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

1. Reassurance: Sinus congestion is normally part of a cold. Usually home treatment can prevent a true sinus infection.
2. 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.
3. Humidifier: If the air in your home is dry, run a humidifier.
4. 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)
5. Pain Medicine: Give acetaminophen or ibuprofen for pain relief. The application of ice over the sinus for 20 minutes may also help.
6. Antihistamines: Give oral antihistamines only if the child also has hay fever.
7. 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.
8. Contagiousness: Sinus infections are not contagious.
9. 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