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In Depth Healing Strategies for Chronic Sinusitis

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Chronic sinusitis, defined as an inflammation of one or more of the paranasal sinuses, is one of the most common chronic illnesses in the United States. One of every seven Americans suffers from sinusitis, which is caused by multiple factors, including structural defects of the nose that interfere with breathing (most commonly a deviated septum), upper respiratory infections that spread to the sinuses (excessively strong nose blowing is often implicated), allergies, infectious diseases such as pneumonia and measles, air pollution, diving or swimming underwater, sudden extremes of temperature, and complications from tooth infections.

People who suffer from chronic allergies are particularly susceptible to sinusitis, because allergies create hyper-reactions in the nasal membranes, leading to postnasal drip, which, in turn, irritates and inflames the sinuses.

Indoor pollution, caused by a lack of circulating fresh air in the home (the most common culprits are air conditioning and certain types of heating systems, as well as energy-saving devices such as double-paned windows that keep the air locked in the house), can also contribute to irritation and hypersecretion of the sinus cavities. If you are like most people, you spend much, if not most, of the day inside your home, school, or office, where the air contains varying amounts of toxic substances such as carbon monoxide, nitric oxide, and nitrogen dioxide. Older buildings may be insulated with asbestos, or the walls may be covered with lead-based paint. In newer homes carpeting, plastics, glue, textiles, and foam insulation release toxic formaldehyde vapors.

Formaldehyde is also found in antiperspirants, mouthwashes, germicidals, dentifrices, shampoos, air deodorizers, hair-setting gels, nail polish, oils, polishes, waxes, adhesives, and detergent soaps. Numerous house-cleaning products, including bleaches, laundry soaps, toilet cleaners, disinfectants, floor waxes, mildew removers, and oven cleaners, contain toxic chemicals that can damage your health, impair your immune system, and contribute to chronic allergies and sinus infections.

Symptoms: Sinusitus causes the mucous membranes to become inflamed and swollen, which leads to partially or wholly blocked nasal passages. Mucus accumulates in the nose and sinuses, putting pressure on the sinus walls, which, in turn, creates discomfort, pain, and difficulty breathing. Consequently, your entire head feels congested, and you find it difficult to think clearly. Extreme fatigue, general weakness, and chronic pain concentrated around the nose and behind the eyes make you cranky and irritable. Symptoms tend to be worse in the morning, and many people with sinusitis claim that they can’t find the energy to drag themselves out of bed. Moving around helps stimulate nasal drainage (which often has a yellow or greenish tint to the mucus), and you generally feel better as the day goes on.

While these symptoms occur with both chronic and acute sinusitis, chronic infections can also cause persistent low-grade fevers (especially at night), daytime cough, generalized achiness, chronic headaches (often behind the eyes), and dizziness when you stand up, lie down, or change position.

WESTERN TREATMENT

Doctors often prescribe antibiotics for sinus infections, usually for a three- or four-week course. The most commonly prescribed antibiotics are in the “broad-spectrum” category, because they are capable of destroying many different kinds of bacteria. While broad-spectrum antibiotics typically offer fast relief from symptoms, in most cases the underlying disorder remains, and the symptoms simply reappear after the antibiotic is discontinued. Increasing numbers of doctors are sensitive to the dangers associated with repeated doses of broad-spectrum antibiotics-specifically, the destruction of large populations of friendly bacteria and the creation of antibiotic-resistant bacteria-and encourage their patients to take nutritional supplements, change their diet, and reduce stress to help prevent recurrent infections.

Both prescription and over-the-counter decongestants and expectorants (Dristan, Allerest, Drixoral, Actifed, Afrin) are available to relieve the symptoms of congestion. Decongestant nasal sprays work quickly to clear blocked nasal passages, but as you build up tolerance to these drugs, you have to use more and more of them to attain the desired effect. These decongestants also cause side effects. One common side effect is “rhinitis medicamentosis,” in which the symptoms are exacerbated when you stop using the medication. People often interpret this flare-up as evidence of how well the medication worked and immediately begin using it again. For these reasons physicians caution patients to use over-the-counter decongestants only when absolutely necessary and only for short periods of time.

