Sinusitis
Sinusitis is an inflammation of one or more sinuses. Often, acute sinus infection begins during or after a cold. The mucous membrane in the nose and sinuses swells up, making mucus less easily removed. This can lead to nasal congestion, pressure or pain in the face, headache and discharge from the nose or throat.
In some people the symptoms disappear within a relatively short period of time. In others, nasal congestion, postnasal drip, pressure in the head or decreased sense of smell remain present for a long time or the symptoms regularly return.
Within Chinese medicine, a distinction is made between acute and chronic sinusitis and between different types of complaints. Acupuncture and Chinese herbal medicine are tailored to this individual picture of complaints.
Common symptoms
Sinusitis may include:
- a blocked nose;
- Thick or coloured nasal secretion;
- mucus in the back of the throat;
- pressure or pain around the forehead, nose, cheeks or eyes;
- headache;
- reduced or absent sense of smell;
- tiredness or heavy feeling in the head;
- cough, sometimes especially at night;
- fever or feeling sick in acute sinusitis;
- Bad breath.
In chronic sinusitis, pain and fever are not always present. Long-term nasal congestion, mucus, postnasal drip and decreased sense of smell may be more prominent.
Possible causes
Acute sinusitis often occurs during or after a viral upper respiratory infection, such as a cold. Due to inflammation and swelling of the mucous membrane, the openings of the sinuses can narrow and mucus can be less easily removed. Sometimes a bacterial infection occurs.
In chronic or regular sinusitis, multiple factors may play a role. Allergic rhinitis, prolonged swelling of the nasal mucosa, nasal polyps and anatomical factors can affect for example the ventilation and discharge of the sinuses.
Within Chinese medicine, acute symptoms are often linked to an external pathogen that causes Heat. In chronic sinusitis, it also looks at lagging Heat, Dampness and Phlegm and at underlying patterns that make mucus and constipation more easily return.
How can acupuncture help with sinusitis?
Acupuncture looks at both local complaints and the underlying TCM pattern. Among other things, the location of the pain or pressure, the colour and thickness of the mucus, nasal congestion, heat or cold symptoms and the distinction between acute and chronic complaints are important.
The treatment may include:
- reduce nasal congestion and help clear the nose;
- reduce pressure and pain around the sinuses;
- support the removal of mucus;
- reduce postnasal drip and mucus formation;
- treat headache and heavy or full-bodied sensation in the head;
- In chronic or recurrent sinusitis, also treat underlying factors that according to TCM contribute to mucus formation and recurrent constipation.
In acute sinusitis, temporary treatment more frequently may be useful than with chronic symptoms.
How can Chinese herbal medicine help with sinusitis?
Chinese herbs are tailored to the stage and the symptoms. An acute sinusitis with fever, facial pain and thick yellow mucus requires a different approach within TCM than long-term nasal congestion with lots of white mucus, fatigue and recurrent complaints.
The treatment may include:
- reduce nasal congestion, headache and pressure around the sinuses;
- help to reduce thick and difficult drainable mucus;
- Heat treatment when redness, heat and yellow or green mucus are present;
- Treatment of Dampness and Phlegm with chronic mucus formation and a heavy feeling;
- treat remaining complaints after respiratory infection;
- in recurrent sinusitis, also treat the underlying susceptibility.
The herbal combination may change if an acute infection passes into a recovery phase or if chronic sinusitis is temporarily worsening.
How does Chinese medicine view sinusitis?
Within Chinese medicine, especially the Lung, Spleen, Stomach, Liver and Gallbladder organ system are relevant in sinusitis. Which systems are involved depends on the grievance picture.
The Lung has a close relationship with the nose and upper respiratory tract within TCM. An acute infection can disrupt the normal function of the Lung and present itself as Wind-Heat for example.
With stronger heat phenomena, according to TCM, Heat can also rise from the Stomach or Liver/Gallbladder to the head and sinuses. These patterns give different combinations of headaches, facial pain, thirst, colored mucus and other heat symptoms.
In chronic sinusitis, Dampness and Phlegm play an important role. TCM describes an accumulation that can be expressed in mucus, swelling, constipation and a heavy feeling in the head. The Spleen is involved within TCM in the processing of nutrition and body fluids and can therefore play an underlying role when someone easily forms Dampness and Phlegm.
In the case of long-term or recurrent complaints, Lung-Qi may also weaken. In a smaller proportion of people, according to TCM theory, deeper Yang deficiency, including Kidney-Yang deficiency, can also contribute to chronic cold and humid complaints.
Acute and chronic patterns
In acute sinusitis, relatively strong patterns are usually in the foreground, such as Wind-Heat, Stomach-Heat or Liver-Gallbladder-Fire.
In chronic sinusitis we often see a combination. For example, Heat or Phlegm may still be present while at the same time an underlying Qi deficiency exists. This allows someone to recognize themselves in several of the patterns below.
What is a TCM organ system?
A TCM organ system describes a group of related body functions and is wider than just the anatomical organ with the same name. Read more at TCM basics .
What is a TCM pattern?
A TCM pattern is a recognizable combination of complaints and physical characteristics that indicates which imbalance is likely to contribute to the complaints. Read more at TCM basics .
The most common and clinically relevant patterns are discussed below. Other patterns are possible and multiple patterns may occur at the same time. This allows you to recognize yourself in different descriptions. Also, someone with a certain pattern does not have to have all the symptoms mentioned. The pattern is determined based on the overall picture of complaints.
Most common TCM patterns
Wind-Heat
Brief explanation
Wind-Heat is an important pattern in acute sinusitis, often during or after a cold. The term Heat describes the inflammatory nature of the symptoms and does not mean that hot weather is the cause.
Common symptoms
- sudden nasal congestion;
- yellow or white-yellow mucus;
- pressure or pain in the forehead or around the sinuses;
- headache;
- decreased sense of smell;
- dry or painful throat;
- thirst;
- fever or feeling warm;
- sometimes slight chills.
Examples of Western disorders
This pattern can be recognised in acute viral rhinosinitis and other acute upper respiratory infections involving the sinuses.
Stomach-Heat
Brief explanation
Within TCM, strong heat can rise from the stomach system to the face and sinuses. This usually gives a pronounced warm grievance with a lot of thirst and obvious facial complaints.
Common symptoms
- severe nasal congestion;
- thick yellow or green mucus;
- pressure or pain around the cheeks and sinuses;
- frontal headache;
- red or warm face;
- strong thirst, often for cold drinks;
- dry mouth;
- bad breath;
- sometimes gum or gum complaints;
- constipation.
Examples of Western disorders
This pattern can be recognised in acute sinusitis where pain around the maxillary sinuses, much coloured mucus and obvious heat phenomena are present.
Liver-Gallbladder-Fire
Brief explanation
With this pattern, according to TCM strong Heat rises from the Liver and Gallbladder system to the head. As a result, complaints can mainly be present on the side of the head and around the eyes or sleep. Emotional tension can be part of the overall complaint picture.
Common symptoms
- nasal congestion;
- thick yellow or green mucus;
- severe headaches, often around sleeping or side of the head;
- pressure or pain around the eyes;
- bitter taste in the mouth;
- dry mouth and thirst;
- irritability;
- red face or eyes;
- dizziness or ringing in the ears.
Examples of Western disorders
This pattern can be recognised in acute or severe flare-up sinusitis with strong headaches, colored mucus and clear heat symptoms.
Phlegm-Dampness and Phlegm-Heat
Brief explanation
In chronic sinusitis, accumulation of Phlegm and Dampness is an important TCM mechanism. Phlegm and swelling remain present and hinder the normal passage of nose and sinuses.
Phlegm-Dampness usually gives a colder or more neutral image with white mucus. When Heat arises, the mucus becomes yellow or green and stickier; this is called Phlegm-Heat.
Common symptoms
- chronic nasal congestion;
- a lot of mucus;
- postnasal drip;
- decreased sense of smell;
- heavy or palpable sensation in the head;
- pressure around the sinuses;
- nasal polyps, if any;
- more frequent white or clear mucus in Phlegm-Dampness;
- with Phlegm-Heat more often yellow or green, thick and sticky mucus;
- in Phlegm-Heat sometimes thirsty, dry mouth or feeling warm.
Examples of Western disorders
This pattern can be recognised in chronic rhinosinitis, chronic sinusitis with postnasal drip and chronic rhinosinitis with nasal polyps.
Heat in the Lung meridian
Brief explanation
According to TCM Heat, this chronic pattern remains present in the area of the Lung and the upper respiratory tract. It can occur for example after repeated or inadequate repaired acute airway complaints. The Heat can gradually thicken the mucus and irritate the mucous membranes.
Common symptoms
- chronic nasal congestion;
- relatively little but thick and sticky yellow mucus;
- postnasal drip;
- red or swollen nasal mucosa;
- pressure sensitive sinuses;
- frontal headache;
- irritated or dry throat;
- dry mouth;
- sometimes a dry or slightly productive cough;
- may cough worse at night.
Examples of Western disorders
This pattern can be recognised in chronic sinusitis after recurrent respiratory infections and in chronic nasal and sinus complaints that combine irritation, dryness and sticky mucus.
Liver-Qi-stagnation with Heat
Brief explanation
Stress plays a clear role in this pattern. According to TCM, prolonged stagnation of Liver-Qi Heat can cause and affect normal circulation around the head and sinuses. Complaints can therefore significantly worsen during stressful periods.
Common symptoms
- chronic or recurrent nasal congestion;
- pressure in the head or sinuses;
- headache;
- symptoms are clearly worse in the event of stress or emotional tension;
- irritability;
- feeling tense in the chest or flank;
- dry or bitter taste in the mouth;
- yellow or sticky mucus, if any;
- Sometimes trouble sleeping.
Examples of Western disorders
This pattern can be recognised in chronic or recurrent sinusitis where stress is a clearly worsening factor.
Lung-Qi-deficiency with residual Cold
Brief explanation
According to TCM, prolonged or regular respiratory complaints can weaken the Lung-Qi. This makes it less easy for someone to recover completely and allows nasal congestion and mucus to linger after colds or re-emerging.
The term remaining Cold describes the character of the complaint image, with pale mucous membranes and white or clear mucus.
Common symptoms
- chronic or recurrent sinus complaints;
- prolonged nasal congestion;
- white or clear mucus;
- postnasal drip;
- pale and swollen nasal mucosa;
- fatigue;
- easy colds;
- complaints that linger for a long time after a cold;
- spontaneous or easy sweating;
- sometimes shortness of breath or a weak voice.
Examples of Western disorders
This pattern can be recognised in recurrent or chronic sinusitis, especially in people who easily develop respiratory infections and then slowly recover.
Spleen-Qi-deficiency with Dampness
Brief explanation
The Spleen is involved in the processing of nutrition and body fluids within TCM. When this function is weakened, Dampness can be more easily created. This can contribute to chronic swelling and mucus formation in nose and sinuses.
As a result, nose problems often occur with tiredness, heavy feeling and indigestion.
Common symptoms
- chronic nasal congestion;
- a lot of white or sticky mucus;
- postnasal drip;
- swollen nasal mucosa;
- feeling heavy or blurred in the head;
- decreased sense of smell;
- fatigue and sluggishness;
- low appetite;
- bloating;
- soft or loose stools;
- possible nasal polyps.
Examples of Western disorders
This pattern can be recognised in chronic rhinosinitis and chronic rhinosinitis with nasal polyps, especially when fatigue and digestive problems are present.
Kidney-Yang-deficiency
Brief explanation
Kidney-Yang deficiency is a deeper and less common pattern in long term sinusitis. According to TCM, there is insufficient heat and transformative power to handle body fluids properly. This can cause chronic cold, humid complaints.
This pattern becomes especially relevant when the nasal symptoms are part of a broader picture of Yang deficiency.
Common symptoms
- prolonged nasal congestion;
- clear or white watery mucus;
- chronic postnasal drip;
- strong crucibility;
- cold hands and feet;
- fatigue;
- low back weakness or low back pain;
- pee more often or at night;
- hold any fluid.
Examples of Western disorders
This pattern can be recognised in long-term chronic sinusitis when, in addition to the nasal symptoms, there are clear general characteristics of a chronic cold and weakened sign of symptoms.
When to contact your doctor?
Acute sinusitis often occurs during or after a cold and usually recovers without complications. Medical assessment is wise when the symptoms are severe, clearly worsen or persist for a long time.
Contact a doctor promptly for severe headaches, high or persistent fever, severe signs of illness, or swelling and redness around an eye. Changes in vision, drowsiness, confusion, neck stiffness or other neurological symptoms also require prompt medical assessment.
In the case of recurrent or prolonged sinusitis, research into underlying factors such as allergies, nasal polyps or anatomical abnormalities may be useful.
Outlook
The course of treatment depends, among other things, on the duration and severity of sinusitis, whether the symptoms are acute or chronic, the underlying TCM pattern and any factors that sustain the symptoms. A recent acute sinusitis can generally change faster than chronic or long-term sinus complaints.
In acute sinusitis, a higher frequency of treatment may be appropriate. Depending on the severity, temporary treatment can be performed two to three times a week. In chronic sinusitis, one treatment per week is a common guideline in the initial phase. If symptoms become less and more stable, the frequency can be reduced.
Chinese herbs can be used daily between treatments when appropriate. In chronic or recurrent sinusitis, the treatment pathway may last longer, as in addition to nasal congestion, mucus and pressure in the sinuses, underlying patterns such as Spleen-Qi deficiency, Lung-Qi deficiency or Kidney-Yang deficiency can be treated.
When to contact your doctor?
Acute sinusitis often recovers by itself, but medical assessment is important when the symptoms are severe, clearly worsening or unusually prolonged.
Contact your GP promptly for high or persistent fever, severe or rapidly worsening facial pain or headache, marked swelling around an eye, vision problems, severe drowsiness or confusion, or if you feel seriously ill.
Regular assessment may also be useful in the case of long-term or recurrent sinus complaints, including to exclude other causes of chronic nasal and sinus problems.
Contact
Do you have frequent sinusitis or chronic sinus symptoms and want to know if acupuncture and/or Chinese herbal medicine can fit in with your complaints? During a first consultation we discuss your symptoms, their course and other relevant symptoms. Based on the overall picture of complaints, it is considered which TCM pattern is likely to be at the forefront and what treatment fits in with them.