SINUS PAIN AND 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).
  • he 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.

Cause

  • Sinus opening is blocked by a cold or hay fever.

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WHEN TO CALL YOUR DOCTOR FOR SINUS PAIN AND CONGESTION

Call 911 Now (your child may need an ambulance)If

  • Not moving or too weak to stand

Call Your Doctor Now (night or day) If

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

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

  • You think your child needs to be seen.
  • Fever present for more than 3 days.
  • Earache occurs.
  • Lots of yellow or green nasal secretions present for more than 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 for more than 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 nose drops followed by suction or nose blowing 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 nose drops - add ½ teaspoon 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 (e.g. Afrin).  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 (e.g. Tylenol) 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 for more than 1 day after starting treatment.
    • Sinus congestion and fullness persist for more than 1 week.
    • Fever or yellow/green nasal discharge lasts for more than 3 days.
    • Your child becomes worse or develops any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Pediatric HouseCalls Online. Copyright © 2000-2004 Barton Schmitt, M.D. FAAP

Reviewed 8/2004

Revised 8/2003

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