Sinus Pain/Congestion

Symptom Definition

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
Main Cause: Sinus opening is blocked by a cold or hay fever

See More Appropriate Topic

If age < 5 years old or doesn’t sound like sinus congestion, see Colds
If also has active nasal allergies, see Hay Fever (Allergies)

Call Your Doctor Now (night or day) If

Your child looks or acts very sick
Fever > 104°F (40°C)
Redness or swelling on the cheek, forehead or around the eye
Severe pain

Call Your Doctor Within 24 Hours (between 9 and 4) If

You think your child needs to be seen
Fever present > 3 days
Earache occurs
Lots of yellow or green nasal secretions present > 3 days with sinus pain
Sinus pain persists after using nasal washes and pain medicine for 24 hours

Call Your Doctor During Weekday Office Hours If

You have other questions or concerns
Sinus congestion and fullness lasts > 1 week

Parent Care at Home If

Sinus congestion as part of a cold and you don’t think your child needs to be seen

Home Care Advice for Sinus Congestion

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. 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 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 5 to 7 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 and fullness persist > 1 week
- Fever or yellow/green nasal discharge lasts > 3 days
- Your child becomes worse or develops any of the “Call Your Doctor” symptoms