Sinus Infections

Your nose seems to have been stuffed with a dozen cotton swabs and somewhere inside your head, just beyond your nose, a throbbing time bomb seems to perennially tick. There seems to be some sort of pressure and pain in your eyes and nose. To top it all off, you feel like you’re coming down with a fever and the sore throat is not helping things any.

You are the proud owner of your very own sinus infection.

A sinus infection (more commonly known as sinusitis) is an inflammation of the nasal passages and sinuses. It can be categorized as acute or chronic.

The sinuses are four major pairs of cavities in the human skull. They are air-filled, hollow and they help insulate the skull and reduce its weight, as well as allow the resonance of voice within it, among others. The four major sinus pairs are the frontal sinuses (found in the forehead), the maxillary sinuses (found behind your cheek bones), the ethmoid sinuses (found between your eyes) and the sphenoid sinuses (found behind the eyes).

Sinus infections occur when bacteria enters any of the sinuses due to the disruption of the normal host defenses inside the sinuses. When this happens, the sinus linings become inflamed, thickening with fluid that obstructs the nasal passage. The obstruction, in turn, disrupts the normal process that removes whatever bacteria are normally present in the nasal passage. When these bacteria begin to multiply and invade the sinus linings, you get the normal symptoms of a sinus infection.

While you can have your sinus infection treated by a doctor, there are several self-medications you can do to alleviate your condition.

Treat the infection with zinc. A lot of sinus infections are set off by viral infections. Studies indicate that zinc may have important effects on the human body’s immune system, and it may also directly have an effect on viruses. A recent study on a nasal gel that contains zinc glutamate has shown that it has shortened the severity and duration of the cold by about two days. It has been said that zinc supports the antiseptic agents and directly kills the microbes. Zinc also contains the growth of rhino viruses(those responsible for colds and sinusitis) to take hold in the body by binding to the same cell receptor sites as the rhinovirus.

However, care must be taken not to overdose on zinc. Long-term use of it (daily doses of 100 mg and up) has been linked to anemia, heart problems and other conditions. Zinc side effects also include:

• constipation
• nausea
• severe vomiting
• dry mouth
• dehydration
• allergic response

Zinc may also reduce the absorption of certain antibiotics and, in high doses over a long period of time, it can cause copper deficiency.

Thin the mucus via expectorants. Expectorants are medicines that help clear the mucus in your respiratory tracts. When looking for what expectorants to use, make sure you use the one that contain guaifenesin, like Robitussin. Expectorants help thin the mucus secretions, promoting drainage from the sinuses. Decongestants containing pseudoepherdine also help in thinning out the mucus.

For relieving the pain that comes with sinus infections, medicines that contain ibuprofen, acetaminophen and aspirin are effective ways to reduce pain as well as swelling. Reducing the swelling can help open the airways, giving you relief from clogged breathing.

Reduce the inflammation by using nasal decongestants. The good thing about nasal decongestants is that they take effect immediately by going directly to the source of the inflammation. Over the counter nasal sprays like Afrin and Otrivin work the fastest – about one to three minutes. It should be noted, however, that you should not use these agents for more than a couple of days, since they become less effective and, in due time, more frequent applications are needed in order to achieve the same clarity in breathing as the first dosage. The result is that some people end up overdoing their nasal treatment and soon become dependent on nasal sprays in order to breathe properly.

Also, nasal (and oral) decongestants have side effects including increased heart rate, rise in blood pressure, insomnia, dry mouth, blurry vision and headache. Sometimes, they also cause urination ability problems. It is recommended, therefore, that people with a history of heart and cardiac disease should consult a doctor before using decongestants.

Begin steam treatments and promote drainage. Steam treatment involves inhaling steam two to four times per day to clear your body of phlegm or mucus. Lean over a bowl of boiling hot water with a towel over your head to capture the steam. You can also use a steam vaporizer. Inhale the steam for about 10 minutes. Repeat this procedure until your phlegm becomes clear or white. You can also take a hot shower and stay in the shower for a couple more minutes while inhaling the steam. For a more effective steam treatment, adding mentholated preparations like Vicks to the water is advisable.

