20 Sep What are the symptoms of acute sinusitis?
Symptoms that commonly occur include:
- Pain and tenderness over the infected sinus. The pain is often throbbing and worse when you bend your head forward. Chewing may be painful.
- Nasal symptoms. You may have either:
- A blocked nose. Both sides of your nose usually feel blocked. Your sense of smell may also go for a while.
- A runny nose. If the discharge is greeny/yellow, it is more likely that you have a germ (bacterial) infection in your sinuses. The green/yellow colour is due to infected mucus and pus. A runny nose may dry up if the sinus drainage channels become blocked with thick mucus. If this happens, pain and tenderness over the infected sinus may become worse.
- A high temperature (fever). This may develop and you may feel generally unwell.
Other symptoms that may occur include:
- Bad breath
- A feeling of pressure or fullness in the ears
In children, symptoms may include:
- Ear discomfort
- Mouth breathing
- Feeding difficulty
- Nasal speech
How is acute sinusitis diagnosed?
Your doctor can usually diagnose acute sinusitis from listening to your typical symptoms. They may also check to see if you have a temperature or if you have tenderness over your sinuses. They may examine your nose, as often the lining of the nose is swollen in acute sinusitis. Investigations are not usually needed to diagnose acute sinusitis. Occasionally, blood tests, X-rays or scans are advised if the diagnosis is not clear.
What are the treatments for sinusitis?
Are antibiotics needed?
Not usually. Most cases of acute sinusitis are due to infection with a germ called a virus. Like with colds, the immune system usually clears the virus and symptoms generally go within a couple of weeks. Antibiotics do not kill viruses. Also, even if the infection is caused by germs called bacteria, the immune system will usually clear it away. So, for most people with acute sinusitis, antibiotics are not needed. Antibiotics can also cause side-effects. Side-effects can include diarrhoea, a feeling of sickness (nausea), being sick (vomiting), skin rashes and fungal infection (thrush). However, antibiotics are sometimes useful. Your doctor is not likely to prescribe an antibiotic for a mild bout of acute sinusitis. But a course of antibiotics may be prescribed in some cases – for example:
- If your symptoms are severe or if you are very unwell.
- If you have another illness such as cystic fibrosis, heart problems or a weakened immune system.
- If your symptoms are not settling within seven days, or are worsening.
Treatment to relieve symptoms
Some treatments may help to relieve symptoms whilst waiting for your immune system to clear the infection. These include the following:
- Painkillers such as paracetamol or ibuprofen will usually ease any pain. They will also help to bring down any high temperature (fever) that you may have. Sometimes stronger painkillers such as codeine are needed for a short time.
- Decongestant nasal sprays or drops are sometimes used. You can buy these from pharmacies. They may briefly relieve a blocked nose. However, they are not thought to shorten the duration of acute sinusitis. You should not use a decongestant spray or drops for more than 5-7 days at a time. If they are used for longer than this, they may cause a worse rebound congestion in the nose.
- Keeping hydrated can be helpful, so have plenty of drinks.
- Warm face packs held over the sinuses may help to ease pain.
- Saline nasal drops may help to relieve congestion and blockage in the nose.
Steam inhalation is a traditional remedy but is now not usually advised. This is because there is little evidence that it helps. Also, there have been some reports of people burning themselves trying to breathe in steam from a kettle. However, some people say that their nose feels clearer for a short while after a hot shower.
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