What and Why? 

Your head is a very heavy structure that is kept as light as possible by excavations in the bone that we call sinuses. These begin in childhood as dimples in the lining of your nose, and develop eventually into caves or large blisters of air that are lined with closely fitting pouches of skin from your nose cavity and remain connected to it by narrow passages. The best known of them are in your face just above and below each eye, but a whole labyrinth of others lie around the back of your nose cavity and between your eyes. Apart from economizing on bone they play an important part in forming the tone of your voice, resonating like organ-pipes to sound from your vocal cords.

If you have a cold or hay fever the changes in the skin of your nose may affect your sinuses and the passages to them in just the same way, thickening their skin and producing catarrh. Your sinus passages cannot expand because they are drilled through solid bone, so if their linings swell the passages must get narrower to make space for them. If the passages happen to be rather narrow in the first place they can easily be closed off altogether.

That leaves the cavity of your sinus completely enclosed. If it is dry the air it contains is gradually absorbed into your blood-stream, creating a suction effect. If it is producing catarrh or if its lining skin is very swollen these contents are trapped in your sinus, quickly building up intense pressure. Either way you quickly become aware of a change in the quality of your voice, then intense pain in your face made much worse by bending over or straining. Your nose may be running very little because most of the catarrh is made in your sinuses; only if a passage eases open does the pain diminish and the catarrh flow out.

That is how sinusitis develops. It need not involve germs at all, even if it is an infection in the proper sense. You can easily mistake it for toothache, and in a mild case you may think it is eyestrain — it certainly does make reading difficult. If you are unfortunate enough to have very narrow or tortuous sinus passages you cannot help being vulnerable to sinusitis once you have a cold — but you can get rid of it quickly, and you can work up your resistance to colds in the first place.

What can I do?

Advice to maximise and maintain health

1. The best first aid for sinus pain is to jet cold water from a shower nozzle directly on your face from close quarters at full mains pressure, until your skin is numb and your eyes ache with cold. By then your sinuses are probably relieved and likely to stay that way for ten minutes at least.

2. Next take a decent dose of a decongestant such as Pseudoephedrine. Too little may not work at all, but a little too much is unlikely to do any harm. That should last a few hours at a time; you can repeat the dose a few times if necessary. Do not, however, take decongestants for longer than a few days at a time. You quickly get used to them so that their effect becomes less and less; many people are partially addicted to them as a result.

3. Pain-killers on their own are unlikely to relieve this kind of pain; you must release the pressure.

4. Homoeopathic remedies like Merc. sol., Aconite or Nat. mur. (see homoeopathy) may turn out to give you good relief and are safe to continue indefinitely if necessary. But you will still need to discover and attend to whatever makes your nose congested in the first place.

5. If you get colds easily and often, see colds for advice on how to build up your resistance to them. If you always seem to have cold symptoms then your problem is perennial rhinitis which is more like hay fever. See hay fever, which explains how to deal with that.

6. Do not press your doctor for antibiotic treatment unless your sinuses keep on draining foul catarrh for days after you have relieved the blockage.

7. Keep your sinuses free by breathing deliberately through your nose, and taking several deep draughts of fresh air each day whenever you have the chance. Singing and humming notes like ’mmm’ and ’nnn’ that vibrate in your nose is good too — it vibro-massages the skin and helps to keep it in good tone, not slack or congested.

8. Inhalations of Menthol and Eucalyptus, in steam or directly from a handkerchief that you keep in a warm place, help to stop a new cold from progressing to sinusitis.

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