Chronic sinusitis without yukky mucus: what's wrong with me?

[Sasha]

I've had sinus headaches for years without realising that that's what they were, because apart from a stuffy nose, I don't have horrible mucus pouring out of my nose. My GP agrees it's sinusitis because of the position o the pain but thinks I don't have an infection because there's no green mucus. The only treatment he's given me has been nasal steroids drops (which didn't help) and painkillers (which are ineffective).

I'd rather be treating the cause than the symptoms but I don't know what's causing the sinusitis.

Things improved somewhat when I started daily nasal irrigation with buffered saline a year ago but I still get, on average, two bad headaches a week and once started, they last all day and are quite debilitating.

Is this really not an infection? Should I be getting some kind of investigation? Getting a referral to an ENT specialist?

 

[Nielk]

I've had sinus headaches for years without realising that that's what they were, because apart from a stuffy nose, I don't have horrible mucus pouring out of my nose. My GP agrees it's sinusitis because of the position o the pain but thinks I don't have an infection because there's no green mucus. The only treatment he's given me has been nasal steroids drops (which didn't help) and painkillers (which are ineffective).

I'd rather be treating the cause than the symptoms but I don't know what's causing the sinusitis.

Things improved somewhat when I started daily nasal irrigation with buffered saline a year ago but I still get, on average, two bad headaches a week and once started, they last all day and are quite debilitating.

Is this really not an infection? Should I be getting some kind of investigation? Getting a referral to an ENT specialist?

Whatever you have, Sasha I have it too.

I have had two sinus surgeries. I take daily antihistamines and nasal steroid drops. I am even on oral steroids now for my RA with no relief of my constant sinus pain/headache. I have no runny nose. If someone can figure this out, I would be very appreciative.

 

[xchocoholic]

Have you looked for triggers ? Soy was causing my constant post nasal drip. I've been told dairy can cause congestion.

Pediatricians have been telling mothers for decades to withhold dairy from their children's diet if the child had congestion in nose, sinus, lungs or inflamed ears. Where they screw up is by telling mothers to add it back to that child's diet asap. Duh !

Your trigger may not be one of these tho. That's where determining triggers gets complicated.

Tc ... x

 

[Sasha]

Whatever you have, Sasha I have it too.

I have had two sinus surgeries. I take daily antihistamines and nasal steroid drops. I am even on oral steroids now for my RA with no relief of my constant sinus pain/headache. I have no runny nose. If someone can figure this out, I would be very appreciative.

Sorry to hear about your RA diagnosis - one more thing you don't need. Sorry to hear your sinus pain is constant, too - at least I get some days off.

Why did you have the surgeries? Did you have a scan showing something structural?

 

[Sasha]

Have you looked for triggers ? Soy was causing my constant post nasal drip. I've been told dairy can cause congestion.

Pediatricians have been telling mothers for decades to withhold dairy from their children's diet if the child had congestion in nose, sinus, lungs or inflamed ears. Where they screw up is by telling mothers to add it back to that child's diet asap. Duh !

Your trigger may not be one of these tho. That's where determining triggers gets complicated.

Tc ... x

Thanks, X. I'm currently on Chris Kresser's 30-day 'restart' Paleo Diet and have been for several months - no dairy, no grains, no pulses, no seeds, no nightshade family vegetables, no sugar, coffee, chocolate, nothing artificial or manufactured. I'm breathing more easily at night (possibly the dairy?) but still the headaches.

 

[Nielk]

Sorry to hear about your RA diagnosis - one more thing you don't need. Sorry to hear your sinus pain is constant, too - at least I get some days off.

Why did you have the surgeries? Did you have a scan showing something structural?

Thanks, Sasha.
The first surgery was for a deviated septum (35 years ago). The second one was to clear blocked sinus cavities that showed up on a ct scan (6 years ago).

The deviated septum one helped in that I used to get full blown sinus infections constantly which has diminished greatly. The second surgery did nothing at all. As son as I recovered from the surgery, all my pains were still there.

 

[manna]

i believe the block is energetic not physical. probably a problem with the colon as that meridian goes up either side of the nose and so connects to the sinuses.. ive seen someone with a very blocked nose have it disappear immediately with acupuncture on a colon point on the hand. salt pipes clear it for me too.

 

[Nielk]

i believe the block is energetic not physical. probably a problem with the colon as that meridian goes up either side of the nose and so connects to the sinuses.. ive seen someone with a very blocked nose have it disappear immediately with acupuncture on a colon point on the hand. salt pipes clear it for me too.

