What Is Sinus Congestion?

Sinus congestion is the result of inflammation of your nasal passages and the sinuses, which are empty cavities behind your nose. It is often seen as a symptom of a cold or allergies and can be a sign of a sinus infection (rhinosinusitis). While you may be able to get relief from home treatments and over-the-counter medications, it is good to understand when you should talk to your healthcare provider.

Common symptoms of sinus congestion may include:

• Head feels stuffed up
• Pressure in your face and eyes
• Pressure-like pain in the face, behind the eyes, or toothache
• Difficult to breathe through the nose
• Runny nose
• Postnasal drip and sore throat

While sinus congestion might clear up in a day or two, sometimes it lingers and goes from acute (less than four weeks) to subacute (four weeks to three months) to chronic (three months or longer).

Signs that you should see a doctor include:

• Swelling of the forehead, eyes, or face
• Discharge that has a bad smell
• Discharge from only one side
• Symptoms lasting more than three weeks
• Fever

Normally, your sinuses are empty, air-filled spaces that warm, moisten, and filter air breathed through the nose. The lining produces mucus that is moved out of the sinuses and nasal passages buy small hairs (cilia). Inflammation due to infection or an allergic reaction can result in excessive mucus and make it difficult for it to drain from the sinuses. At times, there can be a mechanical obstruction that prevents sinus drainage. Once sinus congestion is present, it can lead to a bacterial sinus infection.

Common causes of sinus congestion include:

• Viral respiratory infections, such as the common cold and influenza
• Allergies
• Mechanical blockages such as a deviated nasal septum, nasal polyps, or nasal bone spur
• Sinus infection
• Pregnancy

Sinus congestion is often seen with other symptoms, which may point towards the cause. If it seems to be part of an uncomplicated cold or flu, you might not seek a further diagnosis. Often, these will go away on their own after a few days. But if you have any concerns about your symptoms, or if it lingers or worsens, contact your healthcare provider to see if you need more of a workup.

Your doctor will take your history and do a physical examination. If the flu is suspected, you may get a flu test. If allergies are suspected, you may be given allergy testing. Imaging tests such as endoscopy or computed tomography (CT) of the sinuses may be performed to look for structural blockages. If a sinus infection is suspected, you might get a nasal culture.

How sinus congestion is treated depends on its cause. Home remedies and self-care can help relieve it if you are waiting for a cold to run its course. Medications that can relieve the symptoms might also be used. In the case of structural causes, surgery might be needed.

A variety of non-medication treatments are available to help relieve sinus congestion. Simple solutions include placing a warm, moist washcloth on your face a few times a day and making sure you drink enough help thin the mucus. Also, inhaling steam may help. Other options include humidifiers, saline nasal sprays, and saline nasal drops.

Humidifiers

Humidifiers help keep moisture in the air. Running a cool mist humidifier, especially while sleeping, will help reduce the risk of dried nasal passages and thick congested noses in the morning.

Saline Nasal Spray and Drops

Saline nasal spray used a few times a day can help loosen congestion and improve drainage. This is a safe and effective alternative to medication as saline nasal spray is simply sterile saltwater. For infants, saline nose drops and a bulb syringe can help clear thick mucus from the nose.

Neti Pot

Neti pots have been used for many years to rinse out the sinus cavities. Using a saline solution, you can use this device that looks like a miniature teapot to rinse the mucus out of your sinuses naturally, without taking medications. As well, there are other forms of sinus and nasal irrigators.

There are over-the-counter and prescription medications that may help relieve sinus congestion.

Antihistamines are used for a runny nose. They help dry the sinus congestion and slow the nasal drips. Antihistamines are most commonly used to treat seasonal allergies. Some common antihistamines include Benadryl (diphenhydramine), Claritin (loratadine), Zyrtec, and Allegra.

Decongestants are used for that stuffy, full feeling in your head. They reduce the swelling in your nasal passages and allow mucus to drain. Some common decongestants include Sudafed (pseudoephedrine) and Sudafed PE (phenylephrine).

Many medications combine one of these decongestants or antihistamines with other medications to make multi-symptom treatments. They are sold under numerous brand names.

Nasal corticosteroid sprays may also be used to decrease swelling if you have allergies or nasal polyps.

If sinus congestion has resulted in a bacterial sinus infection, your doctor may recommend antibiotics.

For allergies, your doctor may recommend allergy shots (immunotherapy) that can help prevent sinus congestion in the future.

For chronic sinus congestion caused by a deviated septum, nasal polyps, or a fungal sinus infection, you may need surgery to allow the sinuses to drain properly.

While sinus congestion is unpleasant, it should resolve if it is due to a cold or other respiratory infection. Having sinus congestion from allergies can set you up for a sinus infection, however, so it is good to consult your doctor if your congestion is ongoing.