If you've ever had a cold, you know the symptoms: Congestion, pressure, headache, mucus, and a clogged up feeling that leaves you miserable. For many people, those symptoms aren't limited to when they have a cold.

Sinusitis affects almost 30 million Americans and some of them have it chronically. What's the difference between a sinus infection and chronic sinusitis? There are key factors that help determine proper treatments.

The American Academy of Allergies, Asthma and Immunology reports that sinusitis (also called rhinosinusitis) occurs when the sinus openings become blocked or too much mucus builds up causing one or more of the cavities to become inflamed or swollen.

Symptoms may include:

  • A thick mucous discharge (yellow, green, or clear)
  • Nasal congestion
  • Sinus pressure, pain, or swelling
  • Pain or tenderness around the eyes, cheeks, forehead, nose, teeth, ears, or upper jaw
  • Cough
  • Sore throat
  • Fatigue
  • Aches and pains and other general feelings of illness
  • Fever (may or may not occur)

Most cases of sinusitis are considered "acute," and last for less than four weeks. An acute sinusitis might start with a cold, but then progress to a sinus infection if bacteria is trapped in the sinuses that then creates swelling and inflammation. Most acute cases of sinusitis resolve on their own without medical treatment, though some require antibiotics or other treatment.

Recurrent sinusitis occurs when a patient has three or more sinusitis occurrences in a year. If sinusitis keeps cropping up, doctors start looking for underlying causes like allergies, blockages in the sinus passages, or problems with a patient's immune system that inhibit her from fighting off infection.

Sinusitis can be stubborn and many patients require more than one course of treatment. For example, patients might need a couple courses of antibiotics plus antihistamines. If symptoms last longer than three months, a patient will likely be diagnosed with chronic sinusitis.

How Is Sinusitis Diagnosed?

Your physician will ask about your symptoms and medical history and will do a physical exam. For most acute cases of sinusitis, no further testing will be needed for your doctor to make a diagnosis. If your physician is concerned about recurrent or chronic sinusitis, however, she may order tests including a sinus CT scan, endoscopy (a flexible tube and light threaded into the sinuses after administration of local anesthesia) to visualize the inside of your sinuses, as well as allergy testing to determine the root cause of your sinus inflammation.

How Is Recurrent or Chronic Sinusitis Treated?

Treatment plans vary depending on what's causing your sinusitis. If allergies are the culprit, you may need antihistamines, decongestants, steroid nasal spray, or allergy shots. If a defect in the structure of your sinuses is diagnosed, it's possible you'll need surgery to correct it.

If you've experienced symptoms of sinusitis for longer than a few weeks, ask your doctor about ways to treat and prevent it. 

Heather Weldon, MD,OB-GYN, reviewed this article.



American Academy of Asthma, Allergy and Immunology