Anyone with chronic sinusitis, which is chronic inflammation in one or more of the sinuses, knows it can affect your quality of life. The constant pain and pressure in your sinuses can spread from your forehead to your cheekbones, and even down to your upper teeth. Untreated chronic sinusitis can also lead to rare but serious complications. Chronic sinusitis treatment is important to help ease your pain and reduce the risk of complications, but it can take time and persistence. With the right treatment, you should get sinus relief, and hopefully the inflammation will not return. How Chronic Sinusitis Differs from Acute Sinusitis You may have chronic sinusitis if you’ve had the signs and symptoms of sinusitis for 90 days or longer. These symptoms can include a persistent pain or pressure around the sinuses, stuffy nose, discolored nasal discharge, and a foul taste in your mouth. Sinusitis that lasts less than 30 days is what medical professionals term acute sinusitis, most often due to a virus infection. Sinusitis that lasts between 60 days and 90 days is subacute sinusitis. However, chronic sinusitis is not acute or subacute sinusitis or a sinus infection that hasn’t cleared up. It is a separate diagnosis. While doctors aren’t entirely sure what causes chronic sinusitis, it is often associated with malformations, abnormalities or scarring in the nasal passages or sinuses, allergies, or trauma to the nose or sinuses. Infections and allergies can also lead to chronic sinusitis and make the condition worse. In some cases, doctors cannot determine the underlying cause. If you had sinusitis that went away but came back—even if it was within 90 days—you have what doctors call recurrent sinusitis. Chronic Sinusitis Treatment: A Two-Pronged Approach Chronic sinusitis treatment often has two approaches. The first and most important task is to calm the inflammation to relieve your pain and discomfort. The second approach is to deal with the reason why you have inflammation in the first place. Treatment may include correcting problems in the nasal passages or sinuses. If these conditions are not treated, sinusitis may return. It may seem that antibiotics should be the first choice in treating chronic sinusitis. However, not everyone with chronic sinusitis has an infection and the infection may not be caused by bacteria. Antibiotics only are effective in treating bacterial infections, not viral or fungal infections. Antibiotics also have no effect on sinus inflammation associated with allergies or other causes. Therefore, unless your doctor knows or suspects your infection is bacterial, you will not be prescribed antibiotics. To treat inflammation, some of the most common chronic sinusitis treatments include: Increase your fluid intake: Increasing your fluid intake will hydrate your body and help thin out the nasal mucus, allowing it to drain rather than stay in the sinuses. Warm compresses: Applying warm compresses to your face for 20 minutes at a time can help loosen the mucus to help it drain and relieve the pain and pressure. Humidify your air: Filling a bathroom with steam or using a vaporizer in an enclosed room will provide moist air for you to breathe, which will help ease pain and drain the mucus. Sleep with your head elevated: Lying flat can increase sinus pain if you have a sinus infection since the sinuses can’t drain. Sleeping with your head elevated allows the mucus to flow downward. If you can’t sleep on your back or you find a pile of pillows too uncomfortable, try lifting the head of your bed by placing blocks or bricks under the two legs. This puts the whole bed at an incline and allows you to sleep in your usual position. Saline rinses: Nasal saline rinses can help rinse away irritants causing inflammation and drainage in your nasal passages and sinuses, and thin out the mucus already there. Nasal corticosteroid sprays or drops: Corticosteroid medications help prevent or reduce inflammation. There are many types of over-the-counter products that can help treat sinusitis, such as Flonase or Nasacort, as well as some stronger prescription-strength products. It is important to follow the instructions and not overuse nasal corticosteroids though, as overuse can result in rebound inflammation. This is an increased inflammation of the tissues caused by the medication. Oral corticosteroids: Taking prescription corticosteroids, like prednisone, by mouth is only recommended if nasal sprays are not effective. If prednisone is prescribed, it is for as short a duration as possible to reduce the risk of side effects. Treating the Cause of Chronic Sinusitis Once you treat the initial pain and discomfort of chronic sinusitis, it’s important to determine the underlying cause, especially if you have repeated bouts of chronic sinusitis. If your doctor finds the cause, he or she may recommend additional treatment to prevent the inflammation from reoccurring. Additional treatments may include: Allergy medications: If your chronic sinusitis occurs with allergies, you may get relief by taking allergy medications, which regulate how your body responds to allergens. Antimicrobials: Your doctor may prescribe an antibiotic if a bacterial infection is present or an antifungal if you have a fungal sinus infection. Surgery: Surgery to remove blockages or malformations, or to repair scarring from trauma may allow your sinuses to drain more effectively, reducing the chances of fluid backing up into the sinuses and becoming infected. Leaving Sinusitis Untreated Can Lead to Complications Complications related to chronic sinusitis are rare, but they can happen. Sticking with your treatment plan can help reduce the risk of developing complications such as: Spread of infection—if one is present—to the bones, eyes or skin Loss of vision Loss of smell People with chronic sinusitis caused by other factors can still develop a sinus infection, so if symptoms don’t go away with treatment or they get worse, follow up with your doctor.