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Lungs and Respiratory System
Sinusitis: What It Is and Why It Is Difficult to Cure
January 22, 2025
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Sinusitis is the inflammation of the tissue lining the sinuses ‑ the air‑filled cavities in your skull around your nose, cheeks, and forehead. When these spaces become swollen and blocked due to a viral, bacterial, or fungal infection, they can't drain properly, leading to pain, pressure, congestion, and sometimes infection.
Acute sinusitis typically lasts less than four weeks and is often triggered by a cold or allergies. Chronic sinusitis persists for 12 weeks or longer and can significantly impact quality of life.
Why Sinusitis Is Challenging to Cure
The difficulty in treating sinusitis stems from several anatomical and biological factors. The sinuses have tiny drainage openings that can easily become blocked by swelling, making it hard for infected material to clear out naturally. Unlike other body parts with good blood flow, the sinuses have limited circulation, which means medications and immune cells have trouble reaching infected areas effectively.
Sinusitis rarely has just one cause. It can result from viral or bacterial infections, allergies, nasal polyps, deviated septums, or immune system issues. Environmental factors, such as pollution, dry air, or irritants, can exacerbate symptoms. This complexity means that treating one aspect might not resolve the overall problem.
In addition, sinus anatomy varies significantly between people. Some have naturally narrower drainage passages or structural abnormalities that predispose them to recurring problems. What works for one person may not work for another due to these anatomical differences.
What are the risk factors?
Certain risk factors can make people more likely to get this condition:
- Smoking
- Having hay fever or cystic fibrosis
- Undergoing altitude changes (when flying or scuba diving)
- Having abnormal paranasal sinus structure
For kids, going to a daycare is the main risk factor.
Adults can develop symptoms of acute sinusitis after a cold that does not improve or gets worse after five to seven days. The most common symptoms are:
- Stuffy and runny nose
- Headache
- Sore throat and postnasal drip
- Pain or pressure behind the eyes or in the teeth
- Fatigue and feeling of general discomfort
- Fever
- Bad breath or loss of smell
- Cough that generally gets worse at night
The signs of chronic sinusitis are the same as those of acute sinusitis, although they tend to be milder and last more than 12 weeks.
How to protect yourself
If you have this condition, you can try different options to relieve your symptoms.
To alleviate the absence of airflow in the paranasal sinuses, specialists recommend:
- Applying a warm, wet washcloth to your face several times a day
- Drinking plenty of fluids (to dilute mucus)
- Inhaling steam two to four times a day
- Rinsing the nose with saline solutions
You should exercise regularly, sleep six to eight hours a night, and avoid flying (because of altitude changes).
When to see a doctor
You should see a health care professional if:
- The symptoms last more than ten days without improving (most cases resolve on their own during this time).
- You feel intense pain around the nose and eyes.
- You have a fever (above 40 °C or 104 °F) or a rapidly spreading rash.
Experts recommend caution when using over‑the‑counter nasal decongestants, such as oxymetazoline (Afrin) or neo‑synephrine, as using them for more than three to five days can be counterproductive.
The most extreme cases may require surgery to enlarge the opening and drain the paranasal sinuses.
Remember:
Until there is significant scientific evidence from studies in humans, people should be very careful when using herbal therapies and supplements.
Don’t stop or change your medications or treatments before speaking to a doctor about the potential effects of complementary or alternative therapies.
Don’t forget that the medicinal properties of herbs and supplements can also interact with prescription medications and other herbs and supplements and may even affect your diet.
Sources: Natural Medicines Comprehensive Database; National Library of Medicine; Mayo Clinic.
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