Sinus Pain or Congestion

When To Call

Call 911 Now

• Not moving or too weak to stand
• Severe trouble breathing (struggling for each breath, can barely speak or cry)
• You think your child has a life-threatening emergency

Go to ER Now

• Acts or talks confused

Call Doctor or Seek Care Now

• Trouble breathing, but not severe. Exception: gone after cleaning out the nose.
• Redness or swelling on the cheek, forehead or around the eye
• Severe headache and getting worse
• Severe pain and not better after using care advice
• Weak immune system. Examples are: sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
• Fever higher than 104° F (40° C)
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Headache lasts more than 48 hours
• Fever lasts more than 3 days
• Fever returns after being gone more than 24 hours
• Earache
• Sinus pain (not just pressure) and fever
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• Sinus pain (not just pressure or fullness) lasts more than 24 hours, after using nasal washes
• Thick yellow or green pus draining from nose and not improved by nasal washes. Exception: yellow or green tinged secretions are normal.
• Sinus congestion and fullness lasts more than 14 days
• Runny nose lasts more than 14 days
• You have other questions or concerns

Self Care at Home

• Normal sinus congestion as part of a cold

Care Advice

What You Should Know About Sinus Congestion:

• Sinus congestion is a normal part of a cold.
• Nasal discharge normally changes color during different stages of a cold. It starts as clear, then cloudy, turns yellow-green tinged, then dries up.
• Yellow or green-tinged discharge. This is more common with sleep, antihistamines or low humidity. Reason: decrease the amount of normal nasal secretions.
• Usually, nasal washes can prevent a bacterial sinus infection.
• Antibiotics are not helpful for the sinus congestion that occurs with colds.
• Here is some care advice that should help.

Nasal Saline to Open a Blocked Nose:

• Use saline (salt water) nose spray (such as store brand). This helps to loosen up the dried mucus. If you don't have saline, you can use a few drops of water. Use bottled water, distilled water or boiled tap water. Teens can just splash a little water in the nose and then blow.
• Step 1: put 3 drops in each nostril.
• Step 2: blow each nostril out while closing off the other nostril. Then, do the other side.
• Step 3: repeat nose drops and blowing until the discharge is clear.
• How often: do saline rinses when your child can't breathe through the nose.
• Saline nose drops or spray can be bought in any drugstore. No prescription is needed.
• Reason for nose drops: suction or blowing alone can't remove dried or sticky mucus.
• Other option: use a warm shower to loosen mucus. Breathe in the moist air, then blow each nostril.

Fluids - Offer More:

• Try to get your child to drink lots of fluids.
• Goal: keep your child well hydrated.
• It also will thin out the mucus discharge from the nose.
• It also loosens up any phlegm in the lungs. Then it's easier to cough up.

Humidifier:

• If the air in your home is dry, use a humidifier. Reason: dry air makes nasal mucus thicker.

Decongestant Nose Spray (Age 12 years or Older):

• Use this only if the sinus still seems blocked up after nasal washes. Use the long-acting type (such as Afrin).
• Dose: 1 spray on each side. Do this 2 times per day.
• Always clean out the nose with saline before using.
• Use for 1 day. After that, use only for symptoms.
• Don't use for more than 3 days. Reason: can cause rebound congestion.
• Decongestants given by mouth (such as Sudafed) are another choice. They can also open a stuffy nose and ears. Side effects: They may make a person feel nervous or dizzy. Follow the package directions.

Pain Medicine:

• To help with the pain, give an acetaminophen product (such as Tylenol).
• Another choice is an ibuprofen product (such as Advil).
• Use as needed.
• Try saline first. Sometimes it alone relieves the pain.

Cold Pack for Pain:

• For pain or swelling, use a cold pack. You can also use ice wrapped in a wet cloth.
• Put it over the sinus for 20 minutes.
• Caution: Avoid frostbite.

Allergy Medicine:

• If the child also has nasal allergies, give an allergy medicine.
• Long-acting allergy medicines (such as Zyrtec) are best. Reason: these meds do not cause your child to act sleepy. Age limit: 2 and older.
• A single dose of Benadryl can be given for any breakthrough symptoms.
• No prescription is needed. Age limit: 1 and older.

What to Expect:

• With this advice, the viral sinus blockage goes away in 7 to 14 days.
• The main problem is a sinus infection from bacteria. This can occur if bacteria multiply within the blocked sinus. This leads to a fever and increased pain. It needs antibiotics. Once on treatment, the symptoms will improve in a few days.

Return to School:

• Sinus infections cannot be spread to others.
• Your child can return to school after the fever is gone. Your child should feel well enough to join in normal activities.

Call Your Doctor If:

• Sinus pain lasts more than 24 hours after starting treatment
• Sinus congestion lasts more than 2 weeks
• Fever lasts more than 3 days
• You think your child needs to be seen
• Your child becomes worse

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