Sinus Pain or Congestion

Is this your symptom?

  • Feeling of fullness, pressure, and pain on the face over a sinus cavity. These are found above the eyebrow and behind or around the eye. They are also found over the cheekbone.
  • Pain or pressure may be on both sides of the face. More often, the pain is on one side of the face.
  • Other problems include a blocked nose, runny nose, and postnasal drip.

Some Basics...

  • The sinuses are spaces of air between the bones around the nose. They make mucus that drains into the nose.
  • Sinus pain and congestion are caused by blocked sinuses. This can result from infection or nasal allergies.
  • Sinus pain and congestion are normal parts of a cold.

Causes

Sinus pain happens when one or more sinuses become blocked by an infection or nasal allergy.

  • Allergic Sinusitis (Hay Fever): When an allergen bothers the nose, it may cause a stuffy nose. This is due to swelling of the sinus passages. Other symptoms include sneezing, itchy and clear runny nose, and itchy watery eyes.
  • Viral Sinusitis: This type of sinusitis is caused by a virus. These include rhinosinusitis and a cold. The infection of the nose lining can spread to the lining of the sinuses. Antibiotics do not help this type of sinusitis get better.
  • Bacterial Sinusitis: This type of sinusitis is caused by bacteria. It can develop after viral sinusitis. One or more sinuses with the virus may then become infected with bacteria. Sinus symptoms that last more than 10 days suggest that bacterial sinusitis is present. Sinus pain can get worse and fevers may return. Antibiotic treatment is usually needed.
  • Rhinitis Medicamentosa: This is caused by using decongestant nose drops for more than 5 days. This can cause the nose to become even stuffier.

Treatment

Treatment depends on the cause.

  • Allergic (Hay Fever): Antihistamines can help. These include diphenhydramine (Benadryl), loratadine (Claritin, Alavert), fexofenadine (Allegra), or cetirizine (Zyrtec). Nasal corticosteroid sprays work very well to treat hay fever. Nasal washes are also helpful.
  • Viral: Use nasal washes. Antibiotics are not helpful.
  • Bacterial: Use nasal washes. Antibiotics may be needed.

When to Call for Sinus Pain or Congestion

Call Doctor Now or Go to ER

  • Severe pain
  • Fever over 103° F (39.4° C)
  • Fever over 100.4° F (38.0° C) and over 60 years old
  • Fever and have diabetes
  • Fever and have a weak immune system from:
    • HIV
    • Cancer chemo
    • Long-term steroid use
    • Splenectomy
  • Fever and are bedridden (nursing home patient, stroke, chronic illness, or recovering from surgery)
  • Redness or swelling on the cheek, forehead, or near the eye
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Fever lasts more than 3 days
  • Fever returns after being gone for over 24 hours and symptoms are worse or not better
  • Sinus pain (not just pressure) and fever
  • Earache
  • You think you need to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Sinus pain (not just pressure) after using nasal washes for 24 hours
  • Sinus congestion (pressure) lasts more than 10 days
  • Runny nose lasts more than 10 days
  • You have other questions or concerns

