Sinus issues every winter - head (sinus), throat pain, dizziness, nausea

December 2, 2024 4:17 AM

I get what seems to me (a non-medically trained, but scientifically educated person) sinus issues more or less every winter - even when it's not especially cold out, although it sure feels it because it's humid this year. Doctors are not really helping me in depth, please suggest ideas to be my own health advocate and/or manage the symptoms (detailed within)...

Symptons include:
- head (sinus) pain that is just aching and grinding, I can feel what seems like the actual contours of the sinuses in my ear, nose and throat all along one side of my head (the right side this time), I assume this is inflammation? Could it be some kind of bacterial infection that is kind of dormant and just flares up when it's cold and wet enough?
- throat pain, which again makes it seem like a cold or virus, kind of centered on the roof of my mouth on that same side...
- dizziness when I stand up, I assume because of the ear thing?
- nausea / "mailaise" in my whole body, mostly when I stand up, but also "background" feelings generally.

Put together it feels like a very annoying cold or flu, but I have had various blood tests and the doctors tell me it's not a virus, including COVID.

Last year I had the same thing but maybe slightly more painful and I agreed to a head xray, which I would normally avoid, because this is so debilitating. Nothing.

All I got this year from the doc was a spay to reduce the sinus pains (Mometasone) which, now I have looked it up, I am even more skeptical of...

Flu medicines help with the symptoms a bit but I am really struggling here.

Could it be nasal polyps? Which specialist should I approach to test and diagnose that?

In this country you really have to be your own health advocate (that's putting it politely, I could also say the medics come across as basically apathetic) so please don't be afraid to tell me precisely what you would do, and I will figure out whatever makes sense to me.

posted by KMH to Health & Fitness (14 answers total)

I get a lot of sinus infections due to a combination of terrible allergies and a deviated septum and I sort of manage it with allergy medicine, neti pot, and steaming my head over a bowl of hot water. A heated weighted eye mask is soothing. I went to an ENT who confirmed that I had the deviated septum and swollen polyps, but that surgery should be the last resort, at least for me. He recommended getting back to immunotherapy, which is a pain but made sense to me. Good luck! It feel terrible to always feel slightly terrible.
posted by chocotaco at 4:37 AM on December 2, 2024 [2 favorites]

I get sinus infections every fall. I don’t have these symptoms, mine are a fever and then clogged nose, sore throat, tons of gross mucus. I neti as a preventative measure. Stream also helps to loosen up any mucus so infection is less likely. TBH this sounds a bit different and more intense.
posted by MisantropicPainforest at 4:37 AM on December 2, 2024

Have you ever had allergy testing done? Being closed up inside for months at a time, constantly exposed to pet dander, dust and tree sap (if you are allergic) can cause the issues you are describing. I used to have sinus infections that would drag on for months in winter. Getting tested and monthly shots has improved the quality of my life considerably.
posted by theBigRedKittyPurrs at 4:37 AM on December 2, 2024 [3 favorites]

An Ear, Nose, and Throat specialist can check whether you have nasal polyps, (or a deviated septum) and wether you need surgery. Or whether other treatments might work for you.

Both of those conditions make you much more prone to infection, and slower to recover.

The only other suggestion I have is, do you have any damp and mold in your home? The sore throat in particular sounds like a reaction to an allergen like mold, often worse in winter when humidity is high an air circulation lower as your home is more closed up.
posted by Zumbador at 6:07 AM on December 2, 2024 [1 favorite]

Because I have allergies and nasal congestion, my frequent headaches were deemed "sinus headaches" for years but actually turned out to be migraines. Dizziness and nausea are also migraine symptoms. Changing weather conditions (dropping temps; drier air; air pressure changes) can trigger migraine. Actual sinus irritation can go on to trigger migraine. Maybe the throat/mouth pain is sinus-related?

For me the diagnosis came from me mentioning that having a single drink could also trigger my "sinus" headaches, and because of that the doctor prescribed me a few sumatriptan to try for my next "sinus" headache.

Anyway, suggesting to ask, 'if I didn't have this nasal stuff going on, what else could be causing headaches?'
posted by Tandem Affinity at 7:20 AM on December 2, 2024 [1 favorite]

My allergies make me feel like you're describing, and I used to think I was just a sickly person. Now I know that it was my allergy to leaf mold and dust mites, both of which ramp up considerably in the fall and winter. Get that checked out, if you haven't already!
posted by zoetrope at 7:24 AM on December 2, 2024 [1 favorite]

Anecdata, but I have a friend who suffered from sinus infections every winter for something like forty years. I suggested he try daily irrigation with a neti pot and he literally literally (as opposed to figuratively literally) has not had a single sinus infection in over a decade. YMMV, but its worth trying no matter the root cause of your issues.
posted by slkinsey at 7:33 AM on December 2, 2024

If you control your own ventilation making sure you've replaced your furnace filters and - if it's been a few years - had your ducts and carpets cleaned might make your life quite a bit better.
posted by mhoye at 7:40 AM on December 2, 2024

Something that occurs every season like this does make me think allergies. If you can't get tested easily, you might see if treating allergies works for you. In the US, there are several different daily allergy pills available with very few side effects. Some people take two different kinds. I think drowsiness is the biggest concern and so I would try taking one every night for about two weeks and see if it made any difference. There is also a nasal spray called fluticasone nasal that is not habit forming and would be my next step after the pills if they helped but did not totally get rid of the symptoms.
posted by soelo at 10:02 AM on December 2, 2024

My sinuses have been bothering me this week, and I'm pretty sure that it's just because the inside of my house is much, much dryer than it was two weeks ago (down from ~50% to more like ~15%) It's an unlikely explanation for your severe symptoms, but hygrometers are cheap so it might be worth buying one and seeing if it tracks your symptoms.
posted by eraserbones at 11:10 AM on December 2, 2024

If you're going to use a neti pot and tap water instead of distilled, make *sure* you boil it for 10 minutes* and let it cool before using, or you're at risk of a brain infection.

*This article says 1 to 3, depending on elevation. I've read 10 elsewhere, and would rather be certain!
posted by kate4914 at 2:28 PM on December 2, 2024

Shower, gargle with salt, netipoti in the shower (also with salt), daily antihistamine (cetirizine).

If it turns out to be an air-borne allergen, wearing a mask is your friend (even a dustmask if you prefer space around your nose and mouth.
posted by Elysum at 3:54 PM on December 2, 2024

I just went to an ENT doctor for a similar thing. For me it's especially worse in the Fall. He stuck a tiny, tiny thin tube up my nose and asked if I had trouble breathing because there was "hardly any room up there." I guess I have a very deviated septum.

I've already started taking Zyrtec for allergies, which helps. He suggested I also use Flonase nasal spray daily and also use a saline spray or Neti pot daily. This was just last week, so no major changes for me yet.

Maybe try to see an ENT too - it was validating to hear there was a reason for all of my sinus troubles and to know there were no polyps.
posted by jdl at 7:38 PM on December 2, 2024

Do you have a humidistat in your home?

If you are running the heat, it can make the indoor air unpleasantly dry regardless of outdoor humidity levels. That can irritate the crap out of your sinuses.

Do you open your windows the rest of the year but leave then closed all winter?

Modern homes are less drafty than older homes, but the downside of that is there are fewer air changes per day and thus carbon dioxide accumulates, sometimes to levels that start to make people feel sluggish.
posted by Jacqueline at 7:42 AM on December 3, 2024 [1 favorite]