Wednesday, October 20, 1999
Sure it's sinuses?
Symptoms of cold, asthma often misidentified, treated as sinusitis
BY SUE MacDONALD
The Cincinnati Enquirer
When Laura Davis went to a chiropractor for treatment of her back pain, she got an added bonus: clogged sinuses that drained freely.
Ms. Davis, 48, a patient finance services employee at Children's Hospital Medical Center, says her sinus problems improved and she uses less asthma medicines since seeing a chiropractor.
“Whenever I have an allergy attack, my sinus passages close up,” she says. “When the chiropractor adjusts my neck and sinuses, the sinuses open up and everything starts draining.”
With cooler weather coming on, Tristaters will soon be looking for all kinds of ways to unclog their blocked-up sinuses and breathe freely, especially with the onset of upper respiratory infections that cause coughs, colds, scratchy throats and runny noses. Sometimes, cold-like symptoms that linger lead to a condition called sinusitis — another word for a sinus infection.
Chiropractic treatments won't work for everyone with sinus problems, says Pleasant Ridge chiropractor Dr. Kendall Gearhart, but some patients report freer breathing, less congestion and more sinus drainage after adjustments to their upper spines.
Sinusitis is a common health problem, affecting about 14 percent of the population at a cost estimated at more than $2.4 billion a year. Clogged sinuses can make it difficult to breath, with symptoms including headaches, tooth pain, tender cheeks and fatigue.
Some people have chronic sinus problems, while others can experience them suddenly and at any time in life, says Dr. Mark Michael, an allergy specialist with offices in Montgomery, Western Hills and Colerain Township.
“The word "sinusitis,' which means sinus infection, is misused in about 80 percent of patients, because people think that every time they have a stuffed-up nose or pressure in the head, that means it's sinusitis,” Dr. Michael says. “That's not true. Some people think that if they have dark-colored drainage coming through the nose, it means they have a sinus infection, and that's not true, either.”
Sometimes, sinus flare-ups are linked to allergies, which trigger an internal reaction that produces swelling, mucus production and clogged sinuses. And when sinuses become clogged, the fluid that builds up inside becomes prone to infection by bacteria.
Typically, sinus problems that are triggered by allergies or asthma won't clear completely unless the underlying allergies or asthma are treated, too, he says.
A normal cold usually resolves in about a week, while sinus problems tend to linger or worsen. Doctors can tell if sinuses are infected by a thorough examination and discussion of symptoms with patients, Dr. Michael says. Sometimes, an internal exam of the nose or an X-ray, CAT scan or MRI of the head and sinuses will be necessary to diagnose an infection.
If a true infection exists, antibiotics can be prescribed, but doctor's concerns about the unnecessary use of antibiotics may mean that some sinus sufferers will simply be told to let nature take its course and allow the cold, stuffiness or congestion to drain naturally, Dr. Michael says.
“Doctors should be prescribing antibiotics only when they're needed or indicated,” he explains. “The indiscriminate use of antibiotics is not recommended.” Because blood flow to the sinuses is rather limited, antibiotics are usually prescribed up to three or four weeks to make sure the infection disappears, Dr. Michael says.
Doctors now know that young children can develop sinus infections, but not all children with a thick, discolored discharge from the nose have sinusitis, Dr. Michael says.
“With winter coming on, children in day-care centers are going to have a lot of runny noses and a lot of darkish nasal discharge because children don't know how to blow their nose,” he says.
Parents and doctors should look for other signs — fever, facial pain, symptoms that don't resolve in about a week, etc. to determine if a child has a bad cold or a true sinus infection.
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