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Old 01-25-2004, 08:48 PM   #1
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JasonofCatan HB User
Sinus pain/pressure without congestion: any suggestions?

This is a longish post - okay, a very long post - but here's the upshot: my fiancée (age 32) has, for three months now, been suffering from steadily worsening sinus pain/pressure in her nose, which sounds like something like chronic sinusitis, except that at no point has she had any congestion, blockage, or unusual nasal discharge. I'll go into detail below, but I'll tell you right away that my questions are: does this sound familiar to anyone? Has anyone had something like this and been treated successfully? What do people recommend she try?

The problem started on October 21, 2003. She first noticed the problem while we were watching TV: a pain on the right side of her nose, and tingling in the nose. It hurt to touch her nose on the right side – but this symptom more or less disappeared within a few days. Her assumption was that this was a sinus infection. There had been no indication before this evening of anything wrong with her nose.

For the rest of October, and throughout November, a bad feeling of pressure came and went, alternating with pain: behind the bridge of the nose and sometimes behind the right eye – possibly sinus headaches? The feeling seemed to correspond with the location of one of the ethmoid sinuses. Generally, the pressure was especially bad at night. She would take Sinutabs to relieve the pressure: at first, this helped to make the symptoms less severe; after a while, though, Sinutabs stopped having any effect.

When she would exercise (30-40 minutes of treadmill running), she would feel a crazy tingling in her nose. That night, the pressure and pain behind her nose would be so bad, it would wake her up.

Throughout this period, her nose never felt entirely normal, but sometimes was less noticeable than others: just a low tingling. Still, its persistence was worrisome and increasingly bothersome. Her nose was never stuffed, and there wasn’t an unusual amount of mucus or any congestion: certainly no unusually coloured nasal discharges, of the sort that one expects to accompany chronic sinusitis.

In November, her GP signed her up for an X-ray, but it showed nothing out of the ordinary. She visited an ENT, and he performed a nasal endoscopy, but again he saw nothing out of the ordinary. He signed her up to have a CAT scan (which she's having in a few days). Her blood was tested and also came up normal: no signs of immunity stress.

In December, it seemed at times to be getting somewhat better (though there some bad days), but then after the Christmas holidays it returned with a vengeance, and became worse in January.

Her GP prescribed her the antibiotic Biaxin, which she took from January 10 to January 23. It didn't clear things up, and in fact, several days during this period were particularly bad.

CURRENT SYMPTOMS:

Here are her symptoms as they have been since about mid-January:

Increasing pressure and pain in the nose, still behind the bridge of the nose, but now moving also to the whole right side of the nose. The most intense level of pressure and pain used to only come in the middle of the night (and only after she had exercised), but now can come even during the day, and can wake her up in the middle of the night even if she hasn’t exercised that day (in fact, she hasn’t exercised since December). Also, it used to be the case that when she felt such extreme pressure and pain lying down, it would at least feel better if she sat upright; now, sitting upright doesn’t make it feel any better.

The pressure and pain have also extended into her upper palate; she sometimes feels pain in her teeth from the upper front teeth, throughout the upper teeth on the right side of her face. Sometimes when the throbbing in her upper palate gets really bad, she feels the gag reflex. In general, the pressure is now more aggressive, the tingling more intense, the pain like an open wound deep inside the nose (still definitely felt more on the right side of the nose). When the sensation gets really bad, it makes her want to open her mouth really wide. A few times, the pressure and pain have been so bad, that they’ve made her dizzy. There’s now often a strong pain in the septum itself: it feels like the septum’s being attacked by some bug. It is not unusual now for her to be woken up in the middle of the night becasue of the pain/pressure, or for it to take her a long time to get to sleep for the same reason. Some days in January have been intolerably horrible: pressure and pain all day, leading to sensations of panic.

At times, she feels a tingling, or painful fizzing sensation, in her nose, as if a chemical reaction is taking place there, as if someone had poured hydrogen peroxide up her nose.

Occasionally, she feels a quick, sharp, stabbing pain in her ear – this is relatively rare though.

Contrary to the advice they give for sinusitis, hot baths and putting her face over steaming hot water do not relieve symptoms at all. In fact, if anything, hot drinks seem to exacerbate it. A coldpack only makes the pain worse.

There may be some correlation with the barometric pressure; the pressure ne never goes away entirely, but it seems like it might be particularly bad when the barometric pressure is very low or dropping rapidly. It also seems to be worse on particularly cold days, and worse outside in the cold than inside.

There is no sensitivity to touch in her cheeks, and only a little in her nose (on the right side).

