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Old 05-29-2010, 06:59 AM   #1
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Chronic sinus congestion/neck-head ache - need advice

Hey there,
I'm hoping someone in the Otolaryngology field can give some advice on a chronic issue I have with sinuses and neckaches. I get sinus congestion neck ache combinations several times a month and sometimes several times a week. I have been dealing with it for approximately 15 years and have never found a defined answer to the cause. I have seen a neurologist, ENT specialist and a Osteopathic doctor. The neurologist diagnosed me with cluster/migraine headaches. The ENT specialist said it was allergies, didn't see anything on a CT of my sinuses and prescribed me allergy medicine. The DO suggested some neck stretching exercises, silica muscle cream and massage. The DO also recommended I continue my self prescribed dosage of ibuprofen and pseudophederine when I have an attack.
My list of symptoms are: (in order as I usually notice them coming on)
Stuffy nose on the right side
Sinus pressure on the right side
Discomfort on the right side of my neck and shoulders
Increasing sinus pressure on the right side
Complete blockage of the right nasal passage
Increasing neck pain
Onset of headache on the rightside
Extreme tightness of the right neck muscle extending behind the ear
Pain extending up behind the ear and towards the top and side of the eye in the temple area
Dry mouth
Bad breath

Some things that I've done to find relief:
Ibuprofen, at least two every three to four hours
Pseudophederine, at least one, sometimes two (30mg)
Nasal decongestant spray
Silica cream on my neck
Heating pad on my neck and right side of head
Hot shower with water massaging the right side of my neck and head
Steam treatment (pot of hot water with a towel over my head)
Neck stretching exercises (sometimes makes it hurt worse)
Massage neck
Massage area around temple and above and behind ear

Sometimes I can get it to go away after taking several ibuprofen and psuedophederine. Sometimes it comes back later that day or early the next day.

After doing some research this morning, I saw some information that leads me to believe the root of the problem is my sinuses. Could it be sinusitis especially of the Sphenoid?
Any suggestions on how to approach more diagnosis? Things to try for treatment?
Really any advice or suggestions would be much appreciated.

Thanks,
Brian

 
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Old 05-29-2010, 11:23 PM   #2
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Re: Chronic sinus congestion/neck-head ache - need advice

Have you tried douching your sinuses with a netipot?

You mix 1 tsp salt and 1/4 tsp bicarbonate of soda in a cup of warm water, and douch your sinuses with that each day - do this every day, even when you feel well

At the first sign of an attack, take 400mg ibuprofen, 60mg pseudoephedrine and put a heat pack on your neck.

Daily use of a nasal steroid spray could help th sinus pain.

Last edited by jonnstar; 05-29-2010 at 11:25 PM.

 
Old 05-30-2010, 02:47 AM   #3
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Re: Chronic sinus congestion/neck-head ache - need advice

Quote:
After doing some research this morning, I saw some information that leads me to believe the root of the problem is my sinuses. Could it be sinusitis especially of the Sphenoid?
Any suggestions on how to approach more diagnosis? Things to try for treatment?
It's pretty unlikely that your sphenoid sinus is causing the symptoms you mention. The sphenoid is located in the middle of your head so your symptoms wouldn't be as focused on the right side as you describe, and it certainly would have shown up on the CT scan of your sinuses.

Allergies are certainly a possible explanation, but you don't mention taking any type of antihistamine (e.g. Claritin or Zyrtec), so that is probably the most obvious next step. You might start with Claritin (the generic is called Loratadine) and take it daily for two weeks to see if you symptoms improve.

The other thing you should consider is saline irrigation using a SinusRinse bottle or neti pot (both are available for around $15 at any drug store or discount store).

If the antihistamine doesn't help you should probably go back to the doctor and ask about a steroid nasal spray like Rhinocort or Flonase. The spray will help shrink the tissues in your sinuses and minimize the flare ups of congestion.

 
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