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Having sinus pain. Took steroid injection and an antibiotic. Any permanent treatment?

Sep 2012
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General & Family Physician
Practicing since : 2008
Answered : 1416 Questions
I have been having sinus pain for 6-7 weeks. The pain initially was felt only when I bent forward but earlier this week it was constant and to the point where I could not sleep. I have been taking over-the-counter decongestants which initially gave short term relief but then failed to help at all. I saw my family physician earlier this week and was given a steroid injection and an antibiotic. I had definite lessening of the pain but today I have noticed increased sinus pressure and pain on bending or leaning forward. What can I do now?
Posted Thu, 29 Nov 2012 in Ear, Nose and Throat Problems
Answered by Dr. Das Arindam 3 hours later
Thank you for asking a question.

Firstly, your symptoms suggest that you are suffering from sinusitis. Depending upon the duration it is classified as sub-acute. It may be bacterial or sometimes fungal.

The antibiotic was effective for you previously. But your present symptom indicates that you have developed relapse of the disease, most probably due to development of resistance against the used antibiotic.

In our clinical experience, we often have these type of resistance against antibiotics we used. It is very difficult to choose a very specific antibiotic.

For a definite treatment the disease has to be confirmed first. A thorough physical examination, characteristic symptoms of pain during bending forward and a long duration, all together leads to its diagnosis. CT scan can aid in the diagnosis. Later on, depending upon the progression of the disease, tissue sample for culture can support the diagnosis or it can exclude a possibility of fungal cause.

The treatment of this disease is first conservative using more broad
spectrum antibiotics (like fluoroquinolone, macrolide and doxycycline) and steroid if required. If the treatment by antibiotics does not give any relief, then a surgical treatment becomes main therapeutic approach. Recently Functional Sinus Surgery becomes the main surgical procedure that have a better result.

So, you have to consult with an Ear-Nose-Throat Specialist for a thorough clinical examination, ordering investigations like CT Scan and for management according to the disease condition and progression.

Hope this information suffices. Let me know if you have any more questions.

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