Can I Blame My Aches and Pains on My Sinuses?

It looks like pain caused by chronic sinus problems might be misdiagnosed as fibromyalgia.

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I've had persistent sinus problems since my early teens—stuffiness, decreased sense of smell, facial pressure, and pain—that my doctors say are tied to my severe allergies. And every few months, I get a nasty acute sinus infection that calls for a couple of rounds of antibiotics. I've also long coped with a chronic condition called fibromyalgia, characterized by muscle pain and fatigue and triggered, I'm told, by a 1996 car accident.

Until this week, it never occurred to me that the symptoms I've experienced since that car accident might be linked to what keeps happening in my nose. My ear, nose, and throat doctor, allergist, and primary-care doctor always ask about facial pressure and pain when I seek treatment for sinus problems, but I don't recall any of them ever asking how my back and knees were feeling at the time. Now, new research suggests that chronic sinus problems may be linked to body pain and fatigue.

"People with chronic sinusitis have about 24 percent more bodily pain than the average person—bodily pain very similar to [that in] those who are 35 years older [and] those with arthritis and depression," says Alexander C. Chester, lead author of the new analysis and clinical professor of medicine at the Georgetown University Medical Center. One passage from the study really got my attention: Because many doctors haven't accepted sinus problems as a cause of body pain, clinicians may "ascribe bodily pain symptoms to another condition...such as fibromyalgia." Chester estimates that 50 percent of people diagnosed with fibromyalgia have chronic sinus problems.

He and other experts caution that more research is needed before anyone can definitively link body pain and sinus problems. The study "doesn't prove in any way that some people are misdiagnosed with fibromyalgia when they really have sinus problems," says Dan Clauw, director of the Chronic Pain and Fatigue Research Center at the University of Michigan.

But the possibility offers sinus sufferers good reason to address their symptoms. Treatment of sinus symptoms, including endoscopic sinus surgery, may help alleviate bodily pain and fatigue, according to the researchers, who presented their findings this week at the annual meeting of the American Academy of Otolaryngology. (Unfortunately, my 1999 sinus surgery didn't resolve my symptoms). Still, treatment of sinusitis can be tricky. People with mild acute sinus infections—different from the chronic cases examined in the new study—don't get much relief from antibiotics. In those cases, it may be best to explore antibiotic-free options for treating sinus symptoms. Last year, I explained what to do for a stuffy nose, and my colleague, Nancy Shute, described how a saltwater nasal rinse can offer relief.

If you've put nasal symptoms "on the back shelf for a while" because you felt pain and fatigue was a bigger issue, Clauw says, it may be time to find out if tackling them might do double duty.