Fasten your seatbelts – plane pain can be a sign of sinusitis

You’ve just endured several hours of cramped seating, overpriced soft drinks and a child constantly kicking the back of your chair.

And just when it feels like you’ve had quite enough of the flight to wherever you’re going on holiday, you begin to get an uncomfortable feeling in your ears or sinuses.

The pilot starts the plane’s descent and the air pressure in the cabin rises.

If there is a blockage in the sinuses – small air-filled pockets in the facial bones and front of the skull – the pressure cannot equalise with cabin pressure. This leads to pain.

All being well, the pain isn’t too bad. For some people, like my patient last week, it can be excruciating. He has chronic sinusitis. Regular or acute sinusitis is quite common after a cold.

What happens is a troublesome virus enters the sinuses, causing inflammation to the lining.

Usually it results in a runny nose, typically with a green or yellow discharge, and the sense of smell is reduced, while the sinuses become sore or feel clogged.

Acute sinusitis usually goes away after a couple of weeks, although sometimes a bacterial infection can develop, which may need antibiotics.

Sinusitis can also be caused by a dental infection, but there are other things which make sinusitis more likely, such as nasal allergies, asthma, smoking or anything which compromises your immune system.

Underlying problems like this may also make the symptoms more likely to last longer.

With chronic sinusitis, which is thankfully not very common, symptoms can last for more than 12 weeks. They may continue even after the infection has gone.

The sinuses can’t drain properly and mucus builds up – which may go on to cause another infection.

It may also cause headaches, bad breath, toothache and coughs.

Treatment of chronic sinusitis depends on what caused it – if it’s an allergy then anti-histamines might help, if it’s a dental problem then a trip to the dentist would do it, and so on.

Steroid sprays or nose drops may help reduce inflammation, as can painkillers.

If things don’t settle surgery might be considered to remove any sinus blockages and improve drainage.

If you are flying and you have a cold or chronic sinus infection, then short-term decongestants may help.