Your doctor will feel for tenderness in your nose and face and look inside your nose, and can usually make the diagnosis based on the physical exam.
Other methods that might be used to diagnose acute sinusitis and rule out other conditions include:
- Nasal endoscopy. A thin, flexible tube (endoscope) with a fiber-optic light inserted through your nose allows your doctor to visually inspect the inside of your sinuses.
- Imaging studies. A CT scan shows details of your sinuses and nasal area. It's not usually recommended for uncomplicated acute sinusitis, but imaging studies might help find abnormalities or suspected complications.
- Nasal and sinus samples. Laboratory tests aren't generally necessary for diagnosing acute sinusitis. However, when the condition fails to respond to treatment or is worsening, tissue samples (cultures) from your nose or sinuses might help find the cause, such as a bacterial infection.
- Allergy testing. If your doctor suspects that allergies have triggered your acute sinusitis, he or she will recommend an allergy skin test. A skin test is safe and quick, and can help pinpoint the allergen that's causing your nasal flare-ups.
Most cases of acute sinusitis get better on their own. Self-care techniques are usually all you need to ease symptoms.
Treatments to relieve symptoms
Your doctor may recommend treatments to help relieve sinusitis symptoms, including:
- Saline nasal spray, which you spray into your nose several times a day to rinse your nasal passages.
- Nasal corticosteroids. These nasal sprays help prevent and treat inflammation. Examples include fluticasone (Flonase Allergy Relief, Flonase Sensimist Allergy Relief, others), budesonide (Rhinocort Allergy), mometasone (Nasonex) and beclomethasone (Beconase AQ, Qnasl, others).
- Decongestants. These medications are available in over-the-counter (OTC) and prescription liquids, tablets and nasal sprays. Use nasal decongestants for only a few days. Otherwise they may cause the return of more-severe congestion (rebound congestion).
OTC pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or aspirin.
Use caution when giving aspirin to children or teenagers. Children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye's syndrome, a rare but potentially life-threatening condition, in such children.
Antibiotics usually aren't needed to treat acute sinusitis. Even if your acute sinusitis is bacterial, it may clear up without treatment. Your doctor might wait and watch to see if your acute sinusitis worsens before prescribing antibiotics.
However, severe, progressive or persistent symptoms might require antibiotics. If your doctor prescribes an antibiotic, be sure to take the whole course, even after your symptoms get better. If you stop taking them early, your symptoms may recur.
If allergies are contributing to your sinusitis, allergy shots (immunotherapy) that help reduce the body's reaction to specific allergens may help treat your symptoms.
Lifestyle and home remedies
These self-help steps can help relieve sinusitis symptoms:
- Rest. This will help your body fight infection and speed recovery.
- Moisten your sinus cavities. Drape a towel over your head as you breathe in the vapor from a bowl of hot water. Keep the vapor directed toward your face. Or take a hot shower, breathing in the warm, moist air. This will help ease pain and help mucus drain.
- Rinse your nasal passages. Use a specially designed squeeze bottle (Sinus Rinse, others) or neti pot. This home remedy, called nasal lavage, can help clear your sinuses.
No alternative therapies have been proved to ease the symptoms of acute sinusitis. It's been suggested that products containing certain combinations of herbs may be of some help. These combination therapies contain cowslip, gentian root, elderflower, verbena and sorrel.
Possible side effects from these herbal products include stomach upset, diarrhea and allergic skin reactions. Check with your doctor before taking any herbal or dietary supplement to be sure they're safe and that they won't interact with any medications you're taking.
Preparing for your appointment
When you see your doctor, expect a thorough examination of your sinuses. Here's information to help you get ready for your appointment.
What you can do
Make a list of:
- Your symptoms, including any that seem unrelated to the reason for your appointment
- Key personal information, including whether you have allergies or asthma and family medical history
- All medications, vitamins or other supplements you take, including the doses
- Questions to ask your doctor
For acute sinusitis, questions to ask your doctor include:
- What's likely causing my symptoms?
- What are other possible causes for my symptoms?
- What tests do I need?
- Is my condition likely temporary or chronic?
- What's the best course of action?
- What are the alternatives to the primary approach you're suggesting?
- I have these other health conditions. How can I best manage them together?
- Are there restrictions I need to follow?
- Should I see a specialist?
- Are there brochures or other printed material I can have? What websites do you recommend?
Don't hesitate to ask other questions.
What to expect from your doctor
Your doctor is likely to ask you questions, such as:
- When did your symptoms begin?
- Have your symptoms been continuous or occasional?
- How severe are your symptoms?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
- Do you smoke or are you around smoke or other pollutants?