Introduction

Sinusitis can be classified into the following categories:

·         Acute: Symptoms lasting less than six weeks.  Usually caused by bacterial infection.  If lasting between six and eight weeks, it may be considered subacute. 

·         Chronic: Symptoms lasting eight weeks or longer and of varying severity.  Symptoms are typically similar to acute sinusitis, but often, more fatigue is present. 

·         Recurrent: Three or more episodes of acute sinusitis occur per year.

Symptoms of sinusitis often include thick nasal drainage, bad-tasting postnasal drip, nasal and head congestion, cough, difficulty breathing, headache, facial swelling, toothache, fatigue, tender cheeks, swollen eyelids, and sometimes fever.¹  While fungal and bacterial infections are likely to play a part, it seems that host response and chronic inflammation also play a significant role in pathophysiology.²  The following reviews the multiple ways that sinus symptoms and inflammation can be addressed from an Integrative Health approach.

Physical Activity

While evidence is lacking that assesses the relationship between regular aerobic movement and sinusitis, it is known that exercise affects immune function.  Growing evidence indicates that moderate amounts of regular exercise decrease the risk of developing upper respiratory infections³ that frequently precede episodes of sinusitis.  There is also evidence that exercise has direct anti-inflammatory effects.  The mechanism for this has yet to be elucidated but may involve reduced accumulation of inflammatory cells in fat tissue, release of immune molecules that attenuate inflammation, and stimulation of the parasympathetic (“rest and digest”) nervous system.  Another possible, and not mutually exclusive, mechanism is that exercise improves the ability of the body to adapt.  That is, exercise acts as a stressor to which the body can respond and improve its function.⁴ Thirty to forty minutes of aerobic exercise most days of the week at an intensity that allows the individual to talk but not sing can be recommended, assuming there are no contraindications.

Surroundings

With each breath, the upper respiratory tract and sinus mucosa are exposed to the air around us.  The quality of that air can have significant health impacts.  Fine particulate air pollution seems to increase population prevalence of chronic sinusitis.⁵  More information on fine particulate air pollution and ways to address it can be found at the following web sites:

·         The Environmental Working Group

·         The Environmental Defense Fund