Although a stuffy nose can occur in other conditions, like the common cold, many people confuse simple nasal congestion with sinusitis. A cold, however, usually lasts about seven days and disappears without treatment. Acute sinusitis often lasts longer than a week.

A doctor can diagnose sinusitis by medical history, physical examination, X-rays, and if necessary, MRIs or CT scans (magnetic resonance imaging and computed tomography).

After diagnosing sinusitis and identifying a possible cause, a doctor can prescribe a course of treatment that will clear up the source of the inflammation and relieve the symptoms. Sinusitis is treated by re-establishing drainage of the nasal passages, controlling or eliminating the source of the inflammation, and relieving the pain.

Doctors generally recommend decongestants to reduce the congestion, antibiotics to control a bacterial infection, if present, and pain relievers to reduce the pain.

Over-the-counter and prescription decongestant nose drops and sprays, however, should not be used for more than a few days. When used for longer periods, these drugs can lead to even more congestion and swelling of the nasal passages.

If symptoms do not improve within 10 to 14 days, the cause of sinusitis is likely to be bacterial. Most patients with sinusitis that is caused by bacteria can be treated successfully with antibiotics used along with a nasal or oral decongestant. A narrow-spectrum antibiotic -- one that fights the most common bacteria -- is the initial treatment recommended.

For many years, the combination of allergic disease and infectious sinusitis has been considered the most difficult form of sinus disease to treat. The patient with uncontrolled nasal allergies frequently experiences a lot of congestion, swelling, excess secretions, and discomfort in the sinus areas. Therefore, the patient should work with a doctor who understands the diagnosis and treatment of allergic diseases to pinpoint the cause of the allergies and follow an allergy care program to help alleviate sinusitis.

Doctors often prescribe steroid nasal sprays, along with other treatments, to reduce the congestion, swelling, and inflammation of sinusitis. Because steroid nasal sprays have no serious side effects, they can be used for long-term treatment. In some people, however, they irritate the nasal passages.

For patients with severe chronic sinusitis, a doctor may prescribe oral steroids, such as prednisone. Because oral steroids can have significant side effects, they are prescribed only when other medications have not been effective.

Although sinus infection cannot be cured by home remedies, people can use them to lessen their discomfort. Inhaling steam from a vaporizer or a hot cup of water can soothe inflamed sinus cavities. Another treatment is saline nasal spray, which can be purchased in a pharmacy. A hot water bottle, an electric heating pad, or hot, wet compresses applied over the inflamed area also can be comforting.

In treating patients with severe sinusitis, a physician may use special procedures. One technique requires the patient to lie on his back with his head over the edge of the examining table. A decongestant fluid is placed in the nose, and air is suctioned out of the nose so that the decongestant fluid can shrink the sinus membranes sufficiently to permit drainage. Or, a thin tube can be inserted into the sinuses for washing out entrapped pus and mucus.

Sometimes, however, surgery is the only alternative for preventing chronic sinusitis. In children, problems often are eliminated by removal of adenoids obstructing nasal-sinus passages. Adults who have had allergic and infectious conditions over the years sometimes develop polyps that interfere with proper drainage. Removal of these polyps and/or repair of a deviated septum to ensure an open airway often provides considerable relief from sinus symptoms.

The most common surgery done today is functional endoscopic sinus surgery, in which the natural openings from the sinuses are enlarged to allow drainage.

(The information about sinusitus on our site is taken from a publication prepared by the National Institute of Allergy and Infectious Diseases (NIAID), a component of the National Institutes of Health. NIAID supports research on AIDS, tuberculosis and other infectious diseases as well as allergies and immunology.)