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Cure for congestion depends on the cause
Decoding sinus infections: colds, allergies, asthma and migraines and how they all relate back to sinusitis

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Date published: 8/23/2009

BY JENNIFER NEFF

Susan Carol battled year-round sinus infections and colds for decades. She tried antibiotics and over-the-counter medicines to feel better, with mixed results.

"For years, I was confused about whether it was a cold or sinus infection," Carol said. "I just couldn't get better."

After a series of terrible sinus infections during the winter of 2008, the 54-year-old Fredericksburg native said she was referred to an allergist, who diagnosed a dust mite allergy.

Turns out that the sinus problems Carol experienced weren't just run-of-the mill colds. Allergies often play a big role in people's sinus woes.

Millions of Americans contend with sinus problems each year--an estimated 37 million experience sinus infections annually.

Many people deal with irritated, inflamed sinuses by trying things such as over-the-counter nasal sprays, nasal rinses or antibiotics.

But it's important to distinguish between sinus infections--which may require antibiotic treatment--and other problems such as allergies or nasal polyps that call for different treatment.

INFECTED SINUSES

A sinus infection--known as sinusitis--occurs when the air-filled cavities, or sinuses, become inflamed or swollen.

Drainage becomes difficult, and mucus begins to build up, leading to sinus pressure and headaches.

Other symptoms of a sinus infection include:

Coughing

Aching in the upper jaw and teeth

Pressure around the eyes and nose.

But these symptoms also are associated with colds, which can make it hard to distinguish between the common cold and a sinus infection.

The main factor in determining whether a sinus infection is present is time. A good rule of thumb comes from Dr. Andrew Kim of the Allergy & Asthma Center of Fredericksburg:

If symptoms last less than seven days, the likely culprit is a cold caused by a virus, and antibiotics are not needed.

If symptoms last longer than seven days or get worse, the sufferer most likely has a bacterial infection or acute rhinosinusitis and will likely need antibiotic treatment.

Acute rhinosinusitis is a sinus infection that lingers for up to four weeks, Kim said. Treatment varies by person but may include a round of antibiotics, nasal rinses and decongestants.

If symptoms don't disappear after treatment, or if they rebound, then the problem may be chronic rhinosinusitis. Chronic rhinosinusitis lasts 12 weeks or more or is recurrent, according to Kim.

"Chronic sinusitis is usually caused by underlying conditions," Kim said.


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When your head and face hurt, a sinus infection is often to blame. Facial pain and headaches are classic symptoms of sinus infections. But migraines can cause similar symptoms. So how can you tell what's causing your pain?

If light and noise intensify the ache, then the pain may stem from a migraine, not a sinus infection. Migraines also often affect just one side of the head. To learn more about migraines and other causes of headaches, type "headache" in the search box at mayoclinic.com.