Sharp sinus pain during air travel, known as barosinusitis, results from inflammation within the air-filled cavities of the face, called sinuses. Though usually not dangerous, it can be an uncomfortable and intense experience.
Understanding the Pain
The head contains several air-filled sinus cavities in the forehead, cheeks, and between the eyes. These sinuses maintain pressure equilibrium with the surrounding atmosphere through small openings connected to the nasal passages. During ascent, cabin pressure decreases, causing sinus air to expand. If not equalized, this creates a “reverse squeeze” effect, pushing against sinus walls.
During descent, cabin pressure increases, causing sinus air to contract. Blocked sinus openings lead to a “squeezing effect” or negative pressure, pulling on the sinus lining. This inability to equalize pressure results in pain, manifesting as pressure around the eyes, cheeks, or forehead, throbbing headaches, or nasal stuffiness. Conditions like common colds, allergies, and sinus infections contribute to this pain by causing swelling and blockage of sinus passages.
Preventing In-Flight Sinus Pain
Preventing in-flight sinus pain involves several strategies. Decongestants, either oral or nasal sprays, help shrink swollen nasal tissues and improve sinus airflow. Oral decongestants like pseudoephedrine can be taken an hour before a flight. Nasal sprays are effective 30 minutes before takeoff and again before landing. Avoid using medicated nasal sprays for more than three consecutive days to prevent rebound congestion.
Pressure-equalizing techniques, such as the Valsalva maneuver, are helpful. This involves pinching nostrils shut, closing your mouth, and gently exhaling through your nose. Simple actions like yawning, swallowing, or chewing gum stimulate muscles that help open sinus and Eustachian tube passages, allowing pressure to equalize.
Maintaining adequate hydration by drinking plenty of water before and during the flight keeps mucous membranes moist, supporting proper sinus function. Avoiding dehydrating substances like alcohol and caffeine reduces the risk of thickened mucus and increased congestion. If possible, delay air travel when experiencing a severe cold or active sinus infection to significantly reduce the likelihood of in-flight pain and potential complications.
Relieving Discomfort During and After Flight
If sinus pain occurs despite preventive measures, several steps can provide relief during the flight. Reattempting gentle pressure equalization techniques, such as the Valsalva maneuver or frequent swallowing, can alleviate building pressure. Applying a warm compress to the face can reduce discomfort by promoting drainage. Over-the-counter pain relievers like ibuprofen or acetaminophen manage the pain effectively.
After landing, continued use of saline nasal sprays helps keep nasal passages moist and flushes out irritants or thickened mucus. Steam inhalation, by leaning over a bowl of hot water with a towel over the head, further assists in loosening mucus and providing relief. While lingering pain is possible for a few days after a flight, these measures help resolve discomfort as sinuses adjust to normal atmospheric pressure.
When to Consult a Doctor
While most in-flight sinus pain resolves on its own, certain symptoms warrant medical attention. Consult a doctor if pain persists for several days after the flight. Seek medical advice for severe symptoms such as high fever, facial swelling, significant headache, or changes in vision.
If sharp sinus pain during flights becomes a frequent issue despite consistent preventive efforts, a medical evaluation can help identify underlying conditions. Individuals with pre-existing chronic sinus problems, a history of sinus infections, or recent sinus surgery should consult their doctor before flying to discuss personalized management strategies. Though rare, potential complications like persistent sinus infections or ear barotrauma may require medical intervention.