Sinusitis

Sinusitis is inflammation of the sinuses — the air spaces behind the cheeks, forehead and around the nose. It often follows a cold, but in some people an underlying allergy keeps the nasal lining swollen, blocks the sinus openings and leads to symptoms that come back again and again. When that is the case, treating the allergy is part of treating the sinusitis.

Common symptoms

• A blocked nose and reduced sense of smell
• Facial pressure or pain over the cheeks, forehead or between the eyes, often worse on beding forward
• Thick nasal discharge, or mucus running down the back of the throat
• Headache, a heavy-headed feeling, or upper toothache
• Tiredness and disturbed sleep when symptoms are prolonged

Short episodes that clear within a few weeks are described as acute. Symptoms lasting more than about twelve weeks, or returning several times a year, are described as chronic or recurrent.

Why allergy matters here

Allergic rhinitis and sinusitis frequently occur together. Persistent allergic swelling narrows the drainage channels of the sinuses, so mucus builds up and infection is more likely. People with recurrent sinusitis and a history of sneezing, itchy eyes or a family history of allergy are worth assessing for an allergic driver.

How it is assessed

History and nasal examination

We map out the pattern of symptoms and examine the nose for swelling, polyps or a structural narrowing.

Allergy testing

Skin-prick or blood testing looks for sensitisation to dust mite, mould, pollen and animal dander. Identifying a trigger allows focused avoidance and, where suitable, immunotherapy.

Imaging

A scan is not needed for most people but may be arranged if symptoms are persistent, one-sided, or not responding as expected.

Treatment

• Saline nasal rinses to clear mucus and improve comfort
• Regular steroid nasal spray to reduce lining swelling, used daily during symptom periods
• Treatment of any confirmed allergy, including trigger avoidance and possible immunotherapy
• Antibiotics only when a bacterial infection is likely — most episodes are viral or allergic
• Referral for a surgical opinion if there is a blockage or polyps that do not settle with medical treatment

When to book an appointment

See us if sinus symptoms keep returning, last more than a few weeks, disturb sleep, or if you also have allergy symptoms that have never been investigated. Severe headache with fever, swelling around an eye, or changes in vision need urgent assessment.

This page is general information and not a substitute for a consultation. Symptoms overlap between conditions, so a clinician's assessment is the reliable way to know what is going on and what will help in your case.