What are salt pipes?

 

[manna]

What are salt pipes?

try it in a google search, perhaps with "salt inhaler", might work better. basically breathing air that is drawn through salt. soothes lungs and nose if you breath out through it.

 

[Ema]

What are salt pipes?

http://www.amazon.com/gp/aw/d/B000OZQBV8/ref=aw_d_dsc_hpc

 

[golden]

I had mine clear up perfectly on 80 10 10. i havent mastered this diet yet and so i started eating one cooked meal a day and its back. But nit as bad. Plus hay triggers it for me too.

When it cleared up it was very helpful in deed.

It may also be to do with the colon as the 80 10 10 gives me lovely clean colon feel too and the inflammation disappeared.

However i am not recommending the 80 10 10 to anyone as it came to me very naturally - i will hopefully start a thread when i get better at it -i was just commenting on what helped mine

 

[N.A.Wright]

I've had sinus headaches for years without realising that that's what they were, because apart from a stuffy nose, I don't have horrible mucus pouring out of my nose. My GP agrees it's sinusitis because of the position o the pain but thinks I don't have an infection because there's no green mucus. The only treatment he's given me has been nasal steroids drops (which didn't help) and painkillers (which are ineffective).

I'd rather be treating the cause than the symptoms but I don't know what's causing the sinusitis.

Things improved somewhat when I started daily nasal irrigation with buffered saline a year ago but I still get, on average, two bad headaches a week and once started, they last all day and are quite debilitating.

Is this really not an infection? Should I be getting some kind of investigation? Getting a referral to an ENT specialist?

The alternative is allergy, which is clearly what your doc suspects. There are nasal sprays as well as drops but as with all steroids the indvidual response is unpredicable so you may need to try several before finding success (fluticasone proprionate may be worth mentioning to GP - beware over use can cause thining of the nasal walls and lead to nse bleeds). Some of the sinus medications contain vaso constrictors, these cause the lining of the sinus connection to the soft palette at the back of the nose, to open. This connection is a tiny tube a few millimetres in length and about a millimetre wide (head of pin), the blocking of this by thickened mucus, produced in response to either infection or allergen produces pain. Combining treatments can help - vasoconstrictors, astringents - like Karvol or Olbas Oil - and steroids, can be more effective than using them singly. Look to reduce allergen exposure - pollen, dust, scented laundry products etc. It may be worth wearing a surgical/diy mask when cleaning, vacuuming etc, as well as taking a general anti allergen like Fexofenadine - this can lead to drowsines though, but is helpful for sleep.

Using nasal flushes can have unwanted consequences, changing the microbiome of the nose can actualy promote infection and inflamation, while the initial problem in the sinus is actually untouched, so you get a double problem that then becomes circular.

 

[Sasha]

The alternative is allergy, which is clearly what your doc suspects.

He must have kept it to himself!

There are nasal sprays as well as drops but as with all steroids the indvidual response is unpredicable so you may need to try several before finding success (fluticasone proprionate may be worth mentioning to GP - beware over use can cause thining of the nasal walls and lead to nse bleeds).

We tried a couple, including a strong one, and they were totally useless. My ME doc wanted me to stop them because steroids suppress the immune system.

Some of the sinus medications contain vaso constrictors, these cause the lining of the sinus connection to the soft palette at the back of the nose, to open. This connection is a tiny tube a few millimetres in length and about a millimetre wide (head of pin), the blocking of this by thickened mucus, produced in response to either infection or allergen produces pain.

That's interesting - it sounds like extremely poor design!

Combining treatments can help - vasoconstrictors, astringents - like Karvol or Olbas Oil - and steroids, can be more effective than using them singly.

I've used vasoconstrictors in the past but they wear off after a few days, and I've tried peppermint oil, olbas oil, etc. which don't do anything - and I've got to stay off the steroids.

Look to reduce allergen exposure - pollen, dust, scented laundry products etc. It may be worth wearing a surgical/diy mask when cleaning, vacuuming etc, as well as taking a general anti allergen like Fexofenadine - this can lead to drowsines though, but is helpful for sleep.

I'm pretty much housebound so don't get much pollen exposure and I get these headaches year-round. I don't use scented stuff and don't do any housework (I hire a helper and leave the room while she's cleaning). I'll ask my ME doc about Fexofenadine - I wish I could get to the cause of this thing rather than treating the symptoms, though, especially since I'm worried about any of these drugs interacting with other stuff.

Using nasal flushes can have unwanted consequences, changing the microbiome of the nose can actualy promote infection and inflamation, while the initial problem in the sinus is actually untouched, so you get a double problem that then becomes circular.

