By Celeste Cooper

Many of my fibromyalgia and ME/CFS friends tell me that they also suffer from chronic sinusitis, which is inflammation of nasal passages. A 2003 study published in the Archives of Internal Medicine found those of us who have unexplained fatigue are ten times more likely to have non-allergy related inflammation. In a 2008 systematic review of change in bodily pain after sinus surgery, nine of eleven studies noted significant improvement in bodily pain scores following endoscopic sinus surgery (ESS) in patients like those of us who have fibromyalgia and ME/CFS.

At the very least, we know the inflammation and dry mucous membranes add to our distress. Maybe we don’t sleep as well. Trigger points that develop in the face and those that contribute to TMJ might be pressing on tissues that are responsible for regulating moisture. Nerves with facial trigger points and nerves affected by migraine disease may be affected. Maybe there is an immune component yet to be discovered. Many contributing factors could be at play including the spring season rich with high winds and flying dust, which further dries winter dry sinus passages. Any or all of these things can cause a rebound. Our nose runs, and our sinuses are still inflamed! For those of us who also have seasonal allergies, our world just got a little more complicated.

It’s important to be proactive because when our sinuses and nasal passages aren’t moist and happy, neither are we. We are at a greater risk for developing a bacterial or yeast overgrowth. A histamine response to allergies makes our sinuses feel like overfilled balloons, and our nasal passages don’t filter out pathogens as successfully. As if all of this isn’t enough, obstruction of airflow can apparently worsen our pain and fatigue.

So What Can We Do?

Things we can do include talking to our doctor about our symptoms. Or maybe a referral to an ear, nose, and throat doctor (ENT) is in order. If you think your symptoms are much worse when allergens in the air are high, maybe you should see a doctor that specializes in allergies; some ENTs do both.

Other Options:

Sterile saline nasal spray. Saline is bio-friendly and moisturizes without the pain and sensitivity of medications.

Periodic saline nasal irrigation. (Overuse may wash away normal protective flora.)

Use a humidifier.

Apply warm moist packs.

Acupuncture.

Consider the following if allergies are also present:

Oral decongestants.

Nasal vasoconstrictors such as Afrin® (Beware of rebound swelling if overused.)

Antihistamines and decongestants for seasonal allergies can further dehydrate mucous membranes. (Follow the precautions on the labels. They are there for your safety.)

Steroid nasal sprays decrease swelling during an attack. (I know these are over-the-counter now, but please check with your doctor first. Using these sprays for a chronic condition can lead to overuse. Consequences of overuse, though rare, can lead to local or systemic yeast overgrowth, weakening of the immune system, and possibly more serious effects.)

Allergy proof your home. (Change air filters frequently and get a maid! Seriously, allergy proofing a home is a tiresome and unending job I know too well. It’s not easy. Solicit help where you can.)

Other considerations:

Your doctor may want you to have a consultation with an ear, nose, and throat doctor (ENT).

Your doctor may want you to have a nasal endoscopy. (Similar to a colon scope, but MUCH smaller, a nasal scope made of flexible tubing with a camera on the end is put into nasal passages to look for abnormalities such as polyps, nasal septum abnormalities and other things that can interfere with normal functioning.)

A CT scan or an MRI (Both provide imaging of sinuses that are not accessible with an endoscope.)

A culture of nasal secretions may be done to look for bacteria, fungi or yeast.

Referral to an allergist.

The goal of any treatment is to reduce inflammation, open nasal passages, minimize the number of flares, and if possible, remove the underlying cause.

“All it takes is a single moment.
And she tried to breathe.”
~ Alison McGhee ~
All Rivers Flow To The Sea

In healing, Celeste

Resources:

Chester AC. Symptoms of rhinosinusitis in patients with unexplained chronic fatigue or bodily pain: a pilot study. Arch Intern Med. 2003 Aug 11-25;163(15):1832-6. www.ncbi.nlm.nih.gov/pubmed/12912720

Chester AC, Sindwani R, Smith TL, Bhattacharyya N. Systematic review of change in bodily pain after sinus surgery. Otolaryngol Head Neck Surg. 2008 Dec;139(6):759-65. doi: 10.1016/j.otohns.2008.09.020. Review. www.ncbi.nlm.nih.gov/pmc/articles/PMC2871684/