Not urgent medically – but an unhappy nose

February 5, 2021 7:58 AM

I have been experiencing nasal congestion since October. The results of a recent CT scan of my sinuses (according to the doctor’s) office “did not indicate urgency” – so my follow-up appointment is not for a few weeks. But I'm so stuffy!

I was on nasal corticosteroids for years and they stopped working (we switched brands two times with no luck.) I have nonallergic rhinitis and I don’t have a cold or any other viral infection. I feel just fine except for my sinuses. I’m in my early 50s and I’ve read this could be a result of perimenopause – and that is indeed well underway.

My question is two-fold. I’m using a neti pot and a humidifier daily and Vicks VapoRub like no one’s business. But frankly it’s not helping. Is there anything else I can do?

Also, I have recently resorted to the smallest amounts of a nasal decongestant spray that seem to help. Without it I can’t get my nose to work. I am a little worried about the rebound effect I’ve read about. I have only ever used those when I have had a cold in the past. Can these be used safely? Should I take a break and just cope with the mouth-breathing for a few days?

I did a search and I did not see any answers related to nasal corticosteroids specifically.

posted by Lescha to Health & Fitness (20 answers total)

Have you tried pseudoephedrine (in pill form)? Where I live you need to ask for it from behind the pharmacy counter, but it does not require a prescription. Application of a heating pad to my face (and sometimes ears) helps my stubborn nasal congestion sometimes too.

That said, I had sinus surgery almost 20 years ago - before they moved the polyps and other physical bits blocking up my nasal passages, absolutely nothing helped. I breathed more freely waking up from anesthesia than I had my entire life, despite post-op swelling.
posted by okayokayigive at 8:05 AM on February 5, 2021

Hope this doesn't sound silly, but after almost 40 years of hating stuffy noses I learned that if you hold your breath long enough the nose will automatically clear. It has worked every time for me, it's a quick fix, not permanent but long enough to get to sleep. I just hold til it's too uncomfortable, don't need to be David Blaine.

YMMV if you have a more severe condition or something but I really feel like I've broken the game open over here.
posted by TheRedArmy at 8:13 AM on February 5, 2021

Are you exposed to any irritants that you know of? I also have nonallergic rhinitis and I was sick with sinus woes CONSTANTLY when I lived with cats and a smoker. Now that I'm pet/smoker free it's pretty much cleared up, however, even a tiny bit of dust build up can irritate me, so I have to take an over-the-counter allergy pill daily and keep my place as dustless as possible. I also use an air purifier. It's annoying how even just a tiny exposure to an irritant can inflame my sinuses but that's the nature of it. I haven't tried the nasal steroids I was prescribed but maybe those help too.

Oh also: Eucalyptus oil clears my sinuses out IMMEDIATELY. I just sniff a bit of Garden of Life essential eucalyptus oil when I feel stuffy and I'm good. I also put it in my humidifier.
posted by Young Kullervo at 8:14 AM on February 5, 2021

I have no idea if this will work for you, but passing it on to add to the array of things you can try: A pulmonary rehab physio recently recommended to me for a stuffy nose/sinuses, that if you can breathe through your nose at all, try and do that for a while. We tend to avoid trying to breathe through our nose when it's stuffed up, but it can actually help to clear it. I tried it for a bit and couldn't decide if it helped or not.

She also mentioned that indoor heating can dry out and inflame your nasal passages, and suggested popping the window open for a bit to help moisten the air a little (I guess that depends on your climate, I live somewhere where the air outside is definitely always damper than the air in a centrally-heated house).

There's a nice Yoga With Adriene 10 minute video, Yoga for When You Are Sick, which doesn't require any particular physical expertise, and has some nice stuff in that might also help. Like, for example, bending over and hanging your head upside down, which feels like it should be the last thing you want to do, but can actually help clear your tubes. Though I guess that works more if they're full of gunk, rather than just inflamed.

Pseudoephedrine is magic, but I think it is one of those that can cause rebound, so use sparingly.
posted by penguin pie at 8:33 AM on February 5, 2021

If you are worried about overusing nasal spray you could try just spraying one nostril one night and the other on the next night.

GERD can cause sinus problems so that might be worth looking in to, if you haven't already.
posted by i_mean_come_on_now at 8:35 AM on February 5, 2021

Being in my house pretty much 24/7 since March has not been kind to my sinuses, especially since I put the heating on in autumn. I bought an air purifier in desperation, and running it in my bedroom overnight is definitely helping: I can breathe much more easily through my nose when it's on, and getting that overnight break seems to be keeping it from reaching really maddening levels during the day. It's not the miracle I was hoping for, but it's good enough for me to want to keep doing it.

However, I don't think my sinuses ever got as bad as what you're describing, and I'm pretty sure there are allergies involved in my case - so this isn't a very confident recommendation, just a straw you might want to clutch at. Sorry; I hope you find something that helps.

Pseudoephedrine, incidentally, *does* help clear my sinuses, but at the cost of making me feel otherwise quite strange and unwell.
posted by ManyLeggedCreature at 8:38 AM on February 5, 2021

I am 61 had post-nasal drip and nasal congestion for months after having flu last year. I tried everything - Sudafed, anti-histamines, Olbas Oil, Vick's, a humidifier. The thing that's finally got rid of it is a supplement called NAC. It's an amino acid and is easily available online. I take 700mg a day.

In addition to getting rid of the snot, there is scientific evidence that it might help fight off flu and possibly Covid too, so that's an added bonus although is not the reason I take it. But if it helps in that regard, it can only be a good thing.

