Sinusitis: symptoms, causes and treatment

Sinusitis is inflammation of the air-filled spaces around the nose, often causing congestion and facial pressure.

Swelling can narrow the drainage openings of the sinuses, allowing mucus to build up. The condition is sometimes called a sinus infection, although inflammation can follow a viral illness, allergy or an anatomical blockage as well as a bacterial infection.

A blocked nose and facial pain or pressure are very common presentations of sinusitis. Headache, cough, earache, postnasal drip, runny nose and nosebleed are common presentations. Thick nasal mucus, reduced smell, upper-tooth discomfort and pressure that worsens when bending forward can also occur.

Many episodes follow a common cold, when the lining of the nose and sinuses swells. Allergic rhinitis can produce similar swelling. Nasal polyps, a deviated nasal septum, smoke exposure, dental infection and changes in pressure during flying or diving can sometimes contribute to blocked drainage.

Acute symptoms often settle as the triggering illness improves. Some episodes last longer, recur, or persist because ongoing inflammation keeps the sinus openings narrow. A change from gradual improvement to a sharp deterioration, or symptoms that repeatedly return, merits clinical assessment.

Recent viral infections, uncontrolled allergies, nasal structural differences, smoking and exposure to irritants can make sinus drainage less effective. People with immune problems or significant long-term illness should seek advice earlier if they develop severe facial pain, fever or a worsening nasal infection.

A GP usually asks about symptom timing, nasal discharge, allergies, dental symptoms and prior episodes. Examination may include the nose, throat, ears and face. Persistent, recurrent or unusual symptoms can lead to referral for nasal examination, imaging or an assessment for allergy and structural causes.

Supportive care may include fluids, rest, saline nasal rinses and pain relief that is suitable for you. A clinician may recommend a nasal steroid spray when inflammation is prominent. Antibiotic treatment is reserved for selected cases where bacterial infection is considered likely; it does not treat viral inflammation.

Use saline rinses only with clean, appropriately prepared water and keep devices clean. Avoid smoke and other irritants, sleep with the head slightly raised if drainage is troublesome, and follow instructions for nasal sprays. Do not use decongestant sprays beyond the advised period, as rebound blockage can occur.

Complications are uncommon but sinus infection can spread beyond the sinuses. Seek urgent care for swelling or redness around an eye, vision change, severe frontal headache, stiff neck, confusion, persistent vomiting, or rapidly worsening facial swelling. These signs need assessment without waiting for routine care.

Managing allergies, avoiding tobacco smoke, treating dental problems and washing hands during respiratory-virus seasons may reduce triggers. If episodes recur, keep a note of timing, exposures and treatments that helped. This record can help a clinician identify patterns such as allergy, workplace irritation or a structural nasal issue.

Arrange a GP consultation for symptoms that are severe, do not improve, keep returning, or interfere with sleep and daily activity. An ear, nose and throat specialist may help when symptoms are persistent or a structural cause is suspected. Urgent eye or neurological symptoms need emergency assessment.