Sinus pain can be treated

At-home tips to alleviate discomfort

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— How can you tell if the pressure across your forehead indicates a sinus condition, a tension headache or a hangover? Read this.

The body's nasal and sinus membranes have similar responses to viruses, allergies and bacterial infections. When membranes become swollen and congested, they cause pain and pressure, usually over the cheeks and sometimes across the forehead, in your ears and around your eyes.

Sinus headaches tend to worsen as you bend forward or lie down. Mucus production increases during inflammation. Secretions may thicken, which sometimes leads to bacterial infection of the sinuses.

Headache is one of the key symptoms of patients diagnosed with acute or chronic sinusitis. Sinusitis patients also often complain of pain in the upper teeth, feeling of blockage in the ears, nasal congestion, yellow or green nasal discharge and bad breath.

However, some headaches related to chronic sinusitis occur without any respiratory symptoms. An examination for a sinus condition should be considered in the evaluation when treatment for a headache disorder is unsuccessful.

Because sinus headaches arise from swelling of sinus membranes and the collection of pus and mucus in blocked sinuses, the key to relieving the pain is to reduce sinus swelling and inflammation and to promote drainage from the sinuses.

Try these at-home steps that alleviate sinus pain by opening nasal passages and reducing congestion.

Breathe moist air by humidifying the dry air. You can use a steam vaporizer, cool-mist humidifier or steam from a shower. Irrigate your nasal passages. This will wash away pollens, dust particles, pollutants and bacteria, reducing mucosal inflammation and swelling. Moist membranes fight infections and allergies better. Several over-the-counter nasal rinse products containing salt water are available.

Decongestants and antihistamines are effective in relieving sinus pressure in many conditions. Afrin, Neo-Synephrine and other brands of decongestant nasal sprays rapidly decongest swollen nasal membranes. They are very useful in the early stages of a common cold and in preventing a sinus infection.

Be aware, however, that after three to five days of use, these nasal sprays create rebound congestion.

Oral decongestants relieve nasal swelling, pressure, dripping and congestion. They may cause increased blood pressure and heart rate, as well as giddiness. Antihistamines combat allergic symptoms of itching, sneezing and congestion. Newer, non-sedating varieties have been shown not to affect school and work performance as the OTC sedating antihistamines do.

If these treatments are not effective, an evaluation by a physician is warranted to establish the correct diagnosis of facial pain or pressure. A full exam including nasal endocsopy with a lighted optical magnification rod will usually be performed.

A CT scan of the sinuses may be ordered to evaluate nasal and sinus anatomy and identify any abnormalities. Treatment can then be tailored based on the exam and scan findings. Treatment options include medications such as antibiotics or nasal steroid sprays and nasal and endocsopic sinus surgery.

Surgery can produce a dramatic improvement for sinus pain sufferers, such as Tina Swinsick, of Steamboat Springs. "I can't believe how great I feel since sinus surgery," she said. "I can breathe easily through my nose now. I never have sinus pain anymore."

Nasal surgery includes straightening a deviated septum the bone and cartilage inside your nose that separates the right from the left nasal passage which may cause pain if it touches one of the sidewalls of the nose.

Endoscopic sinus surgery opens up the natural drainage pathways of the sinuses, which may become blocked by inflammation, infection or masses.

On the other hand, if it's hangover pain that you're suffering from, the best treatment is a blender concoction of tomato juice, raw eggs and Worcestershire sauce chased by 32 ounces of water and a couple of ibuprofen.

Maryann Wall, M.D., F.A.C.S., of Northwest Colorado ENT and Facial Plastic Surgery, is board-certified in otolaryngology and facial plastic and reconstructive surgery.

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