Aspirin and other over-the-counter pain relievers offer some relief from symptoms. Humidifiers often help break up congestion, and air purifiers may improve the quality of the air in your home and reduce the risk of allergies, which in many cases also reduces the risk of sinusitis.

When sinusitis continues for months or years and other methods fail to prevent recurrences, your physician may suggest surgery to enlarge the sinus openings and create adequate drainage and ventilation. While surgery often provides short-term relief, there is no guarantee of a long-term cure, and many surgery patients continue to suffer from chronic and acute attacks within weeks or months after the operation.

TRADITIONAL CHINESE INTERPRETATION

The Chinese interpret sinusitis as a continuous or repeated invasion by the Wind/Heat Devil or the Wind/Cold Devil (indicating a general depletion of wei chi), which interferes with the Lungs’ ability to disperse and spread chi. One of chi’s main functions is to keep the blood and fluids moving throughout the body, and when chi becomes blocked or inhibited, the fluids accumulate and thicken into a mucuslike substance called tan. With insufficient wei chi and chi available to combat the invading Devils, Heat or Cold lodges in the nose and sinuses and over time the tan begins to stagnate and become infected.

If the source of the infection isn’t eliminated, the Lung energy weakens, and infections become chronic and difficult to uproot. Repeated invasions of the nasal passages by Wind, Heat, or Cold gradually weaken the Kidney chi, interfering with the Kidneys’ ability to “grasp” and distribute the Lung chi, which leads to “stuck” energy in the head and general fatigue, weakness, and lethargy.

General treatment strategies involve using acupuncture points and appropriate herbs to drain the “stuck” Wind/Heat or Wind/Cold from the head and support the functions of the Lungs and Kidneys. Taking an individual’s constitutional strengths and weaknesses into account is an essential part of treatment. Because the constant fatigue, congestion, foggy thinking, headaches, and general discomfort inevitably create emotional stress, attention is paid to the individual’s ability to withstand stress, and various stress-reduction techniques are suggested on an individual basis.

COMPLEMENTARY TREATMENTS

Diet

Diet plays a major role in susceptibility to chronic sinusitis. Dairy products, the primary food allergen, are particularly troublesome because they cause allergic reactions in susceptible individuals and create additional mucus in the system. If you suffer from sinusitis, your first step should be to eliminate milk and other dairy products from your diet for three weeks. Keep careful track of your symptoms, noting any improvements. After three weeks, gradually reintroduce these foods, and again carefully note any recurring symptoms. If your symptoms return, stay off dairy products for six months; at that point, if you want to try reintroducing dairy products into your diet, you can do so very gradually, but be on the lookout for any returning symptoms.

In addition to reducing or eliminating dairy products, try to cut down on your sugar and caffeine intake. Many sinus sufferers are addicted to their caffeine drinks because caffeine temporarily relieves symptoms such as foggy thinking, headaches, and fatigue. Counteracting these beneficial effects, however, are caffeine’s negative impact on numerous bodily functions. Caffeine interferes with digestion and the assimilation of nutrients; overstimulates the adrenal glands, which over time can lead to exhaustion, chronic fatigue, anxiety, and panic attacks; and burdens the Liver, which is responsible for detoxifying drugs and other chemicals.

Like caffeine, sugar is an antinutrient, a substance that takes more from the body than it gives. Calorie rich, nutrient poor, heavily refined and processed, sugar exhausts the Spleen/Pancreas, stresses the Liver, and overstimulates the adrenal glands. Avoid sugar and sugar-rich foods whenever possible.

In addition to these dietary changes, be sure to drink at least eight to ten 8-ounce glasses of water daily to help the Liver and Kidney perform their functions and to thin the mucus in the sinus and nasal passages, allowing for easier drainage. Unsweetened apple juice or dark grape juice will also help thin and drain the mucus.

