Sinusitis (Sinus Infection) Causes, Symptoms, Diagnosis, Treatment, Prevention, Home Remedies

Sinusitis (Sinus Infection) Causes, Symptoms, Diagnosis, Treatment, Prevention, Home Remedies


What is Sinusitis (Sinus Infection)?


You're coughing and sneezing and tired and achy. You think that you might be getting a cold. Later, when the medicines you've been taking to relieve the symptoms of the common cold are not working and you've now got a terrible headache, you finally drag yourself to the doctor. After listening to your history of symptoms, examining your face and forehead, and perhaps doing a sinus X-ray, the doctor says you have sinusitis.

Sinusitis simply means your sinuses are infected or inflamed, but this gives little indication of the misery and pain this condition can cause. Normally, sinuses are filled with air, but when sinuses become blocked and filled with fluid, germs (bacteria, viruses, and fungi) can grow and cause an infection.

Sinusitis (Sinus Infection) Causes, Symptoms, Diagnosis, Treatment, Prevention
Sinusitis (Sinus Infection)


Conditions that can cause sinus blockage include the common cold, allergic rhinitis (swelling of the lining of the nose), nasal polyps (small growths in the lining of the nose), or a deviated septum (a shift in the nasal cavity).

 Health care experts usually divide sinusitis cases into

  • Acute, which lasts for 3 weeks or less
  • Chronic, which usually lasts for 3 to 8 weeks but can continue for months or even years
  • Recurrent, which is several acute attacks within a year
Health care experts estimate that 37 million Americans are affected by sinusitis every year. Health care workers report 33 million cases of chronic sinusitis to the U.S. Centers for Disease Control and Prevention annually. Americans spend millions of dollars each year for medications that promise relief from their sinus symptoms.

What are some causes of acute sinusitis?


Most cases of acute sinusitis start with a common cold, which is caused by a virus. These viral colds do not cause symptoms of sinusitis, but they do inflame the sinuses. Both the cold and the sinus inflammation usually go away without treatment in 2 weeks. The inflammation, however, might explain why having a cold increases your likelihood of developing acute sinusitis. For example, your nose reacts to an invasion by viruses that cause infections such as the common cold or flu by producing mucus and sending white blood cells to the lining of the nose, which congest and swell the nasal passages.

When this swelling involves the adjacent mucous membranes of your sinuses, air and mucus are trapped behind the narrowed openings of the sinuses. When your sinus openings become too narrow, mucus cannot drain properly. This increase in mucus sets up prime conditions for bacteria to multiply.

Most healthy people harbor bacteria, such as Streptococcus pneumoniae and Haemophilus influenzae, in their upper respiratory tracts with no problems until the body's defenses are weakened or drainage from the sinuses is blocked by a cold or other viral infection. Thus, bacteria that may have been living harmlessly in your nose or throat can multiply and invade your sinuses, causing an acute sinus infection.

Sometimes, fungal infections can cause acute sinusitis. Although fungi are abundant in the environment, they usually are harmless to healthy people, indicating that the human body has a natural resistance to them. Fungi, such as Aspergillus, can cause serious illness in people whose immune systems are not functioning properly. Some people with fungal sinusitis have an allergic-type reaction to the fungi.

Chronic inflammation of the nasal passages also can lead to sinusitis. If you have allergic rhinitis or hay fever, you can develop episodes of acute sinusitis. Vasomotor rhinitis, caused by humidity, cold air, alcohol, perfumes, and other environmental conditions, also may be complicated by sinus infections.

Acute sinusitis is much more common in some people than in the general population. For example, sinusitis occurs more often in people who have reduced immune function (such as those with immune deficiency diseases or HIV infection) and with abnormality of mucus secretion or mucus movement (such as those with cystic fibrosis).

What causes chronic sinusitis?


If you have asthma, an allergic disease, you may have frequent episodes of chronic sinusitis.

If you are allergic to airborne allergens, such as dust, mold, and pollen, which trigger allergic rhinitis, you may develop chronic sinusitis. In addition, people who are allergic to fungi can develop a condition called "allergic fungal sinusitis."

If you are subject to getting chronic sinusitis, damp weather, especially in northern temperate climates, or pollutants in the air and in buildings also can affect you.

Like acute sinusitis, you might develop chronic sinusitis if you have an immune deficiency disease or an abnormality in the way mucus moves through and from your respiratory system (e.g., immune deficiency, HIV infection, and cystic fibrosis). In addition, if you have severe asthma, nasal polyps (small growths in the nose), or a severe asthmatic response to aspirin and aspirin-like medicines such as ibuprofen, you might have chronic sinusitis often.

