How sinus infection symptoms differ from a cold or sinus pressure, and treatments you can use at home to ease the pain.

Published: November 26, 2018 | Updated: May 1, 2023

Greater Louisville is famous for allergies and congestion that affect residents year-round.

But it’s November when Norton Community Medical Associates offices see a seasonal spike in sinus complaints.

“We see an increase in colds and viruses this time of year, and they can cause congestion,” said Richard Gibson, M.D., internal medicine physician with Norton Community Medical Associates – Barret. “That, in turn, can sometimes lead to sinusitis, which is an actual infection.”

Here are some signs to look for to determine whether you have a sinus infection or sinus congestion.

Simple sinus congestion

Sinus congestion can be caused by a cold or allergies.

Congestion symptoms

• Pressure around the sinuses: under the eyes, between the eyes and just over the eyebrows
• Sore throat often caused by drainage
• Coughing from drainage
• Headache from sinus pressure
• Low-grade fever in adults, sometimes higher in children
• Mucus buildup

Sinus infection

“A sinus infection, also known as sinusitis, happens when bacteria grow in the sinus cavities,” Dr. Gibson said. “A sinus infection can happen after a cold because congestion blocked the sinuses and became a breeding ground for the bacteria.”

Sinus infection symptoms

• Pressure around the sinuses: under the eyes, between the eyes and just over eyebrows
• Coughing from drainage
• Headache that gets worse
• Fever
• Nasal congestion for more than a week
• Bad breath
• Thick mucus that is yellow or green
• Poor sense of smell

Treatment for both

With sinus infections, your doctor may prescribe an antibiotic to kill the bacteria. Because simple sinus congestion is likely caused by a virus or allergy, an antibiotic will not help.

“Only around .5 percent to 2 percent of sinus problems are bacterial and actually require antibiotics,” Dr. Gibson said.

With both, try these at-home treatments to relieve pain and pressure:

• Moisturize the air with a humidifier or take a long shower to breathe in the steam.
• Use saline spray to moisturize nasal passages.
• Try using a neti pot or other nasal irrigator. Use distilled, sterile or tap water that has been boiled 3 minutes and cooled to remove any bacteria. Follow instructions on the package for using and cleaning the neti pot.
• Place a moist, warm washcloth over the sinuses to help relieve pain and open nasal passages.
• Sleep with an extra pillow to keep your head elevated and help drainage.
• Drink more water to thin mucus and help with drainage.
• Try a decongestant nasal spray for no more than three days or an oral decongestant for no more than a week.
• Take pain relievers such as acetaminophen, ibuprofen or naproxen to ease inflammation of the nasal passages.