Advice and Guidance for Managing Symptoms of Sinusitis

Understanding Sinusitis

• Acute sinusitis is an inflammation of the sinuses that typically lasts less than 12 weeks. Symptoms often arise after a cold or viral infection and can last from a few days to a few weeks.
• Chronic sinusitis lasts for 12 weeks or more, with symptoms that may persist despite initial treatment.

Common Symptoms

• Facial pain or pressure, particularly around the eyes, cheeks, and forehead
• Nasal congestion or obstruction
• Thick nasal discharge, often yellow or green
• Reduced sense of smell
• Cough (especially at night), fever, and sometimes fatigue

Self-Management for Acute Sinusitis

• Rest and Hydration:

  • Get plenty of rest and drink fluids like water, herbal teas, or warm broths to help thin mucus, ease congestion, and support your immune system.

• Nasal Saline Irrigation:

  • Using a saline nasal spray or rinse can help clear nasal passages and reduce congestion. Saline rinses can be purchased over-the-counter, or you can prepare a saltwater solution at home (use clean, distilled, or previously boiled water to avoid infection).

• Steam Inhalation:

  • Inhale steam (e.g., from a warm shower or bowl of hot water) to relieve congestion and ease facial pain. Avoid burns by keeping your face at a safe distance from hot water.

• Pain Relief:

  • Over-the-counter pain relievers like paracetamol or ibuprofen can relieve facial pain or headache. Always follow dosing instructions on the package.

• Warm Compresses:

  • Applying a warm compress over the sinuses (such as a warm towel on your face) can help reduce facial pain and relieve congestion.

• Avoid Nasal Decongestants for Prolonged Use:

  • Over-the-counter nasal decongestant sprays (e.g., oxymetazoline) can help with short-term relief of nasal congestion, but should not be used for more than 3 days to prevent rebound congestion.

Self-Management for Chronic Sinusitis

• Daily Nasal Saline Irrigation:

  • Regular saline irrigation can help prevent mucus buildup, reduce inflammation, and improve symptoms over time. Use a sterile, distilled, or previously boiled water source.

• Avoid Known Triggers:

  • For those with allergies or sensitivities, avoid known triggers (e.g., dust, pollen, or smoke), as they can exacerbate sinus inflammation. Using an air purifier and cleaning regularly may help reduce allergens in your home.

• Humidify Your Environment:

  • Use a humidifier in dry environments to keep nasal passages moist, especially in winter when indoor air is often dry. Make sure to clean the humidifier regularly to prevent mold buildup.

• Consider Allergies and Inflammatory Causes:

  • If your chronic sinusitis is related to allergies, antihistamines or intranasal corticosteroid sprays (e.g., fluticasone) prescribed by a doctor may help manage inflammation. Long-term use of intranasal steroids should be done under medical supervision.

When to Seek Further Help

Most cases of sinusitis improve with self-care, but you should contact a healthcare provider if you experience any of the following:

• Severe or Worsening Symptoms:

  • If your symptoms are severe (e.g., intense facial pain, swelling, or high fever) or if they worsen after initial improvement, this may indicate a bacterial infection or another underlying issue requiring medical treatment.

• Symptoms Persist Beyond 10 Days (Acute Sinusitis):

  • If symptoms last more than 10 days without improvement or worsen significantly, a healthcare provider may consider prescribing antibiotics, particularly if bacterial infection is suspected.

• Chronic Symptoms Not Improving with Treatment:

  • If you have chronic sinusitis that does not improve with self-management, your doctor may recommend further treatment, such as prescription nasal corticosteroids or referral to an ENT (Ear, Nose, and Throat) specialist.

• Signs of Complications:

  • Seek immediate medical help if you experience any of the following, which may indicate a serious complication:
    • High fever (above 39°C/102°F)
    • Severe headache, swelling around the eyes, or vision changes
    • Stiff neck or confusion
    • Redness or swelling around the eyes or forehead (potential sign of orbital cellulitis)

• High-Risk Groups:

  • If you have other health conditions (e.g., asthma, weakened immune system), are pregnant, or experience recurrent sinus infections, you may be at increased risk of complications and should seek advice promptly if symptoms persist.

Prevention Tips for Recurrence

• Good Hand Hygiene: Wash your hands regularly, especially during cold and flu season, to reduce the risk of viral infections that can lead to sinusitis.
• Avoid Smoking and Secondhand Smoke: Smoke irritates the sinuses and can contribute to inflammation. Avoid smoking and secondhand smoke exposure.

Summary of Key Points

• Acute sinusitis usually resolves with self-care. Hydration, nasal saline irrigation, and pain relief can help manage symptoms.
• Chronic sinusitis requires ongoing management with daily saline irrigation and possibly allergy management.
• Seek medical advice if symptoms persist beyond 10 days, worsen, or if you have severe symptoms, vision changes, or other signs of complications.

This guidance provides an evidence-based approach to managing both acute and chronic sinusitis using advice from CKS, BTS, and BMJ Best Practice.