Throughout all these months, she’s never had any trouble breathing through her nose: no congestion, no discharges, no stuffed nose. But the feeling of pressure makes her want to keep blowing her nose, in a vain attempt to relieve the pressure. Starting mid-January, she started finding a bit of dried blood in her right nostril when she’d blow her nose.

Her lymph nodes have not been particularly swollen throughout this time, but there now seems to be just a bit of swelling in the lymph nodes on her right side, and a bit of soreness on the right side of her neck in the area of the lymph nodes.

Overall, when the symptoms are bearable, it’s like there’s a chemical reaction going on in her nose: a feeling of burning, fizzing, tingling, and pressure. When the symptoms are at their worst, it’s like there’s a deep mid-face pressure behind the nose and above the palate: like gangrene eating her away in the middle of the head.

Every once in a while, she hears a cracking noise in her nose, like an iceberg breaking up.

Her ears are popping quite frequently.

Most of the time, crying has only made her feel even worse afterwards; however, once, when she cried out of frustration, it seemed to relieve the pressure afterwards.

She got a humidifier for her room, and this seemed to help ease the symptoms, and to help her sleep. She wouldn’t wake up with dry-mouth anymore.

She has also noticed that chewing gum seems to help the pressure and the ear-popping, just as though she were on an airplane.

SOME PERHAPS RELEVANT HISTORY (who knows?):

- In Dec. 1997, she had a very worrisome manifestation of a herpes virus (perhaps herpes zoster, AKA shingles – she can’t recall for sure). This virus produced a large protuberant swollen sore in the middle of her forehead, like a unicorn horn. This drained primarily down the right side of her face: her lymph nodes at the right side of her neck were all swollen. Her tear ducts were completely swelled up, and the fluid in her eyes was swollen. The situation persisted until it was finally correctly diagnosed by a dermatologist, who cleared it up in a matter of days.

- Over the last few years, she has occasionally had extremely bad headaches (exacerbated by stress, it would seem): at their worst, these headaches could be debilitating to the point of nausea. However, they stopped short of being full-fledged migraine attacks. She has also had an ongoing sensitivity to bright lights, especially fluorescent lights: a typical symptom (as I understand it) for those who suffer from migraines.

- Late August – early September 2003: she was going through a phenomenally stressful time studying for an exam. As a result, she had a few panic attacks, and was experiencing bouts of unreality / dissociation from her body for a while.

- September 18, 2003: One month before the sinus problems started, she had a bad backwards fall on her rear, slamming her tailbone against the floor. Didn't seem to cause any damage though.

- Mid-October 2003: For a week or so, she had a sharp, constant, achy pain in her upper abdomen. It briefly felt better when she ate something, but then would come back about an hour later. These seemed to be the symptoms of a stomach ulcer; however, it went away, only to be replaced by the sinus problems a few days later. The stomach pain has not returned since then.

- Was an occasional smoker until 1999.

Well, that's all the information. If you've actually made it to the end of this post, I thank you for your remarkable patience!

And after all that, I shall try your patience further by out-and-out repeating myself:

Does any of this sound familiar to anyone?

Has anyone had something like this and been treated successfully?

What do people recommend she try?

Thank you in advance, anyone who responds to help us out. Any inklings or ideas will be greatly appreciated, big or small.

 
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Old 01-26-2004, 01:24 PM   #2
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Ratatosk HB UserRatatosk HB User
Re: Sinus pain/pressure without congestion: any suggestions?

Does she still have her tonsils? I used to suffer horrific sinus headaches, sometimes with dizziness. Practically lived on Advil Cold & Sinus. Went to several doctors -- "was told it was all in my head" ha ha. Tried nasal irrigation -- basically snorting a bunch of warm salt water -- which felt horrible at the time, but sometimes offered a bit of relief. As did swimming in the lake -- icy cold water made my forehead feel better.

Anyway, I had nasty chronically infected tonsils, which I had removed 'cuz they were just gross and bothering me. granted this was MAJOR surgery. But tonsils are gone and basically, so are my headaches.

 
Old 02-03-2004, 02:47 PM   #3
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JasonofCatan HB User
Re: Sinus pain/pressure without congestion: any suggestions?

Interesting. She does still have her tonsils. But she isn't experiencing any discomfort in her tonsils, so I would think that that's a dead end. But who knows?

Any other suggestions or comments would be greatly appreciated.

 
Old 02-04-2004, 08:06 AM   #4
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Re: Sinus pain/pressure without congestion: any suggestions?

my tonsils never caused me discomfort, but they were full of tonsil stones (infected material). Was just a thought.

