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What causes sinus pain and congestion?

What causes sinus pain and congestion?


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When the sinuses flare up, it can get very painful. Thus, my question - what biological mechanisms cause the congestion and especially the pain associated with sinusitis?


Inflamed sinuses are often associated with some kind of illness or irritant such as flu, the common cold, or hay-fever. As an example the cold causes sinus pain and inflammation because the virus is attacking/located in the nasal passages which causes swelling in the mucus membrane (the mucus membrane lines the sinus cavities). The swelling, along with increased mucus production, combines to create clogging and the pressure associated causes pain. Humidity will help loosen the mucus and anti-inflammatory medication should help reduce pain by reducing the mucus build up and swelling - thus relieving pressure.

The increase in mucus production is because of the role it plays in our bodies - it is produced to trap foreign bodies and help keep our system clean. The more mucus we produce the more our bodies are trying to clean up. This can cause an excess which is difficult to clear such that our sinuses become blocked and dried mucus becomes an irritant.

Sinusitis is the painful condition of swelling in the mucus membrane. Sinus comes from the latin for bent or curved surface, and -itis is from greek meaning swelling or inflammation linked to disease.

In summary: Painful sinuses, aka sinusitis, are painful because of infection in the mucus membrane producing swelling and excessive mucus build-up.


10 Steps to Avoid Sinus Pain and Congestion

Colds, flu, allergens, and pollutants are the most common causes of sinus pain. Learn 10 steps you can take to avoid a sinus infection and the congestion it causes.

Sinus pain is one of the most common reasons people seek medical attention. Each year, more than 37 million Americans experience sinusitis symptoms like sinus pain, nasal congestion, and thick nasal discharge, according to the American Academy of Otolaryngology — Head and Neck Surgery. Those numbers are growing because of an increase in pollutants, along with a resistance to antibiotics.

What causes sinus pain and congestion? “The number one cause is allergies,” says Jyoti Gopal, MD, a family practice physician with the Lehigh Valley Health Network in Bethlehem, Pennsylvania. Some people have seasonal allergies and are bothered most during the spring and fall, when the pollen counts are high, she says, while others have year-round allergies that continually trigger their sinus pain and congestion.

The second leading cause is the common cold or flu, Dr. Gopal says. A cold, which is caused by a virus, can turn into a sinus infection. The cold virus attacks the lining of your sinuses, which respond by swelling this results in narrowing of the drainage pathways in the sinuses and nose, according to the American Academy of Otolaryngology — Head and Neck Surgery. In response, you produce more mucus, which gets blocked in your swollen sinuses. Bacteria like to grow where the mucus builds up and sometimes cause a lingering sinus infection — an infection can linger even after the cold virus is gone.

Other causes of sinus pain, pressure, and congestion include:

  • Pollutants. Air pollution, cigarette smoke, and chemical irritants such as pesticide sprays and household cleaners can inflame the sinus linings.
  • Polyps. These are sac-like growths of inflamed tissue on the lining of the sinuses.
  • Anatomical issues. A structural problem such as a deviated septum or nasal bone spur can prevent mucus from draining out of the sinus, Gopal says.
  • Fungi. This is a growing problem, especially in people with weakened immune systems from conditions such as AIDS, leukemia, and diabetes. Fungi, just like bacteria, can cause a sinus infection, but will not respond to antibiotics. The most common fungus associated with sinusitis is aspergillus, according to the University of Maryland Medical Center.
  • Swimming or diving. These activities can increase your risk for sinusitis because of pressure changes in the nose and sinuses.

Sinus Pain and Congestion: How to Avoid It

Can you prevent sinus pain and congestion? Probably not altogether, Gopal says, but you can take these steps to keep infections and allergens at bay:

