Sinusitis — Symptoms, Causes & Same Day Treatment

Sinusitis symptoms can range from mildly irritating to completely debilitating, depending on the severity and type. The most common signs our GPs see include:

• Facial pain and pressure — a dull, heavy ache that often worsens when bending forward
• Blocked or congested nose — difficulty breathing through one or both nostrils
• Thick nasal discharge — yellow or green mucus, sometimes dripping down the back of the throat
• Reduced sense of smell and taste — a noticeable dulling of both senses
• Headache — particularly across the forehead and between the eyes
• Toothache or jaw pain — caused by pressure in the sinuses above the upper teeth
• Fatigue and feeling generally unwell — your body working hard to fight the infection
• Cough — often worse at night as mucus drips down the back of the throat

Where the pain sits can tell you which sinus is affected:

• Frontal sinusitis — pain across the lower forehead
• Maxillary sinusitis — pain over the cheeks, sometimes spreading to the upper teeth
• Ethmoid sinusitis — pain behind the eyes, with tenderness across the bridge of the nose
• Sphenoid sinusitis — pain behind the eyes or across the forehead; rare on its own

Most cases develop after a cold or upper respiratory infection, when the virus spreads to the sinus lining and causes swelling. Less commonly, sinusitis is caused by:

• Bacterial infection — usually develops after a viral infection has lingered too long
• Allergies — hay fever and allergic rhinitis can trigger swelling that blocks the sinuses
• Nasal polyps — small growths that obstruct drainage
• A deviated septum — a structural issue that makes one side more prone to blockage
• Fungal infection — rare, but more likely in people with weakened immune systems
• Dental infection — an infected upper tooth can occasionally spread into the maxillary sinus

Is sinusitis contagious?

Sinusitis itself doesn’t spread from person to person, but the cold or virus that triggers it usually does — through coughing, sneezing, or touching contaminated surfaces. This is why sinusitis often appears in clusters within a household during cold and flu season.

• Acute sinusitis — the most common type, usually triggered by a cold. Symptoms develop quickly and typically last 2–4 weeks. Most cases are viral and resolve on their own.
• Subacute sinusitis — a middle-ground form where symptoms persist for 4–12 weeks despite initial treatment, often needing a more targeted approach.
• Chronic sinusitis — symptoms lasting more than 12 weeks, frequently linked to nasal polyps, allergies, or a structural issue, and usually requiring specialist ENT review.
• Recurrent sinusitis — four or more separate episodes within a year. These cases should always be investigated to find the underlying cause.

One of the clearest signs that a viral sinus infection has turned bacterial is a pattern doctors call double sickening. This is when you start to feel like you’re recovering from a cold, only to suddenly worsen again a few days later — with a new high fever, intense facial pain, and thick discharge returning. This pattern often means a secondary bacterial infection has taken hold and may need antibiotic treatment, rather than more time to settle on its own.

A GP will usually diagnose sinusitis based on your symptoms and by examining the inside of your nose, checking for swelling, discharge, and tenderness over the sinuses. They’ll ask how long you’ve had symptoms and whether they’re improving or worsening, since duration is the main clue separating a viral infection from a bacterial one. Imaging or nasal swabs are rarely needed for routine cases, and are usually reserved for chronic or recurrent sinusitis.

Most sinusitis clears without any lasting problems, but in rare cases an untreated infection can spread beyond the sinuses, leading to:

• Orbital cellulitis — infection spreading to the tissue around the eye, causing swelling and requiring urgent treatment
• Meningitis — a rare but serious complication if infection spreads to the membranes around the brain
• Osteomyelitis — infection spreading into the bones of the skull, most common with frontal sinusitis
• Chronic sinusitis — untreated acute infections can occasionally develop into a long-term, harder-to-treat condition

Swelling around the eyes, severe headache, confusion, or a stiff neck alongside sinusitis symptoms should be treated as a medical emergency.

Our doctors carry out a full assessment of your symptoms and history before recommending the most appropriate treatment for your case:

• Prescribe a targeted course of antibiotics for confirmed bacterial sinusitis
• Recommend nasal corticosteroid sprays to reduce inflammation and swelling
• Advise on safe saline nasal irrigation to flush out blocked mucus
• Recommend suitable over-the-counter decongestants for short-term relief
• Investigate and address underlying allergies contributing to your symptoms
• Refer you to an ENT specialist if your sinusitis is chronic or recurring
• Issue a fit note if your symptoms are severe enough to keep you off work

Why GPs are cautious with antibiotics:

Most sinusitis is caused by a virus, and antibiotics have no effect on viral infections — they only work against bacteria. Prescribing them too early doesn’t speed up recovery and contributes to antibiotic resistance. This is why GPs often recommend a short period of “watchful waiting” before considering a prescription.

These can ease discomfort but won’t clear a bacterial infection on their own:

• Saline nasal rinse — dissolve a teaspoon of salt and a teaspoon of bicarbonate of soda into a pint of previously boiled, cooled water; always use cooled boiled or distilled water, never straight from the tap, to avoid rare but serious complications
• Warm compress — a warm flannel held over the affected sinus can ease pressure and pain
• Stay hydrated — helps thin mucus and supports drainage
• Painkillers — paracetamol or ibuprofen can ease facial pain and headache
• Elevate your head at night — reduces pressure build-up while sleeping
• Avoid smoking and irritants — these worsen sinus inflammation

• Wash your hands frequently, especially during cold and flu season
• Manage allergies with appropriate antihistamines or nasal sprays
• Avoid smoking and secondhand smoke
• Use a humidifier if you live in a dry environment
• Treat colds early with rest and fluids to stop them progressing
• Stay up to date with recommended vaccinations

Book an online GP appointment if:

• Symptoms have lasted longer than 10 days with no improvement
• You have a temperature above 38°C
• Your facial pain is severe or rapidly worsening
• You notice swelling around your eyes or forehead
• Your nasal discharge is thick, yellow, or green
• You’ve had 4 or more sinus infections in the past 12 months
• Symptoms returned shortly after finishing a course of antibiotics
• You’re pregnant and unsure which treatments are safe to use

Sinusitis accounts for over 1 million antibiotic prescriptions in the UK every year — making it one of the most overtreated and undertreated conditions at the same time. Getting the right diagnosis is everything. Our online GPs are available 7 days a week — no waiting room, no travel, just fast and accurate care from wherever you are.

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