Natural Sinus Congestion Relief
June 28, 2010 Written by JP [Font too small?]If you’re one of the millions of people who suffer from chronic sinus headaches, today’s column is for you. Several weeks ago my wife was in the throes of a severe sinus headache that had lasted several days. Nothing we tried seemed to help drain her sinuses at all. That is, until she came across a home remedy on the Internet that was attributed to one Dr. Lisa DeStefano. Prior to trying it out we were both highly skeptical. But that soon changed. My Healthy Monday tip of the week is to apply rhythmic pressure to your ethmoid and vomer bone in order to promote sinus drainage. Details to follow.
After witnessing the seemingly miraculous effects of this simple exercise I decided to try to track down Dr. DeStefano. I needed to know if this was a fluke experience or perhaps just a placebo effect. To be honest I still wasn’t convinced that the information we tried out of desperation was legitimate. I was pleasantly surprised to find that Dr. DeStefano was in fact an authority in osteopathic manipulative medicine. In fact, she is the chairperson and assistant professor at the Michigan State University College of Osteopathic Medicine. That initial communication lead to the following interview.
JP – Can you please give us a brief overview of the anatomy of the sinuses and how it relates to sinus headaches?
Dr. DeStefano – There are four pairs of paranasal sinuses each is named for the bone which they are in. The largest is the maxillary sinus located in the maxillary bone or cheekbones under the eyes. This is typically where most people experience pain when they have a sinus headache. The ethmoid sinuses are located between the eyes and nose. The sphenoid sinuses are located further back in the head behind the nose and eyes. The frontal sinuses are located above the eyebrows in the forehead. Each sinus is lined with soft tissue that produces mucous. All the sinuses drain into the back of the nose and into the throat. If the sinus cannot drain properly it becomes congested and signals to the brain that there is pressure within the sinus which can be interpreted as pain.
JP – How does applying rhythmic pressure to the ethmoid and vomer bone affect sinus congestion?
Dr. DeStefano – In the living person all the bones of the face have a varying capability to be deformed under pressure. Much like your rib cage can move if you press on one of its bones. Gently pressing the area between the eyebrows deforms the frontal bone and the ethmoid which sits right behind it. Alternately thrusting the tongue upwards on the hard palate deforms the maxilla and the vomer which sits right above it. This rhythmic volleying of subtle gentle motion allows the other bones that surround the sinuses to begin to billow a bit. It might be a small amount, but this motion is often enough to push fluid out of the sinuses. 20-30 seconds of gentle rhythmic billowing is all that is necessary.
JP – Is this exercise something you feel comfortable recommending in your own practice? If so, what type of success have you found?
Dr. DeStefano – I do suggest this in my practice; from my experience most everyone has some short increase in post nasal drainage as a result of this technique. Not everyone has relief however. Much of the success depends on the overall plasticity of the bones in the face and the degree of mucous membrane inflammation.
JP – Are there other natural techniques that can provide additional support when needed?
Dr. DeStefano – When my patients have chronic sinus problems I begin by treating them using cranial osteopathic techniques thus giving them the capability to naturally drain their sinuses. I often will suggest they stop using drying agents such as Sudafed because of the risk of rebound congestion and because it is very difficult to dry a chamber that is meant to be moist, often times what is left is sludge which will attract more moisture from the mucous membranes. I like salt water sprays and Neti pots as they will gently decongest the nasal membranes allowing the sinuses openings to become wider. These however cannot affect the sinuses themselves.
JP – Do you incorporate dietary or environmental interventions as part of a holistic treating plan?
Dr. DeStefano – Diet plays a huge role in congestion of the body in general. High inflammatory diets can have a detrimental effect on one’s sinuses if they have a predisposition to sinus congestion issues. I suggest my patients eat a low inflammatory diet regardless of their condition. Environmental factors also play a large role in sinus problems, but often are more difficult to control or eliminate. In these situations one must eliminate the global inflammatory influence on the body by eating a low inflammatory diet.
Saline Nasal Irrigation May Reduces Sinusitis Symptoms
Source: Arch Otolaryngol Head Neck Surg. 2007;133(11):1115-1120. (link)
Dr. DeStefano also offered this concise, step-by-step guide to applying her technique: “Forget Sudafed. An easier, quicker, and cheaper way to relieve sinus pressure is by alternately and gently thrusting your tongue against the roof of your mouth, then pressing between your eyebrows with one finger. This rhythmic pressure causes the ethmoid and vomer bone, which runs through the nasal passages to the mouth, to rock back and forth. The motion loosens congestion: after 20 seconds, you will feel your sinuses start to drain.”
