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SUNDAY, June 15, 2003 (HealthDayNews) -- Stuffy nose. Headache. A cough that won't quit.
Classic signs of the common cold, right?
Maybe not, say doctors who warn that those symptoms could also signal sinusitis, a potentially painful condition that, left untreated, can become chronic.
Sinusitis is characterized by inflammation of the nasal passages that can be caused by a number of factors, from a cold to allergies to an infection. The inflammation shrinks the passages so mucus can't drain properly, causing the discomfort and infection that are hallmarks of sinusitis.
The result can be health problems that include headache; pain in the teeth, jaws and cheeks; swelling of the eyelids and tissues around the eyes; and pain between your eyes. Other potential problems include stuffy nose, loss of smell, earaches, neck pain and deep aching at the top of the head, according to the National Institute of Allergy and Infectious Diseases.
Left untreated, sinusitis can last anywhere from weeks, to months or even years.
It's also one of the most common chronic health problems in the United States, affecting about 34 million people a year.
The key is to recognize sinusitis early so it can be treated before it becomes a chronic condition. But how's a person to know when to pay attention to their sniffles?
It's tricky, doctors admit.
"There's a continuum between a plain old viral infection, a cold and sinusitis," says Dr. Erica Thaler, a University of Pennsylvania Medical School otorhinolaryngologist. "It's hard to tell the difference between a cold and sinusitis."
"A lot of people think they have sinusitis, but they don't. Half the time it's a lousy cold," she adds. "But you can't be stoic either. If you don't treat it, it can become a chronic condition. Many people have horrible recurrent episodes."
There are some clues that differentiate sinusitis from a cold.
If you have what seems to be a cold that won't go away after a week or two, or seems to get better and then gets worse, it's probably sinusitis.
Another clue to sinusitis is mucus that's thick and yellow-green in color, a sign of bacterial infection, says Dr. Jordan Josephson, an otorhinolaryngologist Lenox Hill Hospital in New York City.
"Other signs are having trouble breathing through your nose, congested nasal passages, fatigue, post-nasal drip, cough, hoarseness and sinus headaches," he says. "If you have a minimum of two of those symptoms, or any one that is causing you exceptional discomfort, you could have sinusitis."
That's when a visit to the doctor is needed.
"People are afraid that the solution to sinusitis will be painful and time-consuming, but there are new medicines so that even those people who have had treatment before can be offered hope for a cure," says Josephson.
A good internist, Thaler says, can take your medical history, examine your ears, nose and throat, and recommend appropriate medicines. They include decongestants; oral antibiotics to control bacterial infection; pain relievers; and steroid nasal sprays to reduce inflammation in the nose.
If your condition persists, your doctor might recommend a visit to an otorhinolaryngologist, who can conduct a more thorough examination of the nasal passages. A specialist may prescribe a fairly new treatment involving intranasal topical medication therapy delivered by a nasal nebulizer, or look to correct the physical features of the nose.
"A patient may need X-rays or an endoscopy," Josephson says, which is a procedure where the doctor, using a slim tube with a camera at the end, can look directly at the sinus passages. There he can check for polyps, which, though rarely cancerous, block the nasal passages, or anatomical abnormalities that make the passages too narrow for the natural flow of mucus.
"Less than 10 percent of patients need surgery for these conditions," Josephson says. "More than 90 percent will have the problem controlled or resolved with sinus medicine alone."
Josephson adds that people can lower their sinusitis risk by making changes in their environment to reduce the triggers for inflammation of the nasal passages.
"Patients need to take some responsibility for their health problems," he says.
For instance, during allergy seasons, keep windows closed, wear protective eyewear against pollens, use saline spray for the nose, and shower before bedtime to wash pollen out of your hair.
Josephson also recommends washing bed sheets in hot water to get rid of dust, cleaning the vents on your air conditioners regularly and keeping your house clean and dust-free.
More information
The American Academy of Family Physicians offers informative information on sinusitis. A description of the sinuses, along with photographs, can be found at the
American Rhinologic Society.
