saline nasal spray or rinse to keep your nasal passages moist.
• Breathe in steam from a bowl of hot water or a warm shower (careful not to burn).
• Place a warm, damp cloth over your face to ease pressure and pain.
• Prop your head up with extra pillows at night to help mucus drain.
• Take over-the-counter pain relievers like paracetamol or ibuprofen to reduce pain and fever (always follow the label or ask your pharmacist).

Medical treatments

If symptoms don't improve, your doctor may suggest a nasal corticosteroid spray to reduce swelling. For bacterial sinusitis, they may prescribe a course of antibiotics (usually for 5 to 7 days). Decongestant sprays or tablets are sometimes used for a short time (no more than 3 days for sprays) to help open the nasal passages. Always follow your doctor's advice about any medication.

When is surgery considered?

Surgery is rarely needed. It may be considered for chronic sinusitis that doesn't get better with other treatments, or if there are structural problems like nasal polyps or a deviated septum. A common procedure is functional endoscopic sinus surgery (FESS) to open blocked sinuses and improve drainage.

Living with this condition

Living with sinusitis can be frustrating, especially if it's a long-term problem. Managing triggers like allergies and avoiding smoke can help reduce flare-ups.

Lifestyle tips

• Use a humidifier at home to keep the air from getting too dry.
• Avoid cigarette smoke, strong perfumes, and other irritants.
• Wash your hands often to prevent colds and viruses.
• Consider a saline nasal rinse daily if you have chronic sinusitis.

Diet and exercise

Eating a balanced diet rich in fruits and vegetables supports your immune system. Staying hydrated is important. Gentle exercise like walking can help your body feel better, but avoid strenuous activity if you have a fever or feel very unwell.

Mental health and emotional wellbeing

Dealing with ongoing sinus pain and congestion can be draining and affect your mood. It's normal to feel frustrated or low. If you feel your symptoms are taking over your life, talk to your doctor. They can help you find ways to manage both the physical and emotional side.

Prevention

You can't always prevent sinusitis, but you can lower your risk by avoiding colds, treating allergies, and not smoking. Keeping your immune system strong with good sleep and nutrition helps too.

Vaccines

Vaccines for flu and pneumococcal disease (pneumonia) can help prevent infections that might lead to sinusitis. Ask your doctor if these are right for you.

Screening programmes

There is no routine screening for sinusitis. If you have frequent or severe episodes, your doctor may recommend tests to find the underlying cause.

Complications

If left untreated

• Chronic sinusitis (symptoms lasting more than 12 weeks)
• Spread of infection to the bones around the sinuses (osteomyelitis)
• Infection around or behind the eye (orbital cellulitis) – rare but serious
• Meningitis (infection of the lining of the brain) – very rare

Long-term outlook

Most people with sinusitis recover fully with simple home care. Even when complications occur, they are rare and can be treated effectively if caught early. With proper treatment, the outlook is very good. Your doctor will help you manage the condition so you can feel better.

Find support

International organisations

• International Patient Organization for ENT (IFOS) ↗
• British Rhinological Society (BRS) - Patient Resources ↗

Local organisations

• Allergy UK ↗ · United Kingdom
• Asthma and Allergy Foundation of America (AAFA) ↗ · United States

Helplines

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