Sinusitis is inflammation of the sinus cavities. The sinuses are air filled spaces in the skull. It is not clear what purpose they serve (except, perhaps, helping opera singers to project sound!). They are often affected by allergies, and are also susceptible to infection by viruses and bacteria.

Allergic sinusitis is usually associated with allergic rhinitis (hay fever). For information on natural and conventional treatment of this condition, see the allergic rhinitis article. Viral sinusitis is typically associated with the common cold. It has no specific treatment, other than decongestants.

Bacterial sinusitis may develop independently, or as a result of viral or allergic sinusitis. Acute bacterial sinusitis typically lasts less than three weeks and resolves on its own; it is not entirely clear whether standard treatment (antibiotics and decongestants) will in fact speed recovery.

Chronic sinusitis involves continuous infection of the sinuses for months or years. Treatment is often quite difficult and may involve extended courses of antibiotics, antihistamines, decongestants and steroids; in certain cases surgery may be helpful.

Proposed Natural Treatments for Sinusitis

A standardized combination of four herbs (primrose, gentian root, elderberry, common sorrel and vervain) has undergone some study as a treatment of sinusitis. In two double-blind, placebo-controlled studies enrolling a total of about 300 young men, this standardized combination proved more effective than placebo in resolving sinus symptoms.1 After two weeks of treatment, about 2/3 of the participants using the herb described their infection as cured, while only about 1/3 of those taking placebo described themselves as cured. This herbal combination is hypothesized to work by thinning mucous and perhaps also by enhancing the immune response to infection.

An extract of eucalyptus oil, cineole, is also thought to thin mucous. A double-blind, placebo-controlled study of 152 people found that it could be helpful for viral sinusitis (which is essentially a "head cold").2 The dosage used was two 100-mg capsules of cineole taken 3 times daily. By day four, symptoms were significantly less in the treatment group as compared to the placebo group; the difference was even greater at day seven. Another study found benefit using a combination therapy that contains cineole. This product, called essential oil monoterpenes, contains, in addition to cineole, d-limonene from citrus fruit and alpha-pinene from pine. In a double-blind placebo-controlled study of about 300 people, use of this product markedly improved symptoms of acute viral sinusitis as compared to placebo.3

The enzyme bromelain has also been advocated for treatment of sinusitis. However, the only support for its use comes from a few poor-quality, double-blind studies performed in the 1960s.4-6 It is not apparent from the published study reports whether the participants in these studies had viral or bacterial sinusitis.

One study provides weak evidence that a standardized combination of horseradish and nasturtium might be helpful for the treatment of sinusitis in children.7

Irrigation of the nose with saline solution is typically recommended, both by conventional and alternative medicine practitioners. It is not clear, however, whether this method actually helps.

For homeopathic approaches to sinus problems, see the homeopathy database.