Have you ever had a facial pain or a headache with nasal congestion that you just can’t seem to shake no matter what over the counter medications you use? You may have sinusitis or in common terms, a sinus infection. Your sinuses are hollow air spaces within the bones surrounding the nose, they produce mucous to help clean the nose. Sinusitis can be caused by bacterial or viral infection, allergies, or irritation by chemicals or particulate matter.

There are several different classifications of sinusitis, including acute infection which lasts up to 4 weeks, subacute infection which lasts 4-12 weeks, and chronic infection which lasts more than 12 weeks. Sinusitis may also be classified as noninfectious which can be caused by allergies and hay fever. Acute sinusitis is common and affects 1 in 10 people each year.

Sinusitis usually begins with a bout of the common cold, influenza or some other viral infection. This causes the nasal mucosa to swell. This swelling causes the mucosa to block the sinuses from draining. Most cases of sinusitis are caused by viruses, but in some cases a bacterial infection can develop. This occurs when the sinus fills with mucous and empties of oxygen, this creates an ideal environment for bacteria to grow. The bacteria are usually already in the nose, but when the individual is healthy the body hold the bacteria in check. During times when the immune system is suppressed or not working properly, these bacteria can cause an infection. Allergies and hay fever may also increase your chances of getting sinusitis.

The main symptoms of sinusitis include facial pain, nasal congestion, post nasal drip and reduced ability to smell, headache, fatigue and cough. Infection of the lower or maxillary sinuses cause toothache in the upper jaw and pain under the eyes. Infection in frontal sinuses causes pain in the temple, and infection in the small sinus behind the eyes causes pain behind and between the eyes. Yellow or green pus may drain from the nose and there may be an unpleasant smell.

Acute viral sinusitis is likely if a person has been sick less than 10 days and symptoms are not getting worse, while bacterial sinusitis is likely if a person is sick for more than 10 days and symptoms are not improving or symptoms are getting worse. Acute viral sinusitis does not benefit from antibiotics, but may be treated using steroid nasal sprays, pain relievers, or salt water irrigation in the nose. These treatments are also beneficial for individuals who have bacterial sinusitis, but the addition of antibiotics is also helpful for a quicker recovery. Chronic sinusitis lasts longer than 12 weeks. Although Infection can play a role in chronic sinusitis, it is not usually the main culprit. It is usually caused by chronic inflammation rather than infection. The goal of treatment for chronic sinusitis is to control inflammation by using saline nasal sprays and nasal steroid sprays. Also, eliminating and treating other causes that may contribute to the inflammation of the nasal mucosa, such as allergies, nasal polyps, and asthma will help control chronic sinusitis.

If you have symptoms of sinusitis, over the counter treatments such as saline nasal sprays and a mucolytic may help reduce symptoms and prevent the sinus passages from becoming blocked. If the symptoms persist without improvement beyond 10 days an antibiotic may be indicated to resolve the infection. Chronic sinusitis requires ongoing treatment to reduce chronic inflammation. Consult your primary care doctor for the appropriate treatment of your symptoms.