Sinusitis: nasal congestion, symptoms and treatment

Sinusitis is inflammation of the cavities around the nose (the sinuses) and often follows a cold or allergy. Most acute cases are viral and clear up within 10 days on their own — antibiotics aren't always needed.

Symptoms

Sinusitis shows up with several symptoms around the nose and face:

• Pressure and fullness in the face, forehead or cheeks (worse when bending)
• A blocked nose and thick, yellow-green discharge
• Headache and a reduced sense of smell
• Post-nasal drip, cough and bad breath

Viral or bacterial?

This distinction matters for treatment. Viral sinusitis (most common) starts with a cold and begins to improve within 7–10 days. Bacterial sinusitis lasts more than 10 days, improves then worsens ('double sickening'), or comes with a high fever — in which case antibiotics may be needed.

Relief at home

Most cases ease with simple measures at home:

• Rinse your nose with saline (salt water)
• Inhale steam and humidify the room
• Drink plenty of fluids and sleep with your head slightly raised
• Ease discomfort with pain/fever relievers

Allergy and chronic sinusitis

When symptoms last more than 12 weeks it is called chronic sinusitis, often linked to allergy, nasal polyps or a deviated septum. Managing the allergy (avoiding triggers, doctor-prescribed sprays) plays a key role in these cases.

Treatment and what to avoid

Saline rinses and steam are the safest methods. Don't use decongestant nasal sprays for more than 3–5 days — otherwise 'rebound congestion' develops. Antibiotics should only be used for suspected bacterial sinusitis, on a doctor's prescription.

When to see a doctor

See an ENT doctor if symptoms last more than 10 days, or with severe facial pain, swelling or redness around the eye, vision changes, neck stiffness or high fever.

Frequently asked questions

Is sinusitis contagious?

Sinusitis itself isn't, but the cold virus that triggers it can be.

Are nasal sprays safe?

Saline sprays are safe; using decongestant sprays for more than 3-5 days can worsen congestion.

How do I tell a sinus headache from a migraine?

A sinus headache usually comes with facial pressure, a blocked nose and discharge; a migraine is throbbing and comes with light/sound sensitivity.

This article is for information only and does not replace a doctor's advice.