Who Gets Sinusitis (Sinus Infection)?


About 37 million Americans suffer from at least one episode of sinusitis each year. People who have the following conditions have a higher risk of sinusitis:


  • Nasal mucous membrane swelling as from a common cold
  • Blockage of drainage ducts
  • Structural differences that narrow the drainage ducts
  • Nasal polyps
Conditions that result in an increased risk of infection such as immune deficiencies or taking medications that suppress the immune system.

In children, common environmental factors that contribute to sinusitis include allergies, illness from other children at day care or school, pacifiers, bottle drinking while lying on one's back, and smoke in the environment.

In adults, the contributing factors are most frequently infections and smoking.

What Are the Signs and Symptoms of Sinusitis (Sinus Infection)?



The location of your sinus pain depends on which sinus is affected.


  • Headache when you wake up in the morning is typical of a sinus problem.
  • Pain when your forehead over the frontal sinuses is touched may indicate that your frontal sinuses are inflammed.
  • Infection in the maxillary sinuses can cause your upper jaw and teeth to ache and your cheeks to become tender to the touch.
  • Since the ethmoid sinuses are near the tear ducts in the corner of the eyes, inflammation of these cavities often causes swelling of the eyelids and tissues around your eyes, and pain between your eyes. Ethmoid inflammation also can cause tenderness when the sides of your nose are touched, a loss of smell, and a stuffy nose.
  • Although the sphenoid sinuses are less frequently affected, infection in this area can cause earaches, neck pain, and deep aching at the top of your head.
Most people with sinusitis, however, have pain or tenderness in several locations, and their symptoms usually do not clearly indicate which sinuses are inflamed.

Other symptoms of sinusitis can include


  • Fever
  • Weakness
  • Tiredness
  • A cough that may be more severe at night
  • Runny nose (rhinitis) or nasal congestion
In addition, the drainage of mucus from the sphenoids or other sinuses down the back of your throat (postnasal drip) can cause you to have a sore throat. Mucus drainage also can irritate the membranes lining your larynx (upper windpipe). Not everyone with these symptoms, however, has sinusitis.

On rare occasions, acute sinusitis can result in brain infection and other serious complications.

Diagnosis of Sinusitis (Sinus Infection)


Diagnosis of sinusitis can be difficult as its symptoms can mimic those of a common cold. In order to make an accurate diagnosis the doctor will take a full medical history including an assessment of the nature and duration of symptoms. They will also perform a physical examination including looking in the ears, throat and nose.

In recurrent and chronic cases a referral to a specialist ear nose and throat surgeon (otolaryngologist) may be required, as more extensive diagnostic procedures may be necessary. These may include: 

  • Examination of the nasal cavity and sinus openings with an endoscope (a small, thin telescope which enables the structures to be viewed through the telescope or on a television monitor).
  • A CT scan (a specialised x-ray that allows a cross sectional view of the sinuses to be seen, also called a “CT Miniseries”).
  • X-rays (less commonly used as CT scans give better resolution). 

How is Sinusitis (Sinus Infection) treated?


After diagnosing sinusitis and identifying a possible cause, a doctor can suggest treatments that will reduce your inflammation and relieve your symptoms.

Acute Sinusitis (Sinus Infection) treatment


If you have acute sinusitis, your doctor may recommend


  • Decongestants to reduce congestion
  • Antibiotics to control a bacterial infection, if present
  • Pain relievers to reduce any pain

You should, however, use over-the-counter or prescription decongestant nose drops and sprays for only few days. If you use these medicines for longer periods, they can lead to even more congestion and swelling of your nasal passages.

If bacteria cause your sinusitis, antibiotics used along with a nasal or oral decongestant will usually help. Your doctor can prescribe an antibiotic that fights the type of bacteria most commonly associated with sinusitis.

Many cases of acute sinusitis will end without antibiotics. If you have allergic disease along with infectious sinusitis, however, you may need medicine to relieve your allergy symptoms. If you already have asthma then get sinusitis, you may experience worsening of your asthma and should be in close touch with your doctor.

In addition, your doctor may prescribe a steroid nasal spray, along with other treatments, to reduce your sinus congestion, swelling, and inflammation.

Chronic Sinusitis (Sinus Infection) treatment


Doctors often find it difficult to treat chronic sinusitis successfully, realizing that symptoms persist even after taking antibiotics for a long period. In general, however, treating chronic sinusitis, such as with antibiotics and decongestants, is similar to treating acute sinusitis.