Self Care at Home

  • Sinus congestion as part of a cold

Care Advice

Mild Sinus Pain and Congestion

  1. What You Should Know:
    • Sinus pain and congestion are normal parts of a cold.
    • Most often, nasal washes can stop you from getting a bacterial sinus infection. Antibiotics are not helpful.
    • You can treat mild sinus pain and congestion at home.
    • Here is some care advice that should help.
  2. For a Runny Nose: Blow the Nose.
    • Runny noses help to wash viruses and bacteria out of the nose.
    • Blowing the nose is all that is needed.
    • The skin near your nostrils may get irritated. You can rub a tiny amount of petroleum ointment on it 1 to 2 times a day.
  3. For a Stuffy Nose - Use Nasal Washes:
    • Salt water washes are a good way to treat sinus pain. You can pour, spray, or squirt water into your nose. Then let the water run back out.
    • How It Helps: The salt water rinses out mucus, dust, and allergens. It also keeps the nose moist.
    • Methods: There are a few ways to do nasal washes. You can use a:
      • Nasal spray bottle (sold over-the-counter)
      • Rubber ear syringe
      • Medical syringe without the needle
      • Neti Pot
    Step-By-Step Instructions:
    • Step 1: Lean over a sink.
    • Step 2: Gently squirt or spray warm salt water into one of your nostrils.
    • Step 3: Some of the water may run into the back of your throat. Spit this out. If you swallow the salt water, it will not hurt you.
    • Step 4: Blow your nose to clean out the water and mucus.
    • Step 5: Repeat steps 1-4 for the other nostril. Do this a couple times a day if it helps you.
    How to Make Salt Water Nasal Wash:
    • You can make your own salt water nasal wash.
    • Add ½ tsp of table salt to 1 cup (8 oz.; 240 ml) of warm water.
  4. Hydration: Drink plenty of liquids (6-8 glasses of water a day). If the air in your home is dry, use a cool mist humidifier.
  5. Cold Medicines: Most of these drugs are not helpful. They cannot remove dried mucus from the nose. Antihistamines are only helpful if you also have nasal allergies. Antibiotics are not helpful unless you have an ear or sinus infection.
  6. Nasal Decongestants for a Very Stuffy or Runny Nose:
    • Nasal decongestants can help you breathe better. They reduce the amount of nasal drainage. They may be taken as pills by mouth or as a nasal spray.
    • Most people do NOT need to use these medicines.
    • Pseudoephedrine (Sudafed): This is sold OTC, but it is kept behind the drug store counter. You will need to ask the pharmacist or clerk for it. Normal adult dose is two 30 mg tablets every 6 hours.
    • Phenylephrine (Sudafed PE): This is sold OTC in pill form. Normal adult dose is one 10 mg tablet every 4 hours.
    • Oxymetazoline Nasal Drops (Afrin): These are sold OTC. Blow your nose to clean out the mucus before using. Spray each nostril once. Wait one minute, and then spray a second time.
    • Phenylephrine Nasal Drops (Neo-Synephrine): These are sold OTC. Blow your nose to clean out the mucus before using. Spray each nostril once. Wait one minute, and then spray a second time.
    • Read the instructions on the package insert for all medicines you take.
  7. Fever and Pain Medicine:
    • For fever above 101° F (38.3° C) or pain you can take acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).
    • They are over-the-counter (OTC) drugs. You can buy them at the drugstore.
    • The goal for treating fever is to bring it down to a comfortable level.
    • Fever medicine usually lowers fevers by 2° F (1 - 1.5° C).
    • Use the lowest amount of a drug that makes your fever or pain feel better.
    • Acetaminophen is safer than ibuprofen in people over 65 years old.
    • Read the instructions and warnings on the package insert for all medicines you take.
  8. What to Expect:
    • Sinus congestion from colds most often lasts 5 to 10 days.
    • Sometimes, a cold can worsen and turn into bacterial sinusitis. Sinus symptoms will last more than 10 days. Your pain will get worse. You will also have a fever lasting more than 3 days. You may need antibiotics.
  9. Call Your Doctor If:
    • Severe pain lasts more than 2 hours after pain medicine
    • Sinus pain lasts more than 1 day after starting treatment using nasal washes
    • Sinus congestion lasts more than 10 days
    • Fever lasts more than 3 days
    • You think you need to be seen
    • You get worse

Neti Pot for Sinus Symptoms

  1. Neti Pot
    • The Neti Pot is a small pot with a thin spout. It looks like a small tea pot.
    • How It Helps: You can use the Neti Pot for a nasal wash. The salt water rinses out mucus, dust, and allergens. It also keeps the nasal cavity moist.
    • Indications: Neti Pots are used to help colds, sinus infections, and nasal allergies.
    • Adverse Reactions: None. Though, not all people like the feeling of pouring water into their nose.
    • See Internet videos for instructions, such as: Neti Pot on YouTube
  2. Neti Pot STEP-BY-STEP Instructions:
    • Step 1: Follow the directions on the salt package to make warm salt water.
    • Step 2: Lean forward and turn your head to one side over the sink. Keep your forehead slightly higher than your chin.
    • Step 3: Gently insert the spout of the Neti Pot into the higher nostril. Put it far enough so that it forms a comfortable seal.
    • Step 4: Raise the Neti Pot slowly. The salt water flows in your higher nostril and out the lower nostril. Breathe through your mouth.
    • Step 5: When the Neti Pot is empty, blow your nose. This will clean out the water and mucus.
    • Step 6: Some of the water may run into the back of your throat. Spit this out. If you swallow the salt water it will not hurt you.
    • Step 7: Refill the Neti Pot and repeat on the other side. Again, breathe out strongly to clear the nose.
    How to Make Saline (Salt Water) Nasal Wash:
    • You can make your own salt water nasal wash.
    • Add ½ tsp of table salt to 1 cup (8 oz.; 240 ml) of warm water.

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Last Reviewed: 12/16/2017 1:00:29 AM
Last Updated: 5/7/2017 1:36:17 PM

Copyright 2000-2017 Health Navigator, Inc. All rights reserved.

Health Center