  1. Wash your hands frequently. This is especially important during cold weather, when viruses can live longer on doorknobs and other surfaces, Gopal says.
  2. Get a flu shot yearly. By preventing the flu, you may also prevent a sinus infection, according to the Centers for Disease Control and Prevention.
  3. Eat a well-balanced diet and get regular exercise. Staying in good health keeps your immune system on guard, according to Harvard Medical School.
  4. Quit smoking. Cigarette smoke can irritate sinuses, Harvard Medical School states.
  5. Use a humidifier. Dryness can lead to sinus pain. “You can run a hot shower and inhale the steam,” Gopal suggests. “Or put a steaming towel over your head — that’s an old remedy for relief from sinus pain.” If you use a humidification machine, make sure you clean it daily, following manufacturer’s directions, so that the humidifier itself does not become a source for sinus problems.
  6. Don’t overdo the antibiotics. Antibiotics will help if you have a bacterial infection, but they won’t do anything for viral infections. And if you take too many antibiotics, you can build up resistance to the medication, according to Harvard Medical School.
  7. Use a saline nasal solution. You can buy a saline solution at the drugstore or you can make your own by mixing 1/4 teaspoon of salt with 8 ounces of warm water. The American Academy of Allergy, Asthma and Immunology recommends using iodide-free salt and distilled water (or pre-boiled and cooled water). If you are buying a premade saline drop, mist, or spray, make sure that it does not contain a decongestant.
  8. Try a neti pot. This nasal irrigation system, which comes from the ancient Ayurveda yoga tradition in India, has been used for centuries in the East and has become popular in the West in recent years. A neti pot allows a saline solution to be poured into the nasal passages, irrigating them to loosen mucus. You can find them at drugstores, nutrition centers, and health food stores. Be sure to follow directions to use only sterile, pre-boiled and cooled, or distilled water in your neti pot, Gopal says.
  9. Keep your windows closed. “If you have allergies, you don’t want to go outside or open the windows, especially between 5 a.m. and 10 a.m., because that’s when the pollen count is the highest,” Gopal says.
  10. Fight dust mites. Vacuum and wipe down all surfaces regularly, decrease clutter that can trap dust, and use dust mite covers on your pillows and mattresses.

Sinus pain can be worse for people with allergies and weakened immune systems, but following a healthy lifestyle and practicing good hygiene could save you from bothersome sinus pain and congestion.


Severe Sinus Pain: Symptoms, Causes, and Treatments

Your sinuses are pockets of air located behind and around your nose, in your cheeks, around and between your eyes, and in your forehead. When your sinuses become inflamed or clogged, breathing through your nose may become more difficult, and your eyes might feel tender or swollen.

If you are suffering from severe sinus pain, you may have a sinus infection, also known as sinusitis. Understanding the signs and symptoms of severe sinus pain can help you know when and how to seek proper treatment and when to go to the doctor.

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Sinus Pressure and Nasal Congestion

Your sinuses are four pairs of hollow, air-filled spaces in your skull that connect to your nasal passageways. The sinuses are thinly lined with mucus membranes (mucosa), and keep the inside of your nose nice and moist. Normally your sinuses are empty except for a thin layer of mucus. Sometimes a respiratory tract infection can affect your sinuses and cause the mucus membranes (mucosa) inside your sinus cavities and nasal passageways to become inflamed. Your sinuses start to produce more mucus that is extra sticky.

This extra mucus (along with swelling) blocks the passageways and causes buildup. Mucus can’t get out like it normally can. This blockage leads to sinus pressure and pain.

Sinus Congestion Signs & Symptoms

  1. Headache and sinus pain: dull, throbbing pain located at the front of your face. The pain may get worse when you lean over or bend down, when you touch your face (especially your cheeks or forehead) and might also feel more severe in chilly, damp weather. If your sinus headache comes from a cold or flu, you’ll have other symptoms, too. Those might include general body aches, fever, coughing, chest congestion and excess mucus.
  2. Sinus drainage, sore throat and coughing : If you have a sinus pressure and nasal congestion, you might develop a sore throat and experience dry (nonproductive) coughing, or develop a wet productive chest cough. This is due to the mucus in the sinuses draining from the head into the throat, where it can cause additional irritation.
  3. Fever : If sinus pressure and nasal congestion are caused by an infection, a rise in temperature may soon join the mix of symptoms. A sinus infection can trigger some whole-body symptoms as your immune system fights to keep the infection at bay—which may cause fatigue or a fever.

If your fever lasts more than three days, or your cough isn’t going away, please consult your doctor.