Promote drainage by sleeping with your head elevated above the rest of your body (6 inches should be enough). Doing so will allow your sinus to drain more than if you lie on your stomach. It will also relieve the pressure of your sinus infection.

Drink plenty of fluids that contain the necessary vitamins and minerals. Your body needs the necessary vitamins and minerals to boost your immune system and fight off the infection in your sinuses. Fluids also sustain your body’s hydration as well as build the amino acids needed for your immune system to function properly.

There are instances where the treatments mentioned above will still not work on chronic sinusitis. In cases like this, it may be that a complication has developed in addition to the sinus infection. Often, sinus surgery is recommended. The goal of the surgery is to remove the obtrusive mucosal disease, open the nasal passageway and drain the sinuses.

Sinusitis shouldn’t normally pose much of a danger. As long as you get adequate rest, medication and a healthy diet full of vitamins and fluids, you should be able to ride out the condition until it blows over, without any complications at all.

Lower Back Pain

The usual cause is muscle strain brought on by heavy or improper lifting; unaccustomed twisting, bending, or stretching; standing motionless for long periods; overuse of back muscles, or injury to the muscles, ligaments, and discs that support the spine. Or it could be a combination of all or any of these.

What brings on the pain is the pressure put on nerve roots in the spinal canal. More than 50 nerve roots radiate down the spinal column, each running through a hole called a foramen, to limbs and organs. Somewhere along the line, especially when there is some kind of problem with a vertebra, muscle, ligament, or disc, a nerve gets pinched or irritated, tensing muscles and creating pain.

Such nerve root irritation can be the outcome of:

• Some body motion that has created a sudden heavy strain or has increased pressure to the lower back, thereby herniating a disc.
• Joint degeneration, osteoarthritis, which typically develops with age. Spinal stenosis is another age-related condition in which the spinal canal narrows, and the elderly are also more prone to compression fractures of the spine.
• Ankylosing spondylitis, a form of arthritis that most often affects the spine, frequently appears before old age sets in, and can have dire consequences.
• Spondylolysis and spondylolisthesis; these, besides being tongue twisters, are defects that put vertebrae into misalignment when jostled.
• Fractured vertebrae after a blow to the spine.
• Spinal deformities, such as severe scoliosis, kyphosis, or spina bifida.
• Bacterial infection that enters the spine during surgery or injections, or are carried to the spine through the bloodstream from an infection somewhere else in the body.
• Spinal tumors.
• Paget’s disease, causing abnormal bone growth in the spine.
• Scheuermann’s disease, which deforms vertebrae.
• Diffuse Idiopathic Skeletal Hyperostosis.
• Degenerative discs.
• Spinal disc herniation (slipped disc).
• Leg length difference.
• Restricted hip motion.
• Misaligned pelvis.
• Osteomalacia.
• Ochronosis.
• Chondrocalcinosis.
• Poor posture.
• Tension myositis syndrome.

This Ain’t No Party, This Ain’t No Disco, This Ain’t No Foolin’ Around

The cause could also be discogenic. Between every vertebra there is a soft, shock-absorbing pad shaped like a hockey puck, gelatinous on the inside and fibrous on the outside. It protects the spinal cord and separates each of the vertebrae. When damaged or worn out, the discs can bulge and press on a nerve root, causing irritation. If it bulges enough, it ruptures (herniates) and puts even greater pressure on the nerve root.

Whatever the cause of pain, the pain itself tends to compound the problem. Muscle strain prompts a person to take on a different gait to compensate for pain coming from the injured area. This, in turn, puts strain on other muscles that have not been used in that way in the past. Those muscles become painful, and lower back pain gets worse. Over time, muscle strain may create an overall imbalance in the spinal structure, leading to chronic back pain. Also, people who are depressed, under stress, or unhappy in their work or with their home life are more likely to have chronic back pain. This is psychogenic pain which must be treated through psychotherapy, psychoactive drugs, or a combination of the two.

