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A runny or stuffy nose can be a real challenge during flu season. You can barely breathe, can’t smell your favorite perfume, your pockets are full of tissues, and your nose hurts from constant blowing and wiping.
The good news is that with a traditional cold, the runny nose clears up within a few days, and you quickly forget the discomfort. The bad news is that recurring episodes create the perfect conditions for sinusitis.
A runny nose, also known as “rhinitis,” is a typical symptom indicating inflammation in the nasal and throat area. When viruses enter the nose, the mucous membrane secretes fluids to expel the invaders. The situation can worsen with bacterial infections, nasal polyps, or anatomical abnormalities that increase mucus production, swell the membrane, and block the “exit.”
When a Runny Nose Worsens
Clear and transparent mucus thickens, the nose becomes congested, headaches occur, fever sets in, and there’s a loss of smell, sore throat, and cough. At this point, we often think, “Cold or flu!” We brew hot tea, take vitamin C, and arm ourselves with patience and enough tissues.
What we often overlook is that viral infections affect not only the nasal cavity’s lining but also the sinuses. The infection spreads to the air-filled channels behind the nose, responsible for draining the mucus. Almost every acute rhinitis involves mild sinus inflammation, which usually heals with the fading of the runny nose.
The real problem arises when the runny nose recurs, lasts longer, and causes increasing discomfort. Acute sinusitis lasts more than four weeks, while chronic conditions persist for months. The earlier treatment is initiated, the better the chances of avoiding future complications.
Recognizing Sinusitis through Pain
To distinguish between a runny nose and sinusitis, recognizing the symptoms is key. Both conditions involve inflamed mucous membranes, excessive secretion, fever, and headaches, but the distinguishing factor is pain.
Pain in the cheeks: Sharp discomfort in the cheekbones or upper jaw indicates maxillary sinusitis. People often mistake it for a toothache and are surprised when the problem is unrelated to dentistry. Redness or swelling may occur, and the pain can spread to one side of the head. The sensation of heaviness worsens with head movements like bending or turning.
Pain around the eyes: Located in the inner corner of one eye, this pain comes with a deep, pulsating headache behind the eyeballs, indicative of ethmoidal sinusitis. It often worsens with coughing or lying on your back.
Localized headache: Felt at the bridge of the nose, between the eyebrows, or the forehead. This is a symptom of frontal sinusitis. The pain intensifies with tapping under or above the eyebrow or when lying down and subsides when the head is upright.
Other typical sinusitis symptoms include nasal congestion, thick yellow-green mucus, and cough. The mucus often has a distinct odor, and inflamed tissues make breathing through the nose difficult. Smell and taste may be impaired. A persistent cough occurs when mucus drips down the back of the throat, while fever signals an inflammatory process.
In some cases, sinusitis is diagnosed due to bad breath, which reveals a bacterial infection in the nasal and throat area.
When Is a Runny Nose Actually Sinusitis?
We often dismiss a runny nose, allowing months or even years to pass before realizing the problem is more serious. It’s challenging because the symptoms of a common cold and sinusitis are almost identical, while pain and headaches are often attributed to stress and fatigue. Statistics aren’t on our side either, as only 50% of people with sinusitis symptoms are correctly diagnosed.
A diagnosis is made by an ENT specialist after a thorough discussion of the patient’s complaints, both current and past. It's essential to identify whether the issue is linked to allergies, dental problems, or specific medications. Blood tests, rhinoscopy, and microbiological analysis are performed.
In more severe cases, X-rays, CT scans, or MRIs of the sinuses are used. Sinus puncture and aspiration are the gold standard for diagnosing bacterial infections when antibiotics fail to work.