I'm sure as with most people who have horrible headaches -- it's hard to get taken seriously. My coworker had horrible headaches and dizziness and her doctor told her she was depressed and wanted to prescribe something for it. Turns out she had an inner ear disorder.

Has she an ENT and had a CT scan to rule out sinus problems?

Last edited by Ratatosk; 02-04-2004 at 08:12 AM.

 
Old 02-06-2004, 02:45 PM   #5
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JasonofCatan HB User
Re: Sinus pain/pressure without congestion: any suggestions?

CT scan happened last week; she has an appointment with the ENT next week on Wednesday, where she will learn the results of the CT scan. So we may discover that it is just plain old sinus blockage at that time. But I will not rule out the tonsils theory. It's a helpful thought, and certainly not one that had occurred to us.

Will keep you posted.

 
Old 02-08-2004, 01:42 AM   #6
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becky1954 HB User
Re: Sinus pain/pressure without congestion: any suggestions?

i have had a bad headache for 4 wks now and my face hurts where my sinuses are.the strange thing is my neck is also sore and the back of my head hurts.i went to a wknd dr and he told me since i didn't have any discharge or draining it was probably my neck causing pain in the back of my head to hurt and gave me valium to relax my muscles.well i can't take that and work and i had made an appt with a new dr for the following monday so i went to her and she did a sinus xray.she couldn't tell for sure but she thought it was a sinus infection and gave me the antibiotic Omnicef.it didn't do anything and i coudn't get in to see her so i went to one of her partners.she sent me for a mri of my brain and sinuses and it showed inflammation of the sinuses and mucous buildup and she put me on levaquin.well i had already made an appt with an ent so i kept the appt.this was like a couple of wks later and he said i still had an infection after 17 days of antibiotics so he gave me a script of prednisone for 6 days.i waited til i only had 2 left and could see it wasn't doing anything and decided i would go back to my old dr.this time i was running a slight temp that i hadn't before.he put me on what he called the strongest antibiotic for a sinus infection.i can't remember what its called and he also gave me allegra d.that was thursday and i still have the sinus pressure.the headache wasn't quite as bad yesterday but i did nothing but rest.it is below my eyes and in my sinuses and my forehead and down the back of my neck.i still do not have any congestion or drainage or anything.i am supposed to go back in 2 wks and if it is not any better the dr will probably order a cat scan.i used to have sinus problems all the time but then i had surgery for a deviated septem several yrs ago and have not had problems since.the headache came on so strange.i turned to the left one night at home and i felt horrible pain in the back of my neck and the next morning my sinuses started hurting.so i may just be having two different types of headaches b/c my neck remains stiff all this time too.pls keep us posted as to what she finds out.i wish her good luck.
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Old 02-13-2004, 09:02 PM   #7
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hilery79 HB User
Re: Sinus pain/pressure without congestion: any suggestions?

Hi,
I was just wondering how the ENT appt went? Did she find out anything?
I've had similar symptoms for awhile now. My dr. always blames it on my sinuses, but I'm starting to wonder if there's something else causing this pain.

 
Old 02-14-2004, 11:23 AM   #8
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becky1954 HB User
Re: Sinus pain/pressure without congestion: any suggestions?

he looked inside my nose and said i still have a sinus infection.that was after 17 days of antibiotics.he gave me prednisone and saline nasal sprays which have done nothing.i then went back to my original dr and he gave me what he called the strongest antibiotic available for a sinus infection.my headaches are a little better but my sinuses still hurt.they hurt the worse when i first go to bed and lie on my left side which is the only way i can sleep.the ent said i am worse on my left side.i go back to the dr next wednesday and if it is not any better he will probably order a cat scan.i am just so tired of this.i am not used to felling tired and bad all the time and its a real pain.
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Old 09-26-2004, 12:41 PM   #9
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Re: Sinus pain/pressure without congestion: any suggestions?

This is me! What was the final diagnosis?

 
Old 09-26-2004, 12:46 PM   #10
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Re: Sinus pain/pressure without congestion: any suggestions?

I have had a headache for 5 weeks starting by my nose and cheekbone. I have have been on antibiotics and steroids but nothing helps. My CT scan said things are "normal" but I am miserable... I have no congestion which is odd, just a lot of sinus pressure and pain. If anyone got a diagnosis for something like this I would love to know what it was...

 
Old 10-01-2004, 08:08 PM   #11
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hartigan HB User
Re: Sinus pain/pressure without congestion: any suggestions?