Modern science likewise supports incorporating neti pots and/or saline irrigation into natural sinus care regimens. The latest study on the matter was published in December 2009. It found that saline nasal irrigation provided significant improvements in the quality of life of children with acute sinusitis. The authors of the study noted symptomatic amelioration of cough, natural congestion, rhinorrhea (runny nose), sleeplessness and throat itching. (1,2,3)
While researching Dr. DeStefano’s comments about the utility of anti-inflammatory diets I discovered a scientific paper that suggests that alternate day fasting (ADF) may be a good way to promote sinus health. Researchers from Louisiana State University Medical Center report that rapid improvements in chronic sinusitis are often found in patients who adhere to an ADF program. Hopefully, future studies will continue to validate the link between diet and sinusitis scientifically. In the meantime, it’s good to know that there are safe and viable tools available courtesy of fine physicians such as Dr. Lisa DeStefano. (4)
Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!
Be well!
JP
Tags: Allergies, Salt, Sinus
Posted in Alternative Therapies, Detoxification, Interviews
June 28th, 2010 at 3:29 pm
Alternate Day Fasting –
As in “starve a cold…?”
Wow – the humble Neti pot!
June 28th, 2010 at 9:50 pm
Anne,
Interesting, isn’t it?
I’m personally considering a trial period of alternate day fasting. Fortunately I don’t have sinus problems but I’m still curious to see how I’d react to ADFing.
Be well!
JP
June 29th, 2010 at 2:12 am
Good Morning, JP ☼
at the moment im enjoying a cup of fresh organic raspberries and your blog 🙂
thanks for reminding me of saline nasal irrigation, we call it “nose shower” 😉
i use it as a helper when i have a infection or in times of very dry air, like at the moment very dry sunny and hot, works also good in winter against the dry hot air from the heater.
highly recommended!
Wish you a inspired and creative week ☼
Nina K.
June 29th, 2010 at 2:14 am
*change inspired for inspirational (hope thats correct now 😉 )*
Nina K.
June 29th, 2010 at 2:27 pm
Thank you, Nina!
Nose shower? I like it! 🙂
I wish the same for you!
Be well!
JP
June 30th, 2010 at 4:33 am
If you want to try alternate day fasting, let me know, we’ll do a mini-trial. I have wanted to try it.
June 30th, 2010 at 11:19 am
Mark,
Let me think it through before I commit. I want to make sure to hold up my end of the bargain. I’ll get back to you with some ideas soon.
Be well!
JP
March 16th, 2015 at 2:02 pm
Update: More support for nasal irrigation …
http://onlinelibrary.wiley.com/doi/10.1002/lary.24224/abstract
Laryngoscope. 2014 Apr;124(4):1000-7.
Long-term outcome of once daily nasal irrigation for the treatment of pediatric chronic rhinosinusitis.
OBJECTIVES/HYPOTHESIS: Chronic rhinosinusitis(CRS) results in significant morbidity and health care expenditure. Safety and efficacy of nasal irrigation use in the treatment of pediatric CRS have been demonstrated, but long-term outcomes are unknown. We reviewed characteristics and treatment outcomes after 6 weeks of once daily nasal irrigation in pediatric CRS based on computed tomography (CT) scans, and summarized parental reports of subsequent use of nasal irrigation for recurring symptoms
STUDY DESIGN: Retrospective cohort study and cross-sectional survey.
METHODS: Review and survey of 144 pediatric CRS patients diagnosed between July 2003 and January 2012.
RESULTS: One hundred four patients were reviewed. Mean age was 8.0 years, and 65.4% were male. Presenting symptoms included congestion (95.2%), cough (79.8%), rhinorrhea (60.6%), headache (48.1%), and fatigue (40.4%). Comorbidities included positive allergy test (50%), asthma (57.3%), and gastroesophageal reflux disease (28.2%). After 6 weeks, 57.7% of patients reported complete resolution of symptoms. Reductions in Lund-Mackay CT scores were 4.14 and 4.38 on the left and right sides, respectively (P < .001). Of the 54 parents who completed the prospective surveys, 53.7% reported using irrigation again in the past 12 months (median = 1, interquartile range = 3). Only nine patients underwent functional endoscopic sinus surgery (FESS) after the initial 6 weeks. Patients requiring FESS were, on average, 3.6 years older than those who did not receive FESS (P = 0.0005). Median length of follow-up was 48 months (range = 20-113). There were no significant differences in age, Lund-MacKay score changes, and symptom resolution proportions between those who completed the survey and those who did not. CONCLUSIONS: Nasal irrigation is effective as a first-line treatment for pediatric CRS and subsequent nasal symptoms, and reduces the need for FESS and CT imaging. Be well! JP
July 31st, 2016 at 4:01 pm
Updated 07/31/16:
http://www.cmaj.ca/content/early/2016/07/18/cmaj.160362.long
CMAJ. 2016 Jul 18.
