Sinusitis treatment

NPR recently broadcast a story about sinusitis treatment.   Acute sinusitis or sinus infections are fairly common, but there are a lot of misconceptions about how to treat it.

The new treatment guidelines cited by NPR continue to downplay the role of antibiotics since most patients with sinusitis eventually get better without antibiotics and antibiotics don't seem to shorten the illness in many cases.  

As needed nasal saline flushes seem helpful for relieving sinus pressure due to poor drainage.  I learned this trick from a wonderful navy ENT (Ear Nose and Throat) surgeon in Japan where patients with chronic sinusitis would have to wait months for the ENT surgeon to visit our base.  There are not many studies on this for acute sinusitis treatment but it is commonly recommended and is an inexpensive, if somewhat annoying, treatment. Some very rare infections were reported from doing this with infected tap water recently so using sterile water to make the saline isn't unreasonable. 

Avoid using nasal decongestant sprays for more than three days as that can cause problems.

Some patients develop complications or have a different problem and not sinusitis.  NPR quickly added a clarification to their story that includes "Signs and symptoms such as worsening headaches, visual problems, changes in mental activity, facial swelling and progressive fever can indicate impending complications."    

Don't make medical decisions based on something you read on the internet, including this.   If you have questions about possible sinus symptoms, call your primary care physician or get examined.  If your physician won't answer your questions without an appointment or it's difficult to get a prompt appointment, consider Direct Primary Care.