This all sounds way to familiar, recently i went to the doctor with sinus pressure with no congestion. He put me on Prednisone which did nothing and acted like it was all in my mind when I told him that. It sounds a like weve got a lot of the same symptoms, pressure in the nose, the eyes, the top of the mouth (to the point where it almost feels numb), the forehead, the ears, usually even in my jaw. I dont know whats causing it or how to cure it, but I was wondering about wisdom teeth. Im 32 and still have my top ones and they havent ever came through. I havent had them xrayed for awhile to know what they are doing but I guess it might be possible for them to hit a nerve or something. Just a guess, does your fiancee have her wisdom teeth? Anyway keep me posted on anything you learn, Im getting tired of this pressure real fast, nick

 
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Old 10-08-2004, 02:09 PM   #12
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Re: Sinus pain/pressure without congestion: any suggestions?

Sorry to tell you all this but it really sounds like migraine symptoms in the worst way!! Exerecise makes them worse, barametric changes send me into a spin, cold helps, heat hurts like hell, hormones changing each month are a trigger, my nose and sinus cavities on the left side plug and drain when I am in a migraine phase. I get migraines on the left and am left handed-(see the pattern ) what hand domination is your girlfriend Jason? Any kind of sinus med taken over several days will give me a bad ha and nutrasweet sends me straight to bed. NO DIET POP!!! I could go on and on but you get the idea. If you want to talk more to her dr. have him do a migraine history in her family. Lots of luck.
BB-Magna

 
Old 10-22-2004, 02:49 PM   #13
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Re: Sinus pain/pressure without congestion: any suggestions?

I'm wondering if your fiance ever found relief from her headaches and/or found out what was causing them. I have a lot of sinus pressure and pain without congestion-sometimes it causes uncontrollable vomiting. My doctor has put me on Nasonex nasal spray and I have had some relief with this. I grind my teeth in my sleep and I know this causes more problems also. I will wake up in the middle of the night with facial pain sometimes and I attribute this to the combination of sinus problems/teeth grinding. If your fiance has not gotten relief maybe she should consider teeth grinding as an option. Sometimes you clench your jaw in your sleep w/out grinding and this is just as bad and isnt apparent to anyone. Please give me an update and I hope she has found relief.

 
Old 10-23-2004, 11:01 AM   #14
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linedoz HB User
Cool Re: Sinus pain/pressure without congestion: Maybe allergies

wave:

I have similar symptoms since about 3 years. I been having sinus pain, jaw and ear pain and dizziness .

I saw 3 ORL specialist (ear nose specialist) and passed many blood tests, sinus x-ray, sinus and head scan, neurologist, 3 sleep tests. After seeing 3 (nose,ear ORL specialist) I was told I was stressed. I told the ORL specialist that I had this sinus pressure all the time maybe yes I was stressed because every time I explained my symptoms I was told your are stressed. After I insisted for him to take a look again at my sinus, the specialist said yes you have a sinus inflammation maybe cause by allergies. After prescribing some Flonase the symptoms started to go away. This was after 2 years of having these symptoms and after many tests and specialists. The Flonase helped very much mostly all my symptoms went away.

But not long ago about 3 weeks ago they started again...I am discouraged. I was taking Flonase for about 1 year ½ . My doctor said maybe the Flonase is not working anymore she gave me Nasonex. It is a little better since a few days. I am also seeing a Chiropractor for my sinus pressure. So is it the Nasonex or my treatment who knows.. For many many (40) years I been having allergies but this sinus pain, dizziness, ear pain, is different because I am not congested. In the past when I had allergies they normally would go away when we got some frost. The weather is colder this week we got some frost. I will be seeing an allergies specialist in November maybe I have new allergies...

Any suggestions....

Last edited by linedoz; 10-23-2004 at 11:07 AM. Reason: typos

 
Old 10-29-2004, 07:30 AM   #15
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cooperm4 HB User
Re: Sinus pain/pressure without congestion: any suggestions?

Hi there,

I am back. My problem has been identified. The middle turbinate on the left side was swollen and competely blocking flow between my sinuses. That and my septum was severly deviated. I had endoscopic surgery last Thursday. It was not bad at all. I was back to work by Wed of this week and everything is going well. The recovery is more annoying the painful, the mouth breathing bit ,but hey it is worth. THe sinus headache I have had for 8 weeks is now gone. I have high hopes that it will decrease the number of sinus infections and other related issues and improve my quality of life. I am already feeling better then before and I think in couple weeks I will be ship shape!

By the way, my earlier "normal" CT was actually not normal once I got a second opinion from and ENT. The first dr. who read my CT was not an ENT. Make sure you have a specialist reviewing this type of information and if you are concerned about the diagnosis, get a second opinion.

Michelle

 
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