Primary Causes of Nasal Congestion and Sinus Pressure

The underlying cause of nasal congestion is anything that inflames or irritates your nasal tissue. When you’re exposed to irritating triggers, like bacteria or a cold or flu virus, your body responds by mounting an immune response and the delicate tissues lining your sinuses start to swell. This, in turn, puts sinus pressure on the underlying tissues in your face, causing that painful sinus pressure you know all-too-well.

Other causes of nasal congestion, among others, are allergies and environmental triggers including tobacco smoke and dry air.

Relieving Symptoms

There are things you can do to help relieve your sinus pressure before you reach for any medicine. Here are a few things you can try to relieve sinus pressure and nasal congestion:

  • Use a humidifier or vaporizer.
  • Take a long, hot shower it may have the same effect as using a humidifier if one is not available.
  • Drink lots of fluids.
  • Use a warm compress on your face resting a warm towel over your sinuses may offer relief.
  • Irrigate your sinuses: Using a neti pot or syringe with salt water may help flush debris from your sinuses to relieve sinus infection symptoms.
  • Sleep with your head elevated.

If these steps don’t work, the next approach is over-the-counter medicine. When trying to relieve sinus pressure and nasal congestion, look for a decongestant. A decongestant will shrink the mucus membranes that have swollen in your sinuses. This will help the trapped mucus drain out—meaning you’ll breathe easier and feel more comfortable.

Nasal sprays, such as Mucinex® Sinus-Max® Full Force® Nasal Spray, can help ease congestion and provide relief. Mucinex® nasal sprays contain oxymetazoline. It’s what is known as a “topical decongestant” and is only found in nasal sprays . That means it needs to be applied to the affected areas in the nose rather than taken as a pill or liquid. This nasal spray starts to work within three minutes of using, and results last up to 12 hours. Breathe easy.

For relief from sinus congestion accompanied by pain, cough, and chest congestion, turn to Maximum Strength* Mucinex® Sinus-Max® Severe Congestion Relief Caplets—or another member of the Mucinex® Sinus-Max® family of products. They combine four maximum-strength medications to help relieve your headache and sinus congestion symptoms. This powerful formula of decongestant, pain reliever, cough suppression, and expectorant works to loosen mucus, reduce sinus swelling, and promote drainage.

When to See the Doctor

Stop use and ask a doctor if nervousness, dizziness or sleeplessness occurs if pain, nasal congestion, or cough gets worse or lasts more than 7 days if fever gets worse or lasts more than 3 days if redness or swelling is present, new symptoms occur, cough comes back, or occurs with rash or headache that lasts. These could be signs of a serious health condition.


Common Sinus Problems

Blockages. Each sinus has a narrow spot, called the transition space (ostium), which is an opening that’s responsible for drainage. If a bottleneck or blockage happens in the transition of any of your sinuses, mucus backs up.

An extra sinus. About 10% of people have one. It narrows that transition space.

Deviated nasal septum. Your nasal septum is the thin wall of bone and cartilage inside your nasal cavity that separates your two nasal passages. Ideally, it’s in the center of your nose, equally separating the two sides. But in many people, whether from genetics or an injury, it’s off to one side, or “deviated.” That makes one nasal passage smaller than another. A deviated septum is one reason some people have sinus issues. It can also cause snoring.

Narrow sinuses. Some people just have variations in their anatomy that creates a longer, narrower path for the transition spaces to drain.

Sinus sensitivity and allergies. You may be sensitive to things in your environment and to certain foods you eat. That can cause a reaction that leads to swelling in the nose.

Your doctor can prescribe medications to control your symptoms. If you have sinus problems and allergies, you should avoid irritants such as tobacco smoke and strong chemical odors.


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I'm in the middle of this right now. I'm having sinus pressure and some ear pain (mild), but the dizziness is what is bothering me the most. I'm no stranger to ear infections as I had them chronically when I was a child and although I don't remember it, my mom insists I was dizzy with them then too.

I'm being treated now with nasal sprays and antibiotics but it's been seven days and I'm really not seeing any improvement. Any idea how long this dizziness will last? I'm on a computer all day at work, so you can imagine how hard it is for me to concentrate and tax season is here I need to be able to focus. Not to mention the fact that it has limited me at the gym and making me very anxious about going places. StarJo February 17, 2012

@Perdido – Unfortunately, the most effective treatment is surgery. My aunt lived for many years with a deviated septum, and she tried every decongestant and antihistamine available. Nothing relieved her sinus pressure.

