Sinus Congestion

Also indexed as: Nasal Congestion, Rhinitis, Stuffy Nose

Breathe freely again by clearing blocked passageways and easing sinus pressure. According to research or other evidence, the following self-care steps may help you find some relief and fight off infection:

Wipe out irritants
Keep your environment free of irritants and allergens that can trigger sinus congestion, such as dust, mould, smoke, chemical fumes, and animal dander

Steam clean with aromatic oils
Use steam inhalation with eucalyptus oil or products containing menthol to reduce nasal stuffiness

Try nasal irrigation
Prepare a warm, salt-water solution in a special ceramic pot known as a “neti lota” pot and pour it through your nose to relieve your sinuses

Uncover food allergies
Work with a knowledgeable practitioner to find out if food allergens may contribute to your sinus congestion

Get a check-up
Visit your doctor to find out if your sinus congestion may be caused by an infection, inhalant allergy, or other treatable medical condition

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or chemist. Continue reading the full sinus congestion article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.

About sinus congestion

Sinus congestion (also called nasal congestion or rhinitis) involves blockage of one or more of the four pairs of sinus passageways in the skull.

The blockage may result from inflammation and swelling of the nasal tissues, obstruction by one of the small bones of the nose (deviated septum), or from secretion of mucus. It may be acute or chronic. Acute sinus congestion is most often caused by the common cold. Sinus congestion caused by the common cold is not discussed here. Chronic sinus congestion often results from environmental irritants such as tobacco smoke, food allergens, inhaled allergens, or foreign bodies in the nose.

Sinus congestion leads to impaired flow of fluids in the sinuses, which predisposes people to bacterial infections that can cause sinusitis. At least two serious disorders have been associated with chronic nasal congestion: chronic lymphocytic leukaemia and HIV.¹ ² For this reason, chronic nasal congestion lasting three months or more should be evaluated by a medical professional.

Product ratings for sinus congestion

Science Ratings	Nutritional Supplements	Herbs
		Eucalyptus
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. For a herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.

What are the symptoms?

Sinus congestion typically causes symptoms of pressure, tenderness, or pain in the area above the eyebrows (frontal sinus) and above the upper, side teeth (maxillary sinus). Other symptoms include nasal stuffiness sometimes accompanied by a thick yellow or green discharge, postnasal drip, bad breath, and an irritating dry cough.

Medical options

Over the counter products may help to reduce the symptoms associated with sinus congestion. Analgesics, such as aspirin (Bayer®, Ecotrin®, Bufferin®), ibuprofen (Motrin IB®, Advil®), and paracetamol (Tylenol®), reduce pain due to sinus pressure. Topical nasal decongestants such asoxymetazoline (Afrin®) and phenylephrine (Neo-Synephrine®) may provide relief from nasal congestion, but they should only be used for a few days. The oral decongestant pseudoephedrine (Sudafed®) may help relieve nasal congestion, while antihistamines such as diphenhydramine (Benadryl®), brompheniramine (Dimetapp®), loratadine (Claritin®, Alavert®), and chlorpheniramine (Chlor-Trimeton®) might help dry excess mucous. Guaifenesin (Robitussin®, Mucinex®) is an expectorant used to remove mucous in the sinuses, lungs, and ears.

Prescription strength pain relievers, such as ibuprofen (Motrin®), naproxen (Naprosyn®), and paracetamol with codeine (Tylenol® with Codeine), may be prescribed. Oral antibiotics, such as amoxicillin/clavulanate (Augmentin®), loracarbef (Lorabid®), azithromycin (Zmax®), and cefprozil (Cefzil®), are generally prescribed for sinus infection. Corticosteroid nasal sprays, such as flunisolide (Nasarel®), fluticasone (Flonase®), mometasone (Nasonex®), budesonide (Rhinocort Aqua®), or triamcinolone (Nasacort AQ®), may also be used to reduce inflammation.

Surgery may be used to unblock the sinuses and drain thick secretions if drug therapy is ineffective or if structural abnormalities are involved.

Dietary changes that may be helpful

Food allergy appears to play an important role in many cases of rhinitis, which is related to sinus congestion. In a study of children under one year of age with allergic rhinitis and/or asthma, 91% had a significant improvement in symptoms while following an allergy-elimination diet.³ In the experience of one group of doctors, food allergy was the most common cause of chronic rhinitis.⁴ Two other researchers have found food allergy to be a contributing factor to allergic rhinitis in 25%⁵ and 39%⁶ of cases, respectively. Food allergies are best identified by means of an allergy-elimination diet, which should be supervised by a doctor.

