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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes severe pain in sinus?

Hi, I have suffered with sinusitis infrequently for years - It is always in the exact same spot above my left eye. Normally I just need sudafed and painkillers for 2 -3 days and it goes. I suffered a bout in May that didn t clear after a week so went to see the doc who prescribed nasonex, after 2 weeks with that, I was able to stop the painkillers and all seemed well. I had another couple of short bouts but cleared them up with the spray within a few days and thought all was fine. 3 weeks ago it came back with a vengence, pain worse than usual. Normally, 2 ibuprofen in the morning would sort me out for the day but now, within 2 hours of taking them, the pain was back and I ended up having to take some time off work as the pain was unmanageable. GP gave me anti-biotics and said that it was a nasty infection. I finished the anti-biotics just over a week ago and while the pain is not a severe, it is still there constantly - I am having to take painkillers regularly throughout the day to get through work and am concerned about taking so many on such a regular basis. I went to see a different GP 2 days ago who said that my sinusis looked clear after a cursory glance and told me to take amytriptaline to help manage the pain. She reluctantly referred me to ENT dept after I pushed her and gave me the impression that she didn t believe that I was really in pain. She mentioned chronic pain syndrome and I am concerned that I am now being considered as someone with a psychological problem even before a thorough investigation into the medical reasons for the symptoms has been conducted. Questions - Would someone normally be labelled with Chronic Pain syndrome after only 3 months, without proper investigation - especially when they rarely visit their GP? Your advice would be much appreciated, Thank you Do you think amytriptaline is the right med to be prescribing for sinus pain ? I get the impression that this is for long term neuropathic pain, and I have only been suffering chronic pain on and off for 3 months.
Wed, 19 Jun 2019
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General & Family Physician 's  Response
Hello,

As per your history, it may be due to recurrent sinusitis.

For pain, you can take tablet acetaminophen. Take steam inhalation twice a day.

You may require broad-spectrum antibiotics like cefixime after consultation.

In case of fever, you may require complete hemogram, chest X-ray, sinus X-ray after consultation.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Shyam B. Kale, General & Family Physician
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