Sinusitis

What doctors say*

* Official guidelines from NICE.

Should antibiotics be used? >

Not generally suitable for antibiotics; consider high-dose nasal corticosteroid (if over 12 years).

Likely duration if untreated >

Up to several weeks

Conventional self-care advice >

  • consider ibuprofen or paracetemol for pain or fever
  • little evidence that nasal saline or nasal decongestants help, but people may want to try them
  • no evidence for oral decongestants, anti-histamines, mucolytics, steam inhalation, or warm face packs.

Opportunities for antibiotic alternatives >

Before prescription. First 10 days, and later unless deterioration or otherwise generally very unwell.

With prescription. Home remedies for are generally compatible with antibiotic prescription: do however check with your doctor to be sure.

 

See also

Note: there is little evidence for home remedies specifically to relieve sinus pain and congestion. However remedies on the Common cold page are likely to help. Viral cold infections are the most common causes of sinus inflammation.

Steaming
> what do these ratings mean?

Using steam inhalations is one of the oldest and apparently helpful approaches to relieving pain and congestion due to sinusitis. However as the NICE advice above states, the independent evidence for effectiveness is actually limited. There are also many reports of steam burns from unwise applications. It may still be worth trying. Make sure the hot water is kept well away from the sufferer and children must be closely supervised. People often report that the effect of steam is enhanced by dropping mentholated or other volatile oils in the steam. Strewing chamomile flowers on the hot water is also a good traditional tip.


See the evidence ...

It is established practice to use steaming for the management of sinusitis [Evans, 1998] and otitis media, and there is evidence that steaming improves the mucociliary functions that could aid decongestion in the airways [Vora, 1993]. However in one study steaming was found to be ineffective in symptom management for acute respiratory infections [Little, 2013]. Much of the literature also reflects the risks of burning if steaming is unwisely applied.

 

References

Evans KL. (1998) Recognition and management of sinusitis. Drugs. 56(1): 59-71

Link to Abstract

Little P, Moore M, Kelly J et al. (2013) Ibuprofen, paracetamol, and steam for patients with respiratory tract infections in primary care: pragmatic randomised factorial trial. BMJ 347: 6041

Link to Abstract and Full Text

Vora SU, Karnad PD, Kshirsagar NA, Kamat SR. (1993) Effect of steam inhalation on mucociliary activity in patients of chronic pulmonary disease. Indian J Chest Dis Allied Sci. 35(1): 31-4

Link to Abstract

Disclaimer

Knowledge and best practice in the health field are constantly changing.  Each person and illness is also unique and no general information can anticipate every circumstance, nor be appropriate for every reader. Each individual case is best assessed in person by a qualified health advisor.

In the case of remedies or other products, users should read the label carefully for detailed information about safe use and in the case of natural products should choose responsible manufacturers with independently assured quality standards and safety monitoring procedures.

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