Lifestyle changes that may be helpful

The most common cause of nasal congestion is allergy to inhalants, such as pollen, moulds, dust mites, trees, or animal dander. Exposure to various chemicals in the home or workplace may also contribute to allergic rhinitis. Indoor and outdoor air pollution may also be a factor in susceptible people. Smoking and secondhand exposure to tobacco smoke have been implicated in chronic nasal congestion⁷ and the prevalence of chronic rhinitis among men has been shown to increase with increasing cigarette consumption.⁸ People exposed to chlorine, such as lifeguards and swimmers, may also be at risk of developing nasal congestion.⁹

Careful evaluation by an allergist or other healthcare professional may help identify factors contributing to nasal congestion. Sometimes strict avoidance of the triggering agents (e.g., thoroughly vacuuming house dust or using dust covers on the mattresses) may provide relief. Where complete avoidance of irritants is not possible, desensitisation techniques (immunotherapy [allergy shots]) may be helpful.

Nasal irrigation with warm water or saline may be helpful for reducing symptoms of sinus congestion, although steam inhalations appear to be less useful. In a study of people suffering from the common cold, steam inhalation did not improve sinus congestion any better than placebo.¹⁰ In a similar controlled study, irrigation of the nasal passages with heated water or saline, decreased nasal secretions, although inhalation of water vapour did not.¹¹

Herbs that may be helpful

Eucalyptus oil is often used in a steam inhalation to help clear nasal and sinus congestion. Eucalyptus oil is said to function in a fashion similar to that of menthol by acting on receptors in the nasal mucous membranes, leading to a reduction in the symptoms of nasal stuffiness.¹²

Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.

Integrated approaches that may be helpful

Acupuncture may be useful for decreasing chronic sinus congestion. In one clinical study, most participants experienced at least temporary relief after acupuncture needles were inserted alongside the nose.¹³

References
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1. Amir R, Dowdy YG, Goldberg AN. Chronic rhinitis: a manifestation of chronic lymphocytic leukemia. Am J Otolaryngol 1999;20:328–31.

2. Lin RY, Lazarus TS. Asthma and related atopic disorders in outpatients attending an urban HIV clinic. Ann Allergy Asthma Immunol 1995;74:510–5.

3. Ogle KA, Bullock JD. Children with allergic rhinitis and/or bronchial asthma treated with elimination diet: a five-year follow-up. Ann Allergy 1980;44:273–8.

4. Rowe AH, Rowe A Jr. Perennial nasal allergy due to food sensitization. J Asthma Res 1965;3:141–54.

5. Derlacki EL. Food sensitization as a cause of perennial nasal allergy. Ann Allergy 1955;13:682–9.

6. Davison HM. The role of food sensitivity in nasal allergy. Ann Allergy 1951;9:568–72.

7. Benninger, MS. The impact of cigarette smoking and environmental tobacco smoke on nasal and sinus disease: a review of the literature. Am J Rhinol 1999;13:435–8.

8. Annesi-Maesano I, Oryszczyn MP, Neukirch F, Kauffmann F. Relationship of upper airway disease to tobacco smoking and allergic markers: a cohort study of men followed up for 5 years. Int Arch Allergy Immunol 1997;114:193–201.

9. Leroyer C, Malo JL, Girard D, et al. Chronic rhinitis in workers at risk of reactive airways dysfunction syndrome due to exposure to chlorine. Occup Environ Med 1999;56:334–8.

10. Macknin ML, Mathew S, Medendorp SV. Effect of inhaling heated vapor on symptoms of the common cold. JAMA 1990;264:989–91.

11. Georgitis JW. Nasal hyperthermia and simple irrigation for perennial rhinitis. Changes in inflammatory mediators. Chest 1994;106:1487–92.

12. Schulz V, Hansel R, Tyler VE. Rational Phytotherapy, 3rd ed. Berlin: Springer Verlag, 1998, 146–7.

13. Hu Y, Liu J. 200 cases of chronic rhinitis treated by acupuncture at nei ying xiang. J Tradit Chin Med 1997;17:53–4.

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or chemist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires March 2007.