Effectiveness of steam inhalation and nasal irrigation for chronic or recurrent sinus symptoms in primary care: a pragmatic randomized controlled trial.
BACKGROUND: Systematic reviews support nasal saline irrigation for chronic or recurrent sinus symptoms, but trials have been small and few in primary care settings. Steam inhalation has also been proposed, but supporting evidence is lacking. We investigated whether brief pragmatic interventions to encourage use of nasal irrigation or steam inhalation would be effective in relieving sinus symptoms.
METHODS: We conducted a pragmatic randomized controlled trial involving adults (age 18-65 yr) from 72 primary care practices in the United Kingdom who had a history of chronic or recurrent sinusitis and reported a “moderate to severe” impact of sinus symptoms on their quality of life. Participants were recruited between Feb. 11, 2009, and June 30, 2014, and randomly assigned to 1 of 4 advice strategies: usual care, daily nasal saline irrigation supported by a demonstration video, daily steam inhalation, or combined treatment with both interventions. The primary outcome measure was the Rhinosinusitis Disability Index (RSDI). Patients were followed up at 3 and 6 months. We imputed missing data using multiple imputation methods.
RESULTS: Of the 961 patients who consented, 871 returned baseline questionnaires (210 usual care, 219 nasal irrigation, 232 steam inhalation and 210 combined treatment). A total of 671 (77.0%) of the 871 participants reported RSDI scores at 3 months. Patients’ RSDI scores improved more with nasal irrigation than without nasal irrigation by 3 months (crude change -7.42 v. -5.23; estimated adjusted mean difference between groups -2.51, 95% confidence interval -4.65 to -0.37). By 6 months, significantly more patients maintained a 10-point clinically important improvement in the RSDI score with nasal irrigation (44.1% v. 36.6%); fewer used over-the-counter medications (59.4% v. 68.0%) or intended to consult a doctor in future episodes. Steam inhalation reduced headache but had no significant effect on other outcomes. The proportion of participants who had adverse effects was the same in both intervention groups.
INTERPRETATION: Advice to use steam inhalation for chronic or recurrent sinus symptoms in primary care was not effective. A similar strategy to use nasal irrigation was less effective than prior evidence suggested, but it provided some symptomatic benefit.
Be well!
JP
April 13th, 2017 at 11:41 am
Updated 04/13/17:
http://www.amjoto.com/article/S0196-0709(16)30609-3/abstract
Am J Otolaryngol. 2017 Apr 4.
Xylitol nasal irrigation in the treatment of chronic rhinosinusitis.
OBJECTIVE: To evaluate the efficacy of xylitol nasal irrigation (XNI) treatment on chronic rhinosinusitis (CRS) and to investigate the effect of XNI on nasal nitric oxide (NO) and inducible nitric oxide synthase (iNOS) mRNA in maxillary sinus.
MATERIALS AND METHODS: Patients with CRS were enrolled and symptoms were assessed by Visual Analog Scale (VAS) and Sino-Nasal Outcome Test 22 (SNOT-22). Nasal NO and iNOS mRNA in the right maxillary sinus were also examined. Then, they were treated with XNI (XNI group) or saline nasal irrigation (SNI, SNI group) for 30days, after which their symptoms were reassessed using VAS and SNOT-22, and nasal NO and iNOS mRNA in the right maxillary sinus were also reexamined.
RESULTS: Twenty-five out of 30 patients completed this study. The scores of VAS and SNOT-22 were all reduced significantly after XNI treatment, but not after SNI. The concentrations of nasal NO and iNOS mRNA in the right maxillary sinus were increased significantly in XNI group. However, significant changes were not found after SNI treatment. Furthermore, there were statistical differences in the assessments of VAS and SNOT-22 and the contents of nasal NO and iNOS mRNA in the right maxillary sinus between two groups.
CONCLUSIONS: XNI results in greater improvement of symptoms of CRS and greater enhancement of nasal NO and iNOS mRNA in maxillary sinus as compared to SNI.
Be well!
JP