Ask Dr Gary: Sinus infections take time to clear

Infected sinuses can be horrible.

For the past two weeks I've had what I thought was just a bad head cold. It started with a very sore throat. After one week a runny nose started, alternating with a blocked nose, even though I used lots of Vicks VapoRub. I drank plenty of fluids, gargled, sucked cough drops, and even sniffed warm salt water up my nose for days without relief. Still there is no improvement. I know you shouldn't go to the doctor for an antibiotic for a cold. Could this have started as a sinus infection with draining making the throat so sore? Is a sinus infection also caused by a virus? -R.

Acute sinusitis can be hard to fix quickly, but the good news is, it almost always goes away, even if it does typically take 10 days. It usually starts with a cold, as yours did. We pick up a virus, and transfer it to our faces with our hands. From there it makes its way into our sinuses, the air-filled spaces in our foreheads, cheeks and behind our noses.

Sinuses are weird, because they're shaped like windowless rooms where the only door is tiny and near the ceiling. Mucus, allergens, viruses and bacteria have a tendency to settle in and fester.

The easiest and most practical thing I would recommend is sinus lavage. It doesn't cure anything, but it can markedly improve symptoms. You don't just sniff water, rather you pour warm slightly salty clean water in through one nostril and out through the other. Mucus will come out, and for the next 20 minutes or so there will be increased clearance of your nasal passages and sinuses. It takes some practice but can lead to relief from the blocked, pressure-like sensation of plugged sinuses.

Staying very well hydrated is important, as is using humidified air if your indoor air is too dry (fireplaces and forced air heaters are notoriously bad for drying out your mucus membranes.

Topical vasoconstrictors like oxymetazoline are effective for reducing swelling, but shouldn't be used for more than three days. Again, the goal is to allow clearance of secretions.

Other things, like topical steroids and menthol rubs and even antibiotics, have not convincingly been shown to be effective.

Having said that, after weeks of symptoms, many doctors would try antibiotics, as some cases of sinusitis can be bacterial, especially cases that don't readily clear themselves.

And lastly, sinus drainage or a post-nasal drip is probably causing your throat to feel sore.

My suggestion is to go to your GP for a review - you've put in a valiant effort managing things on your own for 14 days, but getting an informed second opinion from your doctor at this point is a good idea (especially important if you have had fevers or are a smoker).

Not all blocked noses are because of sinusitis, and a doctor can do some things you can't, like look deep inside your nose and throat and examine your lymph nodes.

Best wishes.