Sinus Pain and Congestion
Description / Symptoms
- A sensation of fullness, pressure or pain on the face overlying a sinus cavity (above the eyebrow, behind the eye, around the eye, or over the cheekbone)
- The pain or pressure usually is just on one side of the face
- Puffiness or swelling around just one eye
- Commonly associated symptoms are a blocked nose, nasal discharge, and/or postnasal drip
- Age limitation: not a reliable symptom before 5 years of age
Cause
Sinus opening is blocked by a cold or hay fever.
See More Appropriate Topic (instead of this one)
- If also has active nasal allergies, see Hay Fever
- If age < 5 years old or doesn't sound like sinus congestion, see Colds
When to Call Your Doctor for Sinus Pain and Congestion
Call 911 Now If:
- Not moving or too weak to stand
Call Your Doctor Now If:
- Your child looks or acts very sick
- Fever > 105°F (40.6°C)
- Redness or swelling on the cheek, forehead or around the eye
- Severe pain
Call Your Doctor Within 24 Hours If:
- You think your child needs to be seen
- Fever present > 3 days
- Earache occurs
- Sinus pain with fever
Call Your Doctor During Weekday Hours If:
- You have other questions or concerns
- Sinus pain persists after using nasal washes and pain medicine for 24 hours
- Sinus congestion and fullness lasts > 2 weeks
- Nasal discharge lasts > 14 days
Home Care (Read "Call Your Doctor…" first):
Reassurance
Sinus congestion is normally part of a cold. Usually home treatment can prevent a true sinus infection.
Nasal Washes
Use warm water or saline nosedrops followed by suction or noseblowing to wash dried mucus or pus out of the nose. Instill 2-3 drops in each nostril. Repeat this until the nose is open.
Do nasal washes at least 4 times per day or whenever your child can't breathe through the nose. To make saline nosedrops: add 1/2 tsp of table salt to 1 cup (8 oz) of warm water.
Humidifier
If the air in your home is dry, run a humidifier.
Decongestant Nose Drops or Spray (no prescription needed)
Use this only if the sinus still seems blocked up after nasal washes. Use the long-acting type (e.g. Afrin).
Dosage: 1 drop or spray on each side 2 times/day if over age 6. Always clean out the nose before using. Don't use for more than 5 days. (Reason: rebound congestion).
Pain Medicine
Give acetaminophen (e.g. Tylenol) or ibuprofen for pain relief. The application of ice over the sinus for 20 minutes may also help.
Antihistamines
Give oral antihistamines only if the child also has hay fever.
Expected Course
With treatment, the viral sinus congestion usually resolves in 7 to 14 days. The main complication occurs if bacteria multiply within the blocked sinus (bacterial sinusitis). This leads to a fever and increased pain. It needs antibiotics.
Contagiousness
Sinus infections are not contagious.
Call Your Doctor If:
- Sinus pain persists > 1 day after starting treatment
- Sinus congestion persists > 2 weeks
- Sinus pain present and fever occurs
- Your child becomes worse or develops any of the "Call Your Doctor…" symptoms
Parent Care for Pediatric Symptoms. Copyright 2000-2006.