What Every Patient Needs to Know About Sinusitis and Sinus Infections

Commentary02/25/25 Marvin P. Fried, MD, Montefiore Medical Center, The University Hospital of Albert Einstein College of Medicine

After several days of suffering from a cold, all you want is to feel better and get back to normal. But that doesn’t always happen.

Sometimes, your congestion and runny nose are joined by fatigue and a headache. Those are all indicators that you’re suffering from a sinus infection, also known as sinusitis. Sinusitis is one of the most common medical conditions, but that doesn’t make it any less unpleasant when you’ve got it. The best way to control the symptoms and reduce the risk of more dangerous complications is to understand the condition and the steps to take to treat it effectively.

Here are five things patients should know about sinusitis that will help them distinguish it from other respiratory disorders.

1. Sinusitis can have many causes

There are four groups of sinuses surrounding the nasal passage in the skull. Sinusitis is the blanket term for inflammation of any of those sinuses. Often, sinusitis is caused by a viral upper respiratory infection, such as a cold, creating a buildup of fluid. However, there are other causes as well, including bacteria and seasonal allergies, which can cause swelling that leads to sinusitis, as can irritants like dust particles or smoke. Certain fungi can also cause sinus infections. Nasal polyps may also be associated with sinusitis.

2. There are telltale symptoms of sinusitis

Sinusitis is closely connected to other respiratory illnesses and is often accompanied by inflammation of the nasal passage, which causes congestion and a runny nose of cloudy or colored discharge.

But there are a few specific symptoms to watch for. Often, sinusitis is more painful than other respiratory illnesses. The pressure in the sinuses causes swelling and aching cheeks, pain behind the eyes, or headaches. Fatigue is another key symptom. People with sinusitis feel run down and more exhausted than if they were suffering from allergies or a cold.

3. Treatment depends on the severity and timing

Timing is another important indicator of sinusitis. A cold tends to last between a week and 10 days. If you aren’t feeling better after two weeks, it’s time to see a doctor and determine if sinusitis is present. Start with an appointment with your primary care physician and be prepared to offer a detailed timeline of your illness and symptoms. Doctors may diagnose sinusitis based on those details and a physical exam. In some instances, they may order a CT scan, which is the gold standard of diagnosis.

For cases of sinusitis causing a fever or severe pain and lasting more than 10 days, doctors may prescribe an antibiotic. Doctors will typically recommend at-home remedies to help the sinus drain, including

Breathing steam from a hot shower
Hot, wet towels covering the sinuses
Drinking hot fluids
Saline rinses
Over-the-counter nasal decongestant sprays

4. Sinusitis can become chronic

Individual sinus infections are known as acute sinusitis. Sinusitis is defined as chronic if it has been ongoing for over 90 days. Doctors do not understand exactly what causes chronic sinusitis, but it involves factors that cause chronic inflammation. Sinusitis may also be subacute (lasting 30 to 90 days) or recurrent (4 or more episodes of acute sinusitis per year). Symptoms of chronic sinusitis are generally similar to those of acute sinusitis.

Patients with suspected chronic sinusitis are often referred to an otolaryngologist, an ear, nose, and throat (ENT) specialist. Treatment tends to be more involved and can include stronger courses of antibiotics, oral steroids, and other medications. Ultimately, surgery may be recommended, depending on the cause of the sinusitis.

5. Getting diagnosed is crucial

The spread of bacterial infection to the eyes or brain can pose serious medical risks. If you or a loved one is suffering from sinusitis symptoms for more than 14 days, seeking proper care is essential. Children, older individuals, and immunocompromised individuals should be especially careful.

The best way to prevent sinusitis and its complications is to prevent the infection from occurring in the first place. That’s easier said than done, particularly during winter months. But making efforts to stay healthy can make a difference – wash your hands and keep a safe distance from others who are sick. And if you do get sick, take care of yourself. Getting enough sleep and prioritizing a healthy recovery are good ways to avoid sinusitis.

For more on sinusitis, visit the Manuals page or the Quick Facts on the topic