Ask the Doctor: The Stuff You Need to Know About Stuffiness
How to tell the difference between congestion and infection
Written by Melissa Bean Sterzick
A stuffy, sniffly, runny nose is unpleasant but usually passes quickly. Home remedies help with minor colds and irritations, but nasal congestion caused by a sinus infection can require a visit to the doctor. Board-certified otolaryngologist David Kim, MD, of Torrance Memorial Physician Network, offers suggestions for treating sinus congestion and infection—and how to tell which one you’ve got.
What causes an ordinary stuffy nose?
A stuffy nose is a common medical condition that is a result of inflammation and swelling of the nasal passages (also known as rhinitis). It can be set off by environmental allergies, infections (viral and bacterial), chemicals (tobacco smoke, car exhaust, perfume and chlorinated water), alcohol, certain medical conditions (including pregnancy and decreased thyroid gland function), medications (certain blood pressure medications, birth control pills and antidepressants) and weather changes. Abnormal anatomy of the nose can also contribute to feelings of stuffiness.
What causes a sinus infection?
A sinus infection (sinusitis) can occur with any condition that creates nasal inflammation and blocks the drainage of the sinuses. Allergies and upper respiratory infections are common triggers. People with nasal blockages due to polyps or a deviated septum, or who have a compromised immune system, can be also more susceptible to a sinus infection.
What are the specific differences between a stuffy nose and a sinus infection?
A sinus infection usually produces thick, discolored (yellow or green) mucus, but with an ordinary stuffy nose, mucus tends to be clear or white. A fever, significant pain or pressure on one side of the face, or pain in the upper teeth point to a sinus infection.
What are the best treatments for an ordinary or cold-related stuffy nose?
Remedies include using a humidifier/vaporizer, staying hydrated and keeping your head elevated while sleeping. Preventive measures can involve avoiding an allergy trigger and irritants like cigarettes/other forms of smoke inhalation and alcohol. A nasal saline spray and rinse is a safe, nonmedicinal option for reducing nasal congestion. Topical medicated nasal sprays and oral antihistamines can be used alone or in combination. And there are numerous over-the-counter (OTC) therapeutic options.
What is the right approach for a sinus infection?
Sinusitis is one of the leading reasons for antibiotic prescriptions in outpatient health care in the U.S. However, many cases are caused by viruses (not bacteria), and antibiotic treatment may not be helpful—and could be harmful in the long term. Many cases of sinusitis will resolve with the use of a nasal saline rinse, a warm compress, and nonsteroidal anti-inflammatory drugs such as acetaminophen and ibuprofen. If a person has persistent symptoms for more than seven days or develops a fever, significant facial pain or thick yellow or green nasal drainage, it is recommended to consult a medical professional.
When should an individual see a specialist for sinus congestion?
If you experience persistent or worsening nasal congestion or frequent sinus infections that do not respond to OTC medications, consult an otolaryngologist (an ear, nose and throat specialist) for a comprehensive head and neck examination. It would also be helpful to see an allergist for an allergy test. A stuffy nose and a sinus infection are best managed by treating the source and the symptoms at the same time.
When is sinus congestion an emergency?
Sinus congestion can become an emergency when it moves into surrounding structures in the head, especially the brain and the eyes. This can cause symptoms such as eye swelling/pain, vision change, fever, severe headache, neck stiffness, altered mental status and neurological deficits. A sinus infection that spreads is serious and potentially life-threatening and requires prompt hospitalization with intravenous antibiotic treatment and surgery. You should seek medical attention immediately if you have experienced a sinus infection and develop any of these symptoms.