Pain itself creates stress that exacerbates the condition. Physical stress affects body chemistry in such a way that it can create more pain in the lower back. Emotional stress does the same thing, sometimes to the point that unhappy thoughts are the primary cause of the back pain. Sometimes pain is accompanied by numbness, tingling, or weakness, all neurologic symptoms. If the neurologic symptoms include bowel or bladder dysfunction or groin or leg weakness or numbness, get immediate medical attention.

Take 2 Non-Steroidal Anti-Inflammatories And Call Me in the Morning

Further complicating matters is that lower back pain may not come from the spine. It may be pain that is referred to the spine from a problem elsewhere in the body. This could be:

• Pelvic inflammatory disease.
• Aortic aneurysm.
• Peptic ulcers.
• Gallbladder disease.
• Pancreatitis.
• Urinary disorders (e.g., kidney stones or urinary tract infections).
• Prostate disease.

In treating lower back pain, unless you are in extreme agony, you will probably start with the least invasive procedure and work your way toward the most invasive. The starting point is to take a non-steroidal anti-inflammatory drug like ibuprofen or Aleve to reduce swelling. Your doctor might also prescribe a pain-killer. Apply ice wrapped in a towel at frequent intervals to the site of the pain for two days, then apply heat indirectly to your skin.

If the pain does not resolve within a few days of this treatment with bed rest, the doctor will probably order tests while putting you in the hands of a physical therapist and ordering that you do some mild workouts (walking, bicycling, or pool aerobics) and trunk stabilizing exercises. He may have you wear a back brace.

Typical tests are x-ray, CAT scan, and MRI. You may then be referred to a spine specialist – a neurologist or orthopedic surgeon. He or she may order additional tests: discography, myelogram, or bone scan. Discography uses a fluoroscope to look at one or more discs which have been injected with a contrast dye. A myelogram does the same, but injecting and looking at the space around your spinal cord. In a bone scan, a specialist injects into a vein a trace amount of radioactive material which travels to and collects in bones. A scanner can then detect spinal problems.

Factectomy, Foraminotomy, Laminotomy, Spinal Laminectomy – Let’s Call the Whole Thing Off

Should the tests reveal a problem requiring surgery, you will be among the 5% of people with back pain who require the most invasive procedure. Your surgeon will encourage you to try several months of non-surgical treatment first; back surgery does not have a fantastic record for long-term relief of back pain. Eventually, the same or similar problems will show up in other parts of the spine, and you may have to undergo additional surgeries. Get a second opinion.

The surgical procedure may be a factectomy, foraminotomy, laminotomy, or spinal laminectomy, all of which are attempts to relieve pressure on nerve roots or the spinal cord. A discectomy removes those portions of a disc that are protruding. Sometimes the surgeon will perform spinal fusion, fastening two or more vertebrae together to restrict movement in an area that is damaged, deformed, or that simply hurts with movement. A problem with the latter procedure is that it may be difficult to accurately identify the source of a patient’s pain. Should the pain come from mental stress, for example, a spinal fusion is extreme, inappropriate, and does not stop the pain.

Most of these procedures can be performed with micro-surgery. With the surgeon using a microscope, very small incisions can be made. This means there will be less pain at the site during recuperation, and you will be able to leave the hospital sooner and return to your regular life more rapidly.

Another recently-developed alternative for quelling chronic lower back pain is the surgical insertion into the spine of an electro stimulation device that delivers small, steady charges of electricity that can be effective in eliminating pain.

Resources:

“Where Does It Hurt? Understanding Lower Back Pain,” Spine-Health.com

“Low Back Pain Exercises,” University of Michigan Health System

“Lumbar Stabilization Exercises,” Physical Therapy Corner