On the downside, as it's sulphur-based, the capsules stink like Satan's butt crack, but the capsules have no taste and I've not noticed any, er, residual gut-related effects either.
posted by essexjan at 8:44 AM on February 5, 2021

I've had severe sinus and nasal problems for years. I would avoid OTC topical decongestants unless for a single day (I used to use them before flying, in the days when we could travel...).

Instead of a netipot, try something like a Neilmed Sinus Rinse. They apply some positive pressure so the saline reaches further inside your sinuses than a netipot, which mostly just washes your nose.

When you can see your doctor again, you might want to ask about using corticosteroids in the nasal irrigation solution, to really get it further into your sinuses. Budesonide respules for nebulizers are commonly used. The advanced version of this is to drip the contents of the respule directly into the nose. This is the only method that works for me. This page has more info.
posted by sizeable beetle at 8:50 AM on February 5, 2021

Echoing others you need to be REALLY careful not to use the nasal decongestants every day.

Have you tried Azelastine? Its an antihistamine nasal spray and it works for me way better than the corticosteroids.
posted by mercredi at 9:10 AM on February 5, 2021

The easiest thing to try is drinking more water. It frequently helps me with this.
posted by Carlo at 9:49 AM on February 5, 2021

You can use plain saline nasal spray as much as you want, and it can help alleviate congestion.
posted by SaltySalticid at 10:09 AM on February 5, 2021

My sinus routine when I have long weeks of congestion from allergies/fire season air is pseudoephedrine (the real stuff you show ID for, any drugstore's brand is fine but don't get the stuff with extra shit in it - JUST pseudoephedrine) + ibuprofen (or whatever you can best take for inflammation) at night and extended-release guaifenesin (Mucinex) expectorant in the day since you're sitting up all day.

Additionally, when it's very bad I have to sleep propped up. This SUCKS and it's not the greatest sleep, but it's the only way to keep it from escalating for me. Ideally you'd use a recliner for this, but I don't have one so I sleep propped up on a mound of pillows and use a humidifier to keep from killing my throat with the mouthbreathing.
posted by Lyn Never at 10:28 AM on February 5, 2021

Something to thin the mucous is indispensable - I like effervescent acetylcysteine. I've also had a nebuliser with plain saline prescribed when my sinuses were particularly bad.
posted by I claim sanctuary at 10:39 AM on February 5, 2021

I hate to say this, but...I had years of sinus issues that cleared up amazingly quickly when I fixed my shitty diet. My goal was to lose weight but the nose thing has been a wonderful side effect. So I guess it meant I was allergic to something I was eating -- I have no idea what, but a "cleaner" diet (that still includes some carby treats + sweets) made a world of difference.

(The reason I hate to say this is because so many people smugly preach diet as a solution to literally everything, when it clearly isn't a solution to everything! But this did work for me.)
posted by BlahLaLa at 11:15 AM on February 5, 2021

I hate to say this, but...I had years of sinus issues that cleared up amazingly quickly when I fixed my shitty diet

Interestingly enough my ENT specialist recommended the same to me. He x-rayed my sinuses, said they were fine, and told me to cut out the wheat and sugar from my diet. Again, I'm sure getting rid of pets and other environmental irritants helped but I also DID change my diet at the same time to eliminate most carbs, grains, and sugar and such. So...IDK that advice seems to be going around.
posted by Young Kullervo at 11:24 AM on February 5, 2021

Since no one has mentioned it yet, spicy food can help open up the ol' nasal passages.
posted by Blue Jello Elf at 11:49 AM on February 5, 2021

I feel like I need mark all as best answers! Thank you all so very much!
posted by Lescha at 11:58 AM on February 5, 2021

I also have nonallergic rhinitis, hi! Took me years to find an allergist to give me the right diagnosis, so kudos for actually knowing what is actually bothering you. For years allergists would say "wow, you are only showing a response to dust mites on your allergy tests, you have a really strong response to dust mites," I even went through immunotherapy for dust mites, ugh.

I find an air purifier enormously helpful - I went from coughing every night from dryness to being able to sleep soundly.

I do NeilMed (similar to NetiPot) and when it's really bad, I do a double rinse twice a day. There's no harm in doing it as frequently as you need to.

Do you take any oral antihistamines? I also take Allegra twice a day and that's helpful. Anithistamines can be sedating, different people have different reactions to different drugs, you can also try Zyrtec or Claritin.

This doesn't help you for the next few weeks, but there are good prescription drugs out there for non-allergic rhinitis, so there is hope on the horizon! I take Atrovent and it's really helpful.
posted by radioamy at 12:36 PM on February 5, 2021

You can make an effective.air purifier for under 50 bucks. Check out DIY air purifier on you tube Quick and easy and couldn't hurt We love ours.
posted by charlesminus at 7:07 PM on February 5, 2021

I've had three sinus surgeries, so basically I no longer have all those small bones in my sinus cavities. I feel your pain. The best option for me, when things are bad, is a sinus nebulizer with ampules of Budesonide (steroid) in saline. I believe they can also include antibiotics, when needed. My doctor prescribed it. It eliminates some of the side effects of oral steroids, and it works pretty quickly. It also helps with ear infections, as I also have weirdly small eustacian tubes, which don't like the winter either.

Having a humidifier on all the time has made a huge difference for me, especially when the heating is on and I am in a dry climate. I also do nasal lavage with a bulb syringe instead of the Neti pot or Neilmed bottles. Someone else mentioned a nasal oil, which I do too. I use Ponaris (Amazon), which is sometimes hard to find, but smells good.
posted by answergrape at 11:39 AM on February 6, 2021