Overview

Whether it’s spring, summer, fall, or winter, if your nose is runny or feels congested, you feel miserable. If you feel pressure in your temples, your eyes water, if your cheeks feel swollen, or you experience pain in a tooth (or teeth) that is reminiscent of a cavity, you may have congestion in your sinuses.

What are sinuses? What is their function? Why do they get congested? What can you do to relieve these symptoms? To begin, we need to look at the anatomy, or structure, of the paranasal sinuses and then I’ll address how massage can help alleviate this discomfort.

Structure

The paranasal sinuses are a group of air-filled spaces located within the bones of the skull around the nasal cavity. They include the frontal sinuses (in the forehead), the ethmoid sinuses (between the eyes), the sphenoid sinuses (behind the ethmoid sinuses), and the maxillary sinuses (in the cheekbones). These sinuses are lined with a mucous membrane and are connected to the nasal passages through small foramina (openings).

Function

There is no one primary function to the paranasal sinuses; rather, they serve several collective purposes. The mucous membranes help trap and remove foreign particles, including bacteria and dust, from inhaled air. The sinuses help filter, moisten, and warm the air that enters the nasal passages. They also play a role in voice resonance and production. Has it ever seemed like someone sounds sick or stuffy when they speak? Finally, because they are large, hollow chambers (and not dense, solid tissue), they take up space but not weight in the cranium, keeping the skull lighter.

Pathology of How and Why Sinuses Get Congested

The most common way the sinuses become congested is through histamine reactions to airborne irritants, such as pollen, dust, or animal dander, to name a few. Just to get a bit technical for a moment, there are H1 and H2 receptors in the body. To avoid getting too technical, there’s a higher concentration of H1 receptors in the head, where inhaled irritants cause a reaction. And then there are H2 receptors, generally found in the stomach, which can result in reactions when certain foods are consumed. To be fair, H1 and H2 receptors exist throughout the body, with reactions occurring when something is touched (like an ingredient in soap or poison ivy, etc.) or when something is inhaled. For the purposes of what a massage therapist can identify and work on, the focus will be on the reactions in the paranasal sinuses and what they can do to help give you relief.

The role of histamine

When an allergen, such as pollen or dust, enters the nasal passages and comes into contact with the mucous membranes in the sinuses, it can trigger the release of histamine. This histamine initiates a reaction in the nearby blood vessels and tissues, leading to various allergic response symptoms. Blood vessels in the affected area begin to widen, resulting in increased blood flow, redness, and swelling. With the blood vessel walls more permeable, they allow fluid to leak out and into the surrounding tissues. This leakage can lead to the characteristic symptoms of congestion and a runny nose. For some people, these reactions in the airways and bronchial tubes can cause the smooth muscles to contract, potentially leading to coughing and difficulty breathing. If these symptoms persist or worsen, they can lead to further inflammation of the sinuses, causing swelling, increased mucus production, and possibly viral or bacterial infections.

Contraindications (When you should not get a massage)

While massage is great for those with sinus congestion, as noted above, it’s possible that there may be an infection as well.  If the nasal discharge is any color other than clear, it’s advisable to consult a healthcare professional for a proper evaluation and treatment.  Having a reaction to flowers, an animal or even the Christmas decorations is one thing, but if you notice a yellow or green discharge, you should be in touch with your doctor.

Some Special Considerations

For the most part, everyone has the same anatomy with regard to the paranasal sinuses; however, there are other factors that can make it difficult for them to function the way they were meant to. Some people may have genetic abnormalities or structural issues resulting from a broken bone that hinders proper sinus drainage, leading to chronic congestion. Others may have had dental or facial reconstruction. Environmental factors such as dry or moist air can contribute to sinus congestion. It’s important to communicate to your therapist if you’ve experienced any of these so they can include that in their assessment and treatment.

How Massage Can Help

Your therapist can help provide you with relief from sinus congestion by using special techniques to massage your face, neck, and upper body. They can direct their attention to the areas that are most affected and can help promote drainage of congested sinuses. These gentle techniques use minimal pressure and can encourage mucus to flow more freely from the sinuses into the nasal passages.

Sinus congestion often leads to pressure and discomfort in the facial, head, and sometimes neck region. It’s common for massage therapists to feel swollen lymph nodes on one or both sides of the neck. Massaging can alleviate this pain by reducing tension in the face and neck, allowing for better drainage of the inflamed tissues, which, in turn, allows for improved lymphatic flow.

The old adage, “pressure relieves pain,” can be very true with sinus congestion. When someone has a toothache, they put their hand to their jaw, and with sinus congestion, this works as well. While gentle techniques used are gentle in areas that are swollen, sometimes firmer pressure works too. Take a couple fingers from each hand and press them against both sides of your temple (it’s the soft area of the sides of your head where the eyebrows typically end). Keeping your fingers stationary, and with firm pressure, rub them in repeated circular motions from the front of the head, to the top of the head, to the back of the head, and then down and around to the front of the head. This technique, performed in this manner, begins to encourage relief from sinus pressure and congestion. Your massage therapist may include other areas such as the zygomatic (cheek) bone, mandible (jaw), ears, Eustachian tube, and countless muscles of the neck and upper shoulder. They may use tools or include techniques from craniosacral therapy and lymphatic massage to help relieve sinus congestion.

What clients report

Another adage, “an ounce of prevention is better than a pound of cure,” also rings true with sinus congestion. Anecdotal evidence from clients claims that using supplements, over-the-counter drugs, spray, and sometimes a combination of all three is their first line of defense to prevent sinus congestion and pressure. I have also had clients report that they’ve had success with saline nasal irrigation and cold packs on the face.

It should be noted that massage is an excellent way to relieve sinus congestion and pressure in the head and upper body. Several times throughout the year, we feel more like plumbers than massage therapists. When there’s tension in the neck, it’s difficult for the sinuses to drain the way they should. Once the areas begin to loosen up and start draining, it feels to them like a floodgate has opened, and they have the built-up drainage begin to flow. It’s common for clients to need a tissue, swallow a bit more, or even cough within 10-15 minutes after the start of the session. Once they stand up, then the results are even more pronounced.

If you have been experiencing sinus congestion or pressure, massage is a great way to provide you with relief. We look forward to taking care of you.

Kindest regards,

Charles “CJ” Bromfield,

LMT, NCBTMB CEU Provider

Owner, Lakewood Massotherapy

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