Exercise

Exercise helps to move chi through the body, stimulating healing, combating physical fatigue, and relieving emotional stress. If you feel achy and depleted of energy, try a gentle exercise like brisk walking. If your energy remains fairly strong and is drained only during acute infections or flare-ups, feel free to exercise more vigorously in between flare-ups.

Nutritional Supplements

  • Vitamin C: This crucial immune-enhancing vitamin and natural antihistamine plays a significant role in keeping your sinuses healthy. When you are feeling healthy and asymptomatic, take 2,000-4,000 mg. (2-4 grams) daily as a general preventive measure. If you suffer from chronic allergies and/or chronic sinusitis, take 1,000 mg. every hour or two, up to 20 grams daily (or to bowel tolerance).   The sicker you are, the more vitamin C your body can tolerate. If you take megadoses of vitamin C and experience diarrhea or loose bowels, cut back about ten percent or until the symptoms disappear, maintaining that dose until the infection is gone. At that point, return to the suggested “maintenance dose” of 2-4 grams daily.
  • Vitamin A or beta-carotene: Vitamin A helps produce mucopolysaccharide, a vital component of the mucous membranes, and helps maintain the integrity ofthe skin and mucous membranes, fortifying the body’s protective barriers against infectious organisms. With its powerful antioxidant and immune-stimulating qualities, vitamin A is extremely important for preventing and curing sinusitis.   It is important to remember that because vitamin A is fat soluble, it can accumulate in the body’s tissues. To avoid any danger of toxicity, we recommend that you take beta-carotene or mixed carotenes, which are converted in the intestines into vitamin A. Even in large amounts, beta-carotene is nontoxic. The only side effect of megadoses is a slight yellowing of the skin, which disappears when large doses are discontinued. Take 25,000 I.U. of beta-carotene twice daily (50,000 I.U. total); if you take vitamin A, do not exceed 25,000 I.U. daily without professional supervision. Note: If you have liver damage or disease, do not exceed 5,000 I.U. of vitamin A without consulting with your health care practitioner.
  • Vitamin E: A powerful antioxidant, vitamin E prevents free radicals from forming, protects the body’s cells from free radical damage, and stimulates the immune system to fight infections. Take 400 I.U. daily as a general preventive measure and 800 I.U. daily during acute flare-ups.
  • Zinc: Zinc increases T-cell production, stimulating the immune system and specifically helping the body fight viral infections and promote healing of cells and tissues; zinc also reduces the incidence and severity of colds and infections. Take 30-50 mg. daily on a preventive basis, and up to 60 mg. daily during active infections; zinc gluconate is particularly well tolerated and easy to absorb. Caution: Because zinc can be toxic in large doses, do not exceed 100 mg. daily.
  • Selenium: Selenium works synergistically with vitamin E, multiplying its protective effects. Like vitamin E, selenium protects macrophages from destruction by free radicals and protects the body against carcinogens (cancer-causing substances). Selenium has also been proven to be useful in treating a variety of inflammatory and autoimmune disorders, including chronic sinusitis, asthma, arthritis, and lupus. Take 200 mcg. daily. Note: The antioxidant effects of selenium and vitamin E are synergistic, so take these supplements together. Because vitamin C can hinder the absorption of selenium, you might want to take these vitamins at different times. Caution: Selenium can be toxic in large doses; do not exceed 600 mcg. daily unless you are under professional supervision.

Sinus Cleanse

If you have chronic sinusitis, you’ve undoubtedly heard about nasal washes and sinus cleansing. Warm saltwater washes are commonly recommended, while more exotic cleanses (which involve using an eyedropper to insert fresh-squeezed garlic directly into the nasal passages or sniffing ginger) are becoming increasingly popular.

For preventing and curing sinus infections, we recommend a variation of a cleanse suggested by Japanese acupuncturist Kiiko Matsumoto. Put a teaspoon of sea salt and a pinch of baking soda in a cup of lukewarm water, mix well, and pour a small amount of this solution into the cupped palm of your hand. Gently inhale through each nostril, moving your head around to circulate the saltwater solution. Let the water drain out of your nose, or spit it out of your mouth; gargle with the remaining solution, and spit it out. Repeat daily.

