What Is Sinus Congestion?

Sinus congestion develops when there's inflammation in the nasal passages and sinuses, which are air-filled cavities behind the nose. It's a common symptom of a cold or allergies and can be a sign of a sinus infection (rhinosinusitis). You can often get relief from home treatments and over-the-counter medications, but there are times when you may need to talk to your doctor about your congestion.

Types of Sinus Congestion

Sinus congestion can be classified by how long it lasts. It might clear up in a day or two, and sometimes it lingers.

• Acute sinus congestion: Lasts less than four weeks
• Subacute sinus congestion: Lasts four weeks to three months
• Chronic sinus congestion: Persists for three months or longer

Sinus Congestion Symptoms

Common symptoms of sinus congestion may include:

• Head stuffiness
• Pressure in your face and eyes
• Pressure-like pain in the face or behind the eyes
• Difficulty breathing through the nose
• Runny nose
• Postnasal drip
• Sore throat
• Pressure in your ears

Signs that you should see a doctor include:

• Swelling of the forehead, eyes, or face
• Nasal discharge that has a bad smell
• Nasal discharge from only one side
• Symptoms lasting more than three weeks
• Fever
• Double vision or blurred vision
• Swelling of the eye

Causes

Normally, your sinuses are empty, air-filled spaces that warm, moisten, and filter the air you breathe through your nose. The sinus lining produces mucus that is moved out of the sinuses and nasal passages by cilia (small hairs).

Inflammation due to infection or an allergic reaction can lead to excessive mucus production and can make it difficult for the mucus to drain from the sinuses. Mechanical obstruction can also prevent sinus drainage.

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

An uncomplicated cold or flu will often go away on its own after a few days but sinus congestion can sometimes lead to a bacterial sinus infection.

Diagnosis

If you are in a high-risk group for flu complications or if your symptoms linger or worsen, contact your doctor.

They will take your history and do a physical examination. You can also have other symptoms along with your sinus congestion. Sometimes your doctor will determine the cause of your congestion based on your other symptoms.

You might need diagnostic testing if the cause of your congestion isn't clear or if there is concern that you might need medical intervention. For example, you may need a nasal culture, a flu test, or allergy testing.

Imaging tests such as endoscopy or computed tomography (CT) of the sinuses can often identify structural blockages.

Treatment

How sinus congestion is treated depends on its cause. Home remedies and self-care can often help you feel more comfortable as you wait for a cold to run its course. Medications that can relieve the symptoms might also be recommended. In the case of structural causes, surgery might be needed.

Home Remedies

A variety of non-medication treatments can 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 fluids to help thin the mucus.

Inhaling steam can be helpful too. Make sure you keep your face away from hot water or steam to avoid getting a burn.

Other options include:

• Humidifiers: These home devices help keep moisture in the air. Running a cool mist humidifier, especially while you sleep, can help reduce the risk of dried nasal passages or thick congestion in the morning.
• Saline nasal spray and drops: Saline nasal spray used a few times a day can help loosen congestion and improve drainage. Saline nasal spray is simply sterile salt water, and this treatment is a safe and effective alternative to medication. For infants, saline nose drops and a bulb syringe can help clear thick mucus from the nose.
• Neti pot: These have been used for many years to rinse out the sinus cavities. Using a saline solution, you can use the pot (which looks like a miniature tea kettle) to rinse the mucus out of your sinuses naturally.

Medications

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

Antihistamines are used to treat a runny nose. They help dry the sinus congestion and slow nasal drip. 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 your sinus congestion leads to a bacterial sinus infection, your doctor may recommend antibiotics.

For allergies, your practitioner may recommend allergy shots (immunotherapy) to help prevent sinus congestion in the future.

Surgery

For chronic sinus congestion caused by structural issues, such as a deviated septum, nasal polyps, or a fungal sinus infection, you may need surgery to help your sinuses drain properly.

A Word From Verywell

While sinus congestion is unpleasant, it should resolve if it is due to a cold or other respiratory infection. Recurrent sinus congestion can set you up for a sinus infection, so it is good to consult your doctor if your congestion won't go away or keeps coming back.