Current Environment:

Sinus Pain/Congestion

The sinuses are located above the eyebrow, behind the eye, around the eye, or over the cheekbone.

Sinus Pain occurs when there is fullness or pressure within these cavities. Sinus Congestion is a normal part of a cold.

Symptom Management

Nasal Saline to Open a Blocked Nose:

  • Use saline nose drops or spray to loosen up the dried mucus. If not available, you can use a few drops of bottled water or clean tap water. Teens can just splash a little clean tap water up the nose and then blow.
    • Step 1: Instill 3 drops per nostril.
    • Step 2: Blow each nostril separately while closing off the other nostril.
    • Step 3: Repeat nose drops and blowing until the discharge is clear.
  • Do a nasal saline rinse whenever your child cannot breathe through the nose or it’s very itchy.
  • Saline nose sprays can be purchased OTC or made at home using ½ teaspoon of table salt to 1 cup of warm water. Use bottled or boiled water to make saline nose drops.
  • Another option is to use a warm shower to loosen mucus. Breathe in the moist air, then blow each nostril.


Try to get your child to drink a lot of fluids. This will thin out the mucus from the nose and loosen any phlegm in the lungs, making it easier to cough up.


If the air in your home is dry, run a humidifier.

Decongestant Nose Spray Age 12+ ONLY:

  • Use this only if the sinus still seems blocked up after nasal washes
  • Use 1 spray on each side two times per day.
  • Always clean out the nose before using.
  • Use routinely for one day, thereafter only for symptoms. (Note: Do not use it for more than 3 days.)

Oral Decongestants Age 12+ ONLY:

Another choice to open up a stuffy nose and ears is the use of an oral decongestant. These medications may make you feel nervous or dizzy, so it is important to follow the instructions listed on the package.

Pain Medicine:

Give acetaminophen or ibuprofen as needed for pain relief. The application of a cold pack or ice in a wet washcloth over the sinus for 20 minutes may also help.

Antihistamines for Nasal Allergies:

  • Give oral antihistamines only if the child has nasal allergies.
  • Long-acting antihistamines (e.g., Zyrtec, Claritin, or Allegra) are good first choices as they do not cause drowsiness.
  • Benadryl can be used if the nondrowsy antihistamine does not provide adequate relief.
  • See Home Care section titled “Nasal Allergies (Hay Fever)” for dosage guidelines.

Expected Course

  • With treatment, the viral sinus congestion usually resolves in 7 to 14 days.
  • The main complication occurs if bacteria multiply within the blocked sinus. This leads to a fever and increased pain. It needs antibiotics.

When to Call the Office

  • Sinus pain persists for over 1 day after starting treatment.
  • Sinus congestion persists for over 2 weeks.
  • Sinus pain is present and fever occurs.
  • Your child becomes worse.


©1994-2022 Schmitt Pediatric Guidelines, LLC.

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.