Winter Sinus Pain: Do’s and Don’ts for Sinus Relief!
It’s hard not to see a million television ads for sinus, cold and
flu relief on a daily basis. The winter seems to be a time when the nose
takes the blows!
The reason is that the nasal tissue and sinuses play an important role
in helping our respiratory system accommodate to the brutally cold weather
in most parts of the country. The dry air quality, and the fact that we
spend most of our days indoors doesn’t help either. The most important
thing you can do to protect yourself from sinus pain and other problems
is maintaining good sinus hygiene and avoiding medications which can make
the problem worse.
How Do Your Sinuses Work?
The sinuses (see anatomy chart below) are a combination of intricate, delicate
chambers that allow air to flow from the nose into the rest of the respiratory
system. Interestingly, the function of the sinuses is not exactly known,
but it is thought to be important in phonation (how your voice sounds).
This is why many of my opera singers and Broadway actors are so vigilant
in following my instructions to keep their sinuses clean and infection-free.
To understand why sinuses become infected, you need to understand some
basic, logical anatomy. The sinuses are analogous to narrow, tortuous
roads–so it is important that those “roads” don’t
become congested and blocked up. Sinus congestion can occur from changes
in the atmospheric pressure (nothing you can do about that), from allergens
and finally from the mucus from infections itself.
My Plan for Sinus Relief
My immediate plan when a patient begins to feel sinus congestion or pressure
is to use a topical decongestant, such as Afrin, along with a nasal steroid.
Both are now over-the-counter.
I know many patients are afraid or worried about using Afrin, but it is
a very effective nasal medication if used appropriately. The key is not
to become an “Afrin Junkie”. My patients are carefully instructed
to use Afrin nasal mist for 3 days and
always followed within 5 minutes by the Nasal cortisone spray. By implementing
this combination, you avoid the rebound affect from Afrin and won’t
After 3 days, most patients feel significant sinus relief and have avoided
developing a sinus infection. Then, I usually have the patient use the
Nasal cortisone spray for another week or two just to make sure the sinuses
stay open. If a patient is still not feeling enough relief from sinus
pain, I will prescribe an oral decongestant like Sudafed for a few days,
along with a pain reliever (Tylenol or Advil sinus both can be used).
I do warn patients not to use the decongestant pills at night because
they can keep you awake, and also not to use these medications without
supervision if you have high blood pressure or a heart condition.
What NOT to Do
Don’t jump to take an antibiotic right away if you feel sinus pain.
Research clearly shows most congestion and even infections are not due
to bacteria, but
viruses. I too often see patients take too many antibiotics. They don’t get
better, they get side-effects from the antibiotics. There is a place for
antibiotics in sinus infections, but in select cases.
Also, don’t take an antihistamine, even if it’s with a decongestant:
examples such as Allegra-D or Zyrtec-D. Why? Antihistamine don’t
help relieve congestion, and they are very drying and this makes it harder
to allow the mucus drain out from the nose.
Also, Netti pots have been recommended by Dr. Oz and others which I believe
are fine for sinus hygiene maintenance. However I’m not sure there
is any real benefit in an acute situation, and it may be more irritating
in some cases!
In my book,
Dr. Dean Mitchell’s Allergy and
Solution (Marlowe 2006), I devote a whole chapter to the latest research on managing chronic sinus pain.
Oh, and if you are in a bind, say, on the road and not able to get to a
pharmacy, a good old hot shower with steam can bring a temporary smile
to your sinuses!
Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island