With chronic sinusitis, the tissues inside your sinuses become inflamed and blocked for a long period of time due to swelling and mucus buildup.
Acute sinusitis only happens for a short time (usually a week), but chronic sinusitis can last for months. Sinusitis is considered chronic after at least 12 weeks of symptoms. Acute sinusitis is usually caused by a cold, but chronic sinusitis can have many other causes.
Nearly 30 million Americans have sinusitis of some sort. Chronic sinusitis can make it especially hard to breathe due to long-term blockage and inflammation.
Some home treatments can help relieve your symptoms. But you may need medication and long-term treatment to keep the symptoms from coming back.
Sinusitis is considered chronic after symptoms last for more than 12 weeks. Acute sinusitis often happens because of a cold and disappears along with the cold.
You also need to have at least two of the following symptoms for sinusitis to be diagnosed as chronic:
- trouble smelling or tasting food and drinks
- yellow or green-colored mucus dripping from your nose
- dry or hardened mucus blocking your nasal passages
- mucus leaking down the back of your throat (postnasal drip)
- tenderness or discomfort in your face, especially in the area of your eyes, forehead, and cheeks
Other common symptoms of chronic sinusitis include:
- headaches due to pressure and swelling in your sinuses
- pain in your ears
- throat soreness
- jaw and tooth soreness
- feeling nauseous
- cough that feels worse during the night
- bad breath (halitosis)
Following are the most common causes of chronic sinusitis:
- Allergies, especially hay fever or environmental allergies (such as to pollen or chemicals). These can cause your nasal passages to become inflamed.
- Tissue growths known as polyps inside your nose. Nasal polyps can make it hard to breathe through your nose and block your sinuses.
- An uneven wall of tissue between your nostrils. This is known as a deviated septum, and it can limit air flow in one or both of your nostrils.
- Infections in your nose, windpipe, or lungs by viruses or bacteria (including colds). These are called respiratory tract infections. They can cause your nose to become inflamed and make it hard for mucus to drain out of your nose.
Other health conditions can cause chronic sinusitis too, including:
- asthma, a condition that causes chronic inflammation in your airways
- gastroesophageal reflux disease (GERD), a disease of your digestive tract
- human immunodeficiency virus (HIV), a virus that can weaken your immune system
- cystic fibrosis, a condition in which the mucus in your body builds up and doesn’t drain properly, often causing bacterial infections
Many treatments are available for chronic sinusitis. Some you can do at home for short-term relief. Others will help treat the underlying cause of your sinusitis.
Medications and specialist treatment
Over-the-counter (OTC) pain medications can help relieve the pain of a headache or pressure from swelling. These include ibuprofen (Advil) or acetaminophen (Tylenol). Nasal sprays with corticosteroids also help with inflammation. OTC sprays include fluticasone (Flonase Allergy Relief) and mometasone (Nasonex). Nasal sprays can also help make nasal polyps get smaller. This will help you breathe better if they’re blocking your nasal passages.
If your sinusitis is caused by an infection, your doctor may prescribe an antibiotic to treat the infection and relieve some of your symptoms. Chronic sinusitis isn’t often caused by an infection, but serious infections that result in sinusitis may require antibiotic treatment to prevent complications.
If your chronic sinusitis is caused by allergies, your doctor may refer you to an allergist. An allergist can conduct tests to figure out what you’re allergic to. They can then give you regular allergy shots to gradually allow your body to become immune to those allergens. Allergy shots may not take effect until several years after beginning the treatment, but they can help relieve allergy symptoms drastically in the long term.
Use a saline solution made of water and salt to lubricate your nasal passages. This helps mucus drain more easily. This solution can also relieve swelling. Inhale steam from hot water or use a humidifier to help mucus drain and reduce inflammation.
In rare cases, your doctor may recommend surgery if home treatments and medication don’t help. Surgery options for chronic sinusitis include:
Endoscopic sinus surgery: Your doctor inserts a thin tube with a light and a camera into your sinuses to see if polyps, mucus, or other tissue is blocking your sinuses. Your doctor may then remove the blockage. In some cases, your doctor may increase the space in your sinuses to help you breathe.
Deviated septum surgery (septoplasty) or nose surgery (rhinoplasty): Your doctor reshapes the wall between your nostrils or the tissue of your nose to straighten it out or expand it. This can help you breathe more easily out of both nostrils.
If left untreated, chronic sinusitis can make it difficult to breathe, which can keep you from being active or getting enough oxygen into your body. Long-term chronic sinusitis can also cause other serious complications, including:
- permanent loss of your ability to smell because of damage to your olfactory nerve, which helps you smell
- loss of vision if an infection spreads to your eyes
- inflammation of your brain and spinal cord membranes (known as meningitis)
- infection spreading to your skin or bones
Based on the cause of your chronic sinusitis, the symptoms may never be fully treated. You may require long-term treatment to help keep your symptoms from disrupting your daily life.
But in many cases, your symptoms can be treated through home remedies, OTC medications, and a treatment plan developed with your doctor to address its specific causes.