That's interesting. I've become worried about that since I learned about the microbiome. I sent a nasal swab off to uBiome a couple of months ago and am waiting for the result. If I've stuffed up my nasal microbiome, I don't know what to do about it. Argh!

Sorry, I think this is a bit of a negative reply to your response! I think my headache is making me a bit contrary!

 

[Sasha]

Using nasal flushes can have unwanted consequences, changing the microbiome of the nose can actualy promote infection and inflamation, while the initial problem in the sinus is actually untouched, so you get a double problem that then becomes circular.

Further to your comment, I just found this:

http://www.medscape.com/viewarticle/712146

in which a study found that patients who continued daily use of nasal irrigation had more than twice as many episodes of rhinosinutis than those who didn't. Maybe it's time to stop...

 

[xchocoholic]

How about non food triggers ? I need to change my pillow cases about every 3-4 days to avoid getting grit in my eyeballs.

Mold on fresh fruits and veggies nails me too. That was one of my problems with the paleo diet. I was always finding something had gone bad and I needed to get out for more food.

Good to hear some of you're symptoms improved.

Tc .. x

 

[Sasha]

How about non food triggers ? I need to change my pillow cases about every 3-4 days to avoid getting grit in my eyeballs.

Mold on fresh fruits and veggies nails me too. That was one of my problems with the paleo diet. I was always finding something had gone bad and I needed to get out for more food.

I could try changing the pillowcases though I've got no particular reason to suspect them. I don't eat mouldy fruit or veg or let it get to that state so I don't think it will be mould.

I wonder if I should ask for a referral to an allergy clinic.

 

[TigerLilea]

I've had sinus headaches for years without realising that that's what they were, because apart from a stuffy nose, I don't have horrible mucus pouring out of my nose. My GP agrees it's sinusitis because of the position o the pain but thinks I don't have an infection because there's no green mucus. The only treatment he's given me has been nasal steroids drops (which didn't help) and painkillers (which are ineffective).

I'd rather be treating the cause than the symptoms but I don't know what's causing the sinusitis.

Things improved somewhat when I started daily nasal irrigation with buffered saline a year ago but I still get, on average, two bad headaches a week and once started, they last all day and are quite debilitating.

Is this really not an infection? Should I be getting some kind of investigation? Getting a referral to an ENT specialist?

It could be that this isn't sinus related at all, but, instead, a tension type headache. It is estimated that up to 90% of what doctors diagnose as "sinus" headaches aren't sinus headaches at all. Tension type headaches (and some migraines) will produce the dripping sinuses that lead doctors to erroneously believe it is a sinus problem. I have had this problem for over 20 years and can't tell you how many times I was put on antibiotics even though six CT scans showed that I had almost perfect sinuses (according to one of six ENTs I have seen over the years). Over time a tension headache that isn't treated will lead to sinus pain in the face and a stuffy nose.

 

[Sasha]

It could be that this isn't sinus related at all, but, instead, a tension type headache. It is estimated that up to 90% of what doctors diagnose as "sinus" headaches aren't sinus headaches at all. Tension type headaches (and some migraines) will produce the dripping sinuses that lead doctors to erroneously believe it is a sinus problem. I have had this problem for over 20 years and can't tell you how many times I was put on antibiotics even though six CT scans showed that I had almost perfect sinuses (according to one of six ENTs I have seen over the years). Over time a tension headache that isn't treated will lead to sinus pain in the face and a stuffy nose.

Hi TigerLilea - I've never heard of this and couldn't find any references when I googled just now. I think it's clear that they're sinus headaches because of the location of the pain - it's pretty much a map of the sinusus. Is there any evidence in the literature about an untreated tension headache leading to sinus pain?

 

[Arise]

Maybe hayfever?

i believe the block is energetic not physical. probably a problem with the colon as that meridian goes up either side of the nose and so connects to the sinuses.. ive seen someone with a very blocked nose have it disappear immediately with acupuncture on a colon point on the hand. salt pipes clear it for me too.

I find this interesting because someone on this forum once mentioned accupunture being effective in curing hayfever, and I know that hayfever often causes sinus headaches for me.

 

[xchocoholic]

I could try changing the pillowcases though I've got no particular reason to suspect them. I don't eat mouldy fruit or veg or let it get to that state so I don't think it will be mould.

I wonder if I should ask for a referral to an allergy clinic.

Mold spores get into the air. I can smell moldy fruit when it first starts. It's one of my super powers.

Tc .. x