Sinusitis

Monday, December 26, 2016 1:55 PM

Sinus pain is a very common complaint in our area.  While common, it can be tricky to diagnose and treat.  We have to consider migraine headaches, tension headaches, neck disease, oral infections, and more.  Most sinusitis is caused by viruses, and occasionally bacteria, that will resolve on their own with no treatment.   Worse cases may need antibiotics, or even CT scans to evaluate reasons for chronic or difficult to manage infections, but only after symptoms or 7-10 days not responding to conservative care.


Initial care is supportive, anti-inflammatory medication, nasal steroids and sometimes nasal decongestants for very short time.  Neti Pot treatments are invaluable, and when these fail sometimes oral decongestants, steroid shots or antibiotics.   Antibiotics have been overutilized in years past, but a consensus of research proves that they are not only not needed, but more often dangerous.  1 in 4 people on antibiotics have significant reactions nausea, headaches, stomach issues, ER visits or worse like Clostridium Difficile ( C. Diff) infections that can be deadly.  


Since it is proven sinusitis gets better in the same number of days with or without antibiotics, modern medicine recommends holding off unless symtoms worsen significantly or increase over 7-10 days with fever and other complications.  Primary care, Specialists, Surgeons, the CDC, the AAFP, even Consumer Reports agrees with this but it's not always the popular decision.  Please rest assured that we only have your best interests in mind when treating, we never want to argue or anger our patients, but we'll always do what's best for you.  In some cases conservative therapy fails, symptoms may continue for a week or worsen, and we will have you covered.  Be sure to communicate with us if you have issues, complications or changes in your symptoms after a visit.  The Portal is the most convenient method, but we still answer telephone calls as well.


A terrific summary of Sinusitis and proper care is available HERE.