Scope of Care · B
Sinusitis (acute & chronic)
Last updated: 2026-09-20 · Prepared by licensed TCM physicians · Updated 2026-09
Key Points
Sinusitis is inflammation of the sinus lining; the acute form usually follows a cold, while chronic sinusitis persists beyond 12 weeks with purulent discharge, facial pressure and congestion.
- Acute sinusitis typically appears after a cold and lasts under 4 weeks
- Chronic sinusitis persists beyond 12 weeks, often alongside allergy or structural problems
- Hallmarks: yellow thick discharge, facial pressure (worse bending over), congestion, reduced smell
- TCM care focuses on opening drainage, clearing turbidity and reducing recurrences
First, what cannot wait
- High fever with red swollen eyelids, blurred or double vision — possible orbital complication, go to emergency now
- Severe headache, stiff neck or altered consciousness — possible intracranial complication, go to emergency now
- Symptoms lasting over 12 weeks, or multiple flares within a year
- Blood-streaked discharge or steadily worsening one-sided obstruction — structural disease must be excluded
- No improvement in pus and pressure after 2-3 weeks of proper treatment
Understanding the Condition
The sinuses are four groups of air-filled chambers connected to the nose. A cold or allergy swells the nasal lining, blocking the openings — drainage stalls, microbes multiply inside, and you get post-nasal pus, facial fullness and a heavy, thudding pain when bending over.
Acute sinusitis settles within 2-3 weeks. When symptoms persist past 12 weeks, it becomes chronic: long-term swelling, alternating flares and remissions, frequently layered over allergic rhinitis or a deviated septum.
Why It Keeps Coming Back
Because chronic sinusitis is not only "inflammation" — it is "blocked drainage" plus "recurrence-prone constitution". Antibiotics clear a bacterial episode but not the chronic swelling or the repeated obstruction loop.
In long-standing cases, factors intertwine: low immunity, allergic tendency, weather and humidity swings, late nights and dietary heat. That whole picture is where TCM pattern-based care has its role.
Our Pattern-Based Approach
TCM calls sinusitis "bi yuan", defined by persistent turbid discharge. Acute stages are mostly wind-heat invading the nose or gallbladder heat flaring upward — thick yellow pus, headache with facial heat, bitter taste. Chronic stages are mostly lung-spleen qi deficiency with damp-turbidity — white sticky discharge, fluctuating congestion, fatigue and poor appetite; long-standing cases may add kidney deficiency or blood stasis.
Acupuncture treats the urgent first — opening the nose and draining turbidity — then consolidates: Yingxiang (LI20), Yintang, Quanliao (SI18) and Shangxing (GV23) locally; Hegu (LI4) and Lieque (LU7) to vent the lung; Zusanli (ST36) