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Sinus Pain or Congestion

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Care at Home

  • WHAT YOU SHOULD KNOW: * Sinus congestion is a normal part of a cold. * 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 WASHES TO OPEN A BLOCKED NOSE: * Use saline nose drops or spray to loosen up the dried mucus. If you don't have saline, you can use warm tap water. Teens can just splash warm tap 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 nasal washes when your child can't breathe through the nose. * Saline nose drops or spray can be bought in any drugstore. No prescription is needed. * Saline nose drops can also be made at home. Use 1/2 teaspoon (2 ml) of table salt. Stir the salt into 1 cup (8 ounces or 240 ml) of warm water. * 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.
  • HUMIDIFIER: * If the air in your home is dry, use a humidifier. Reason: Dry air makes nasal mucus thicker.
  • DECONGESTANT NOSE SPRAY (NO PRESCRIPTION NEEDED): * Use this only if the sinus still seems blocked up after nasal washes. Also, only use for age 12 years or older. 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 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). * Oral decongestants (such as Sudafed) are not advised. They may lessen nose and ear congestion in some children. But, they also can have side effects.
  • PAIN MEDICINE: * To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed. See Dose Table.
  • ALLERGY MEDICINE: * If the child also has nasal allergies, give an allergy medicine. * An example of this type of drug is Benadryl. No prescription is needed. See Dose Table.
  • 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 * Your child becomes worse
  • FLUIDS: * 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.
  • COLD PACK: * 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.


The information contained in these topics is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition. Nothing contained in these topics is intended to be used for medical diagnosis or treatment.

  • Not a Substitute - The information and materials in Pediatric HouseCalls Symptom Checker should not be used as a substitute for the care and knowledge that your physician can provide to you.
  • Supplement - The information and materials presented here in Pediatric HouseCalls Symptom Checker are meant to supplement the information that you obtain from your physician. If there is a disagreement between the information presented herein and what your physician has told you -- it is more likely that your physician is correct. He or she has the benefit of knowing your child's medical problems.
  • Limitations - You should recognize that the information and materials presented here in Pediatric HouseCalls Symptom Checker have the following limitations, in comparison to being examined by your own physician:
    • You can have a conversation with your child's doctor.
    • Your child's doctor can perform a physical examination and any necessary tests.
    • Your child could have an underlying medical problem that requires a physician to detect.
    • If your child is taking medications, they could influence how he experiences various symptoms.

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