Sinusitis: Symptoms and treatments

Cold and flu season may be dominated by, well, colds and flu, but for many, the scourge of sinusitis is not far behind.

If you're one of up to 10% of Australian adults¹ who find chronic sinusitis an inevitable part of the winter months, you'll know that recognising the symptoms and getting early treatment can be the difference between a quick recovery and weeks of misery.

There are 2 distinct types of rhinosinusitis. Acute sinusitis, which can last for up to 3 weeks, is caused in most cases by a bacterial infection when you're run down after a cold or other viral respiratory bug. Chronic sinusitis can last for several months or even years if not treated correctly.

Acute bacterial rhinosinusitis (ABR) is, in simple terms, inflammation or infection of the sinuses.

In a healthy person, the sinuses are lined with mucus that filters the air and keeps them moist. When they become inflamed (as they might when you have a cold, for example) they swell up and become blocked so the mucus has nowhere to go.

This can allow an infection to take hold, which means that just as you're starting to feel better from your cold or flu, you start to deteriorate again. Allergic sinusitis is similarly triggered by allergies that cause the mucus lining to become irritated.

Sinusitis can make you feel pretty miserable. It's an uncomfortable condition that may sound similar to a blocked nose, but it can have a big impact on daily life.

Persistent sinusitis symptoms include a completely stuffed nose and facial pressure and/or pain that combine to make it difficult to concentrate, sleep or enjoy pretty much any of your usual activities.

Sinusitis symptoms vary depending on the severity of the inflammation. Symptoms can include:²

• blocked nose
• pain and tenderness around the cheeks, eyes and forehead
• sensation of congestion or pressure in the head that gets worse if you lean forward or bend over
• loss of sense of smell or taste
• bad breath and/or an unpleasant taste in the mouth
• sore throat and/or cough
• poor sleep due to congestion, resulting in tiredness during the day
• toothache and/or pain along the jawline
• postnasal drip (mucus running down the back of the throat) which can cause coughing
• thick mucus (snot) from the nose
• fever.

Sometimes, acute sinusitis will go away on its own. There are lots of things you can take or do at home to make milder symptoms more bearable in the meantime, such as using pain killers, saline spray or nasal decongestants.

If your symptoms are severe (such as bad facial pain or fever), if they last longer than 10 days, or they are getting gradually worse, you should seek medical advice.

If your doctor determines that your acute viral rhinosinusitis is caused by a bacterial infection, they may prescribe antibiotics. Sinusitis treatment will most often last for 7 to 14 days. If your symptoms persist, you may also be offered intranasal (spray) steroids³ to reduce the inflammation. If allergies are a contributing factor, antihistamines may be recommended.

If sinusitis is a persistent problem, your GP might recommend you visit an ear, nose and throat specialist (ENT) for further investigation.

Sinusitis itself can't be caught from another person, but the viruses and bacteria that cause it can easily be passed on. If you have acute sinusitis, it's important to be extra attentive to good hygiene practices such as regular handwashing. If you're coughing and sneezing, try to stay away from other people as much as you can.

If you want to avoid inviting sinusitis to the afterparty of your cold or flu, try to keep your nasal passages as clear and moist as possible. Staying well hydrated, using a humidifier in the bedroom and inhaling steam in a hot shower will help to keep your sinuses an infection-free zone.