Your nose is stuffy. You have thick, yellowish mucus. You're coughing, and you feel tired and achy. You think that you have a cold. You take medicines to relieve your symptoms, but they don't help. When you also get a terrible headache, you finally drag yourself to the doctor. After listening to your history of symptoms and examining your face and forehead, the doctor says you have sinusitis.
"Sinusitis" simply means your sinuses are inflamed - red and swollen - because of an infection or another problem. There are several types of sinusitis. Health experts usually identify them as follows:
- Acute, which last up to 4 weeks
- Subacute, which last 4 to 12 weeks
- Chronic, which last more than 12 weeks and can continue for months or even years
- Recurrent, with several acute attacks within a year
In 2009, the Centers for Disease Control and Prevention reported that nearly 31 million adults were diagnosed with sinusitis. Women were almost twice as likely as men to receive the diagnosis, and there were more cases in the southern United States than elsewhere in the country.
Where are my sinuses?
When people say, "My sinuses are killing me," they usually are referring to symptoms of congestion and achiness in one or more of the four pairs of cavities (air-filled spaces) known as paranasal sinuses. These small hollow spaces, which are located within the skull or bones of the head surrounding the nose, are named for the bones that contain them, as follows:
- Frontal sinuses over the eyes in the brow area
- Maxillary sinuses inside each cheekbone
- Ethmoid sinuses just behind the bridge of the nose and between the eyes
- Sphenoid sinuses behind the ethmoids in the upper region of the nose and behind the eyes
The paranasal sinuses open into the nasal cavity and are lined with cells that make mucus to keep the nose from drying out during breathing and to trap unwanted materials so that they do not reach the lungs.
What are the symptoms of sinusitis?
One of the most common symptoms of any type of sinusitis is pain, and the location depends on which sinus is affected.
- If you have pain in your forehead, the problem lies in your frontal sinuses.
- Pain in your upper jaw and teeth, with tender cheeks, may mean your maxillary sinuses are involved.
- Experiencing pain between your eyes, sometimes with swelling of the eyelids and tissues around your eyes, and tenderness when you touch the sides of your nose may mean sinusitis has developed in your ethmoid sinuses.
- Pain in your neck, with earaches, and deep achiness at the top of your head could be a sign that your sphenoid sinuses are involved (though these sinuses are affected less often).
Most people with sinusitis have pain or tenderness in several places, and their symptoms usually do not clearly indicate which sinuses are inflamed. Pain is not as common in chronic sinusitis as it is in acute sinusitis.
In addition to the pain, people who have sinusitis (acute or chronic) often have thick nasal secretions that can be white, yellowish, greenish, or blood-tinged. Sometimes these secretions drain in the back of the throat and are difficult to clear. This is referred to as post-nasal drip. Also, cases of acute and chronic sinusitis are usually accompanied by a stuffy nose, as well as by a general feeling of fullness over the entire face.
Less common symptoms of sinusitis (acute or chronic) can include the following:
- Decreased sense of smell
- Cough that may be worse at night
- Sore throat
- Bad breath
On very rare occasions, acute sinusitis can result in brain infection and other serious complications.
Because your nose can get stuffy or congested when you have a condition like the common cold, you may confuse simple nasal congestion with sinusitis. A cold usually lasts about 7 to 14 days and goes away without treatment. Acute sinusitis often lasts longer and typically causes more symptoms than a cold.
What causes sinusitis?
The paranasal sinuses, like the inside of your nose, are lined with a thin layer of tissue called the mucous membrane, which produces mucus. This mucus flows out through openings of the paranasal sinuses and into the nose. When these openings become blocked, your sinuses are affected.
Anything that causes swelling in the nose can block the openings between your paranasal sinuses and your nose, including a cold, an allergic reaction such as hay fever, or a reaction to some chemical to which you've been exposed. The blockage causes air and mucus to become trapped within the sinuses. This may cause pain and thickened mucus.
- The pain of a sinus attack arises because the trapped air and mucus put pressure on the mucous membrane of the sinuses and the bony wall behind it. Also, when a swollen membrane at the opening of a paranasal sinus prevents air from entering into the sinuses, it can create a vacuum that causes pain.
- Mucus thickens because it loses its water content as it stays trapped inside the sinuses for a long time. In addition, inflammation leads to extra materials being secreted into the mucus, causing thickening.