The pressure was so high inside her sinuses that she often felt lightheaded. Dizziness was dangerous for her, because she worked with heavy machinery.

She finally decided to have surgery to correct the problem. The surgeon repositioned her septum. She spent several weeks in recovery, breathing through her mouth with a bandage over her nose.

There was a lot of bruising, but it went away over time. She said that having this surgery was the best thing she ever did. It is such a relief for her to be able to breathe through her nose, and the pressure and dizziness are gone. Perdido February 16, 2012

Does anyone here suffer from a deviated septum? My nose has always been slightly crooked since birth, and I think that this may be why I have so many sinus problems.

It is hard for me to breathe through my nose. I stay congested most of the time, and over-the-counter decongestants just don't work for me. There is constant pressure in my nose, I'm often dizzy, and I also have nosebleeds from time to time for no obvious reason.

I know I should probably see a doctor about it. Is there a treatment other than surgery that might work? I don't really have enough money saved up for something like this. cloudel February 16, 2012

@Oceana – Since you tried taking antihistamines, I'm guessing that you suffer from allergies. So do I, and I am very familiar with the dizziness and sinus pressure that they can cause over time.

My problems started when I began letting my dogs sleep in the house at night. I seemed to have constant sinus pressure and mucus then, followed by dizzy spells.

My neighborhood is a dangerous place to leave animals outside at night, so putting them out was not something I considered. Instead, I began vacuuming twice a week and sweeping several times in between. I also dust more often and vacuum the pet beds once a week.

This rigorous cleaning schedule has helped relieve my allergies and reduce my sinus pain. I don't know if you know what is causing your sinus issues, but you might get some sinus pressure relief by keeping dust out of your home as much as possible. Oceana February 15, 2012

I suffer from chronic sinus infections. Once my ear pressure increases, dizziness begins, and then I know it is time to see a doctor.

For months at a time, I would just tolerate the swollen sinuses, putting off going to a doctor as long as possible. I would take an antihistamine daily, in hopes that it would rid my nose of the excess mucus. However, the infection almost always traveled to my ears, where it caused itching and a pressure I couldn't relieve just by opening my mouth wide.

I hate taking antibiotics so often, because I fear that the bacteria will eventually become resistant to them. However, there doesn't seem to be any other type of effective treatment for sinus infections.


Symptoms and Causes

What causes sinusitis?

Sinusitis can be caused by a virus, bacteria, or fungus that swells and blocks the sinuses. A few specific causes include:

  • The common cold.
  • Nasal and seasonal allergies, including allergies to mold.
  • Polyps (growths).
  • A deviated septum. The septum is the line of cartilage that divides your nose. A deviated septum means that it isn’t straight, so that it is closer to the nasal passage on one side of your nose, causing a blockage.
  • A weak immune system from illness or medications.

For infants and young children, spending time in day cares, using pacifiers or drinking bottles while lying down could increase the chances of getting sinusitis.

For adults, smoking increases the risks for sinus infections. If you smoke, you should stop. Smoking is harmful to you and to the people around you.

Is sinusitis contagious?

You can’t spread bacterial sinusitis, but you can spread viruses that lead to sinusitis. Remember to follow good hand washing practices, to avoid people if you are sick and to sneeze or cough into your elbow if you have to sneeze or cough.

What are the signs and symptoms of sinusitis?

Common signs and symptoms of sinusitis include:

  • Post nasal drip (mucus drips down the throat).
  • Nasal discharge (thick yellow or green discharge from nose) or stuffy nose
  • Facial pressure (particularly around the nose, eyes, and forehead), headache and or pain in your teeth or ears.
  • Cough.
  • Tiredness. .

What are the symptoms of sinus pain or nasal congestion?

There are many signs that patients may have a chronic condition that needs attention. Some of the more common symptoms include:

  • Swelling around one or both eyes
  • Pain, pressure, or sensation of fullness on the face over the sinuses
  • Pain behind the eye, above the eyebrow, or under the cheekbone
  • Postnasal drip or nasal discharge
  • Stuffy, blocked nose or discharge
  • Chronic bad breath
  • Mouth breathing (due to inability to breathe through the nose)
  • Mild sore throat/dryness/throat clearing

What causes sinus pain and congestion? - Biology

Do you have a stuffy nose? Or a cough that’s worse at night? Suffer sore throat or ear pain? If so, you may have chronic sinusitis (inflammed sinuses).

32 million people have this kind of persistent sinus infection. Pain (in the forehead, upper jaw, or teeth, or around your cheeks, eyes, or nose), postnasal drip, bad breath, fatigue or irritability, dizziness, and even nausea can also signal chronic sinus inflammation.

Commonly prescribed for a sinus infection, antibiotics can turn temporary pain to a chronic problem. That’s because sinus inflammation often stems from biofilms (clumps of pathogens implicated in 80 percent of infections)—and oral antibiotics don’t work against them.

Producing a slimy coating that’s hard to penetrate, Candida albicans is a notorious—and difficult to eradicate—source of fungal biofilms in the body. Because antibiotic drugs kill off both good and bad bacteria, they create an internal environment where Candida yeast, which occurs naturally in the human body, quickly grows out of control.

Antibiotics can also disrupt the body’s natural pH balance. Without a healthy acid balance, immunity is compromised, allowing yeasts, molds, and harmful bacteria to multiply.

One in three American women have symptoms of candidiasis, a chronic yeast infection. Besides nasal congestion and sinus pain, yeast infections cause fatigue, indigestion, acne and skin rashes, sore or bleeding gums, thrush (white patches in the mouth or throat), and urinary or vaginal problems.

Candida yeast overgrowth is prevalent in women who use antibiotics—whether to treat a sinus infection or acne—or who have been on estrogen (including birth control pills), have had children, and/or consume a high-sugar diet.

First, Control the Yeast Infection

To kill off yeast that’s the underlying cause of chronic sinusitis, eat more protein (beans, chicken, fish, and lean meat), as well as essential fats and vegetables. Cut out sugar and high-glycemic carbs, especially grains that contain yeast or molds.

Fungi produce over 300 types of dangerous mycotoxins on foods. Grains pose the most frequent and serious risk for fungal contamination. So people with yeast infections need to limit their consumption of corn, wheat, and peanuts—all subject to fungal contamination.

New research in South Korea finds that pumpkin skins contain a potent antifungal protein that combats yeast infections, including candida. Known as Pr-2, this substance in pumpkin rinds also blocks fungi that attack plant crops.

Caprylic acid, found in coconut oil, is an effective antifungal in the digestive tract. It works as well in tamping down yeast overgrowth as the drug nystatin, which may damage the liver. I also like olive leaf extract, a potent antimicrobial, to fight fungi and yeasts—along with bacteria and viruses.

Most important in crowding out systemic yeasts and other pathogens, take Flora-Key, which contains both probiotics—each teaspoon has 6.5 million good bacteria including acidophilus and bifidus—and prebiotics to feed these beneficial bacteria.

Then, Clear Out Your Sinuses

More effective than antibiotics, salt can prevent sinus problems in the first place. Combine ½ teaspoon of non-iodized salt (or ½ teaspoon salt and ½ teaspoon baking soda) in a cup of lukewarm water and use this mixture in a sterile eyedropper or neti pot.

Rinse your nasal passages twice a day until the infection clears—or whenever you feel sinus pain starting up again. If your throat is sore too, gargle with warm salt water.

Many aromatherapy oils—eucalyptus, oregano, tea tree, and thyme—are antifungal. Use one of these healing essential oils in a room diffuser or add a few drops to your bath water—the steam will help keep your sinuses clear.


If you have inflammation in more than one or all of your sinus cavities, you can see how your entire head might be in pain.

Relieving the sinus headache pain

Some sinus problems can be prevented with regular use of a Neti pot or other rinsing agent to keep your nasal and sinus passages moist.

Once you have that sinus pain, you can relieve the headache with acetaminophen-based products, like BC® Sinus Pain & Congestion powder, that contain acetaminophen as well as an antihistamine and nasal decongestant to help relieve congestion, runny nose and sinus pain.

If your symptoms don’t respond to over-the-counter remedies, you think you have a sinus infection or you have other chronic health conditions, be sure to talk to your doctor to get the treatment you need.



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