For acute flare-ups, repeat this procedure three to five times daily.

An easy alternative to this can be found on our Simple Solutions page.

Herbal Allies

An effective herbal remedy for chronic sinusitis would include three different kinds of herbs

  1. Decongestant and expectorant herbs, which work to break up the blockages in the sinus cavities
  2. Antimicrobial herbs, to fight off bacterial or viral invaders
  3. Supportive (tonic) herbs, to strengthen the system and enhance overall immune function

We highly recommend the following herbs, which can be mixed together in a formula. They may also be found in various remedies (usually combined with other herbs) in health food stores.

  • Licorice root (Glycyrrhiza glabra): This wonderful expectorant herb assists the respiratory system in eliminating excess mucus. Licorice also replenishes the mucous membranes, helps to clear the bronchial system, breaks up congestion in the head, and has both antimicrobial and anti-inflammatory qualities. Licorice is an excellent choice for children with sinus problems.
  • Mullein (Verbascum thapsus): Used for centuries by Native Americans to ease upper respiratory congestion, this expectorant herb soothes irritated mucous linings, relieves coughs, colds, and sore throats, and subdues the pain and discomfort associated with bronchial tissues that become inflamed due to postnasal drip.
  • Osha root (Ligusticum porteri): This extremely powerful antimicrobial herb offers fast and effective relief for sore throats and acute sinus infections.
  • Goldenseal (Hydrastis canadensis): This antimicrobial, antibiotic, and immune-boosting herb works to heal inflamed mucous membranes and generally supports the Liver’s ability to detoxify allergens and other toxic substances.
  • Echinacea (Echinacea angustifolia or Echinacea purpura): This Native American tonic was adopted by European settlers and is now used worldwide. It is renowned for its immune-enhancing antibiotic and antimicrobial actions.
  • For acute flare-ups of sinusitis, try this effective herbal antibiotic treatment: Crush a clove of garlic, mix it with a teaspoon of honey, and swallow. Repeat every two or three hours (if your stomach doesn’t rebel) until your symptoms relent. Dosage: If you purchase your herbs in a health food store (either in tincture form or, as dried herbs, in capsule or pill form), follow the dosage instructions on the label. Because herbs in dried form tend to lose their potency rather quickly, be sure to check the label for the expiration date.

For information on preparing your own herbs from the root, bark, leaves, flowers, or seeds of a plant, refer to my book, A-Z Guide to Healing Herbal Remedies (Dell)

Herbal Inhalations

To relieve the stuffed-up congestion in your nose and sinuses and the headaches that often accompany these symptoms, add a handful of chamomile flowers or several chamomile tea bags to a pot of boiling water. Cover, remove it from the heat, and let it sit for a few minutes. After five or ten minutes, put a towel over your head, uncover the pot, and breathe deeply, inhaling the steam vapors. (Be careful not to burn yourself.) If you are still congested, you can add cinnamon and a drop of eucalyptus or peppermint oil to the hot water.

If you’re in a hurry, try this strategy: Before you shower in the morning, put a few drops of eucalyptus or pine oil on a wet washcloth. Hang the washcloth over the shower head or shower door, turn the water on as hot as you can stand it, and breathe deeply of the sweet-smelling steam.

As a general preventive, use an over-the-counter saline (saltwater) nasal spray. These inexpensive sprays (Ocean is a popular brand) help lubricate the nasal passages and wash away allergens. When used on a daily basis, saline sprays can help prevent or alleviate the symptoms of allergies and sinus infections.

Complementary Herbal Formulations

(Traditionally, in both Western and Chinese cultures, the combining of herbs is of superior value than the individual parts. After over thirty years as an herbalist, the synergy of certain herbs became apparent and this understanding has been used to create our own Integral Health Apothecary formulas. We are also listing tradition Chinese herbal tonics which exemplify this synergy.)

  • Clear Passage: Includes Chinese and Western herbs to clear the sinus passages and resolve the inflammation.  Ingredients: Echinacea, Osha root,  golden seal,  Licorice, Ground Ivy, Wild Indigo, Clivers.
  • For acute flare ups add Bi Yan Pian to resolve the symptoms.

Chinese Patent Remedies

For acute sinus infections, we recommend:

  • Bi Yan Pian (“Benefit the Nose Tablets”): This formula contains twelve herbs (Magnolia Flower is the Emperor herb) to help eliminate the Wind/Heat or Wind/Cold from the nasal areas. Take five pills two to three times a day for symptomatic relief of sinus congestion.

To prevent chronic recurrences, take five pills daily of Bi Yan Pian along with ten pills taken twice daily of:

  • Hsiao Yao Wan (“Relaxed Wanderer Pills”): This famous remedy was specifically designed to keep the Liver chi moving and flowing. Hsiao Yao Wan also helps relieve the allergic response so often associated with chronic sinusitis. The formula, which consists of eight herbs, with bupleurum reigning as Emperor, is extremely gentle and can be used safely for long periods of time.

These Chinese patent remedies are gentle and can safely be combined with any of the following Western herbs. If you need help choosing the most effective formula or combination of herbs for your symptoms, consult an experienced herbalist.

Acupoints

Two Large Intestine points will give you temporary relief from sinus pain and related congestion.

  • Large Intestine 4 (“Great Eliminator”): This is one of the most frequently used points in acupuncture. Traditionally used for draining or dispersing constrained (“stuck”) energy in the upper part of the body, especially the head and neck areas, it relieves headaches, sinus congestion, stuffy nose, irritated eyes, sore throat, swollen glands, and chronic tension in the neck and shoulder regions. This point can be extremely sensitive, even painful to the touch. Location: Large Intestine 4 is located on the top of the hand in the webbing between the thumb and index finger. Massage in circular, clockwise movements for one or two minutes.
  • Large Intestine 20 (“Receiving Fragrance”): This point opens the nasal passages and clears the sinuses, allowing you to “receive the fragrances” of the world around you. (It is commonly used to help people stop smoking.) This point is often painful in people who suffer from chronic or acute sinusitis.  Location: Large Intestine 20 is located on either sides of the nostrils, in the depression just beneath the cheekbone. Press firmly with your fingers using circular motions; continue massaging for one or two minutes. If one side is more sensitive than the other, spend an extra minute or so on that side.
  • Yin Tang (“Seal Hall”): This extra point is not located on any particular meridian. Yet it is one of the most important points to unblock the nasal passages and ease the symptoms of chronic sinusitis. It is also used to promote inner vision and create the space for meditation and enlightenment. It is sometimes called “the Third Eye.” Location: Yin Tang is located between the eyebrows in the center of the forehead. Massage in small clockwise circles with the tips of your fingers .

Questions to Ask Yourself

The Chinese believe that sinusitis is always related to “stuck” chi in either the Liver, Lungs, or Kidneys. These questions will help you “talk” to your illness and discover where your energy is blocked or deficient.

If you are a Wood (Liver) type, you will need to look at your ability to express anger:

  • Who is the object of my anger?
  • How can I effectively express my anger?
  • Where do I typically store my anger?

If you are a Metal (Lung) type, excess or stored-up grief may be affecting your ability to resist disease.  Ask yourself:

  • How do I prevent myself from feeling grief?
  • What do I need to let go of? Why am I holding on?
  • Where do I tend to store my grief?

If you are a Water (Kidneys) type, fear often obstructs your energy. Ask yourself:

  • How does my fear create blockages that prevent me from attaining my goals in life?
  • Where do I tend to store my fear?
  • How do I allow fear to rule my life?
  • What exactly do I fear and why?

Fire and Earth types also suffer from periodic sinus infections. Fire types are prone to overexcitement and agitation, while Earth types are often adversely affected by excessive worrying. Ask yourself these questions:

  • Why do I feel stuffed up emotionally?
  • What can I do to “decongest” my life and give myself more time and space to pursue my goals and passions?
  • Am I overreacting in any way? What can I do to calm myself down?
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