Some people with severe asthma have dramatic improvement of their symptoms when their chronic sinusitis is treated with antibiotics.

Doctors commonly prescribe steroid nasal sprays to reduce inflammation in chronic sinusitis. Although doctors occasionally prescribe them to treat people with chronic sinusitis over a long period, they don't fully understand the long-term safety of these medications, especially in children. Therefore, doctors will consider whether the benefits outweigh any risks of using steroid nasal sprays.

If you have severe chronic sinusitis, your doctor may prescribe oral steroids, such as prednisone. Because oral steroids are powerful medicines and can have significant side effects, you should take them only when other medicines have not worked.

Although home remedies cannot cure sinus infection, they might give you some comfort.


  • Inhaling steam from a vaporizer or a hot cup of water can soothe inflamed sinus cavities.
  • Saline nasal spray, which you can buy in a drug store, can give relief.
  • Gentle heat applied over the inflamed area is comforting.

When medical treatment fails, surgery may be the only alternative for treating chronic sinusitis. Research studies suggest that the vast majority of people who undergo surgery have fewer symptoms and better quality of life.

In children, problems often are eliminated by removal of adenoids obstructing nasal-sinus passages.

Adults who have had allergic and infectious conditions over the years sometimes develop nasal polyps that interfere with proper drainage. Removal of these polyps and/or repair of a deviated septum to ensure an open airway often provides considerable relief from sinus symptoms.

The most common surgery done today is functional endoscopic sinus surgery, in which the natural openings from the sinuses are enlarged to allow drainage. This type of surgery is less invasive than conventional sinus surgery, and serious complications are rare.

Can Sinusitis Be Prevented?

Although you cannot prevent all sinus disorders-any more than you can avoid all colds or bacterial infections-you can do certain things to reduce the number and severity of the attacks and possibly prevent acute sinusitis from becoming chronic.


  • Keep your nose as moist as possible with frequent use of saline sprays or washes.
  • Avoid very dry indoor environments and use a humidifier, if necessary. Be aware, however, that a humid environment also may increase the amount of mold, dust mite, or cockroach allergens in your home; this is important only if you are allergic to any of those organisms.
  • Drinking plenty of fluid - this helps to thin the nasal mucous and allow it to drain more easily.
  • Avoid exposure to irritants such as cigarette and cigar smoke or strong odors from chemicals.
  • Avoid exposure to substances to which you are allergic.
  • Drinking alcohol also causes nasal and sinus membranes to swell.
  • If you haven’t been tested for allergies and you are getting frequent sinus infections, ask your healthcare provider to give you an allergy evaluation or refer you to an allergy specialist.
  • Avoid long periods of swimming in pools treated with chlorine, which can irritate the lining of the nose and sinuses.
  • Avoid water diving, which forces water into the sinuses from the nasal passages.

If you suspect that your sinus inflammation may be related to dust, mold, pollen, or food-or any of the hundreds of allergens that can trigger an upper respiratory reaction-you should consult your doctor. Your doctor can use various tests to determine whether you have an allergy and its cause. This will help you and your doctor take appropriate steps to reduce or limit your allergy symptoms.

You may find that air travel poses a problem if you are suffering from acute or chronic sinusitis. As air pressure in a plane is reduced, pressure can build up in your head blocking your sinuses or eustachian tubes in your ears. Therefore, you might feel discomfort in your sinus or middle ear during the plane's ascent or descent. Some doctors recommend using decongestant nose drops or inhalers before your flight to avoid this problem.

Are there home remedies for a Sinusitis (Sinus Infection)?



Sinusitis (Sinus Infection) caused by viruses can use home (over-the-counter) treatments such as pain and fever medications (acetaminophen [Tylenol]), decongestants, and mucolytics. In addition, some health care providers suggest that nasal irrigation or a sinus rinse solution will help relieve symptoms of sinus infections, even chronic sinusitis symptoms. This irrigation is accomplished with a "Neti-Pot" or a sinus rinse kit (sometimes termed a nasal bidet). The last reference of this article shows a video of a sinus rinse procedure. In 2012, the FDA issued a warning about the use of Neti-Pots; the FDA cautions people not to use untreated tap water for rinsing, as contaminated tap water rinses lead to two deaths.

Bacterial and fungal Sinusitis usually require antibiotic or antifungal therapy so home treatments without them are often not successful. However, some authors suggest home treatments may reduce symptoms after medical therapy has begun; some health care practitioners recommend nasal irrigation after sinus surgery.