The misery of summer cold season is upon us. But for as many as 25 million Americans, a stuffy nose and sinus pain might be a sign of something else altogether: chronic rhinosinusitis, or sinus inflammation. Many people rely on non-drug methods to treat their sinus symptoms at home. Unfortunately, researchers say one of the most popular methods—inhaling steam—doesn’t actually help. They published their findings in the Canadian Medical Association Journal.

The pain, pressure, and congestion of sinusitis could be caused by any number of things. It might well be a bacterial infection, but it could also be the result of growths in your nasal cavity or an allergy to dust mites. Yet even in the absence of a bacterial trigger, many sinusitis sufferers still demand, and take, antibiotics to relieve their symptoms. For obvious reasons, antibiotics often do not resolve the issue, but their misuse does contribute to the ever-growing danger of drug-resistant bacteria. We need other ways to make our sore and stuffy selves feel better.

Today, veterans of sinusitis frequently turn to one of two methods: steam inhalation or nasal irrigation, or rinsing.

A neti pot. Image credit: Kurt Yoder via Wikimedia Commons // CC BY-SA 3.0

It seems like common sense; of course steam and warm water should help soothe and open up blocked airways. But scientists aren’t so sure. Studies of the two treatments’ effectiveness have been small, and their results unimpressive.

So a team of researchers from the UK decided it was time to put the treatments to the test. They sent letters to sinusitis patients at 72 different primary care offices near Southampton, England, inviting them to participate in a study. Participants were all between the ages of 18 and 65, had had two episodes of acute sinusitis or one chronic sinusitis episode in the last year, and reported that their sinus symptoms had a “moderate to severe” effect on their quality of life. Those with other nasal conditions, including polyps, were excluded.

Participants were split into four groups. People in the control group continued whatever treatment, or lack of treatment, they had been using. Members of the nasal irrigation group were given neti pots and a link to an instructional YouTube video, and were asked to irrigate their noses once a day for six months. The third group was instructed to lean over a bowl of steaming water for five minutes a day with a towel draped over their heads to contain the steam. People in the last group were told to do both.

After three months, and again at six months, all the participants were asked again about the impact of their sinus symptoms. They filled out a 20-question Sino-Nasal Outcome Test (SNOT-20, and no, we are not making this up) and answered questions about respiratory symptoms, use of over-the-counter medications, and whether or not they’d experienced any adverse effects from their assigned treatment. They were also asked about their quality of life, if they’d gone to the doctor and/or gotten antibiotics, and how they felt about antibiotics and the need to see the doctor about sinus symptoms in the future.

After analyzing results from the 671 patients who completed the entire study, the researchers were underwhelmed. Steam inhalation didn’t appear to relieve people’s symptoms at all. People in the neti pot treatment group reported a modest improvement and were less likely than others to have headaches. Interestingly, of all the elements of the study, the YouTube video showing how to use a neti pot seems to have had the greatest effect. After watching it, people were less likely to take over-the-counter drugs and less likely to feel like they needed a doctor or a prescription.

But for some reason, this didn’t make them less likely to actually see a doctor for their symptoms during the six months of the study.

In short: We still need a better alternative to antibiotics. Steam inhalation doesn’t seem to help. Nasal irrigation could be useful, but more research is needed to understand the video/treatment combo’s effects on symptoms and behavior. On the other hand, if you feel that something is helping your symptoms, and your doctor's cool with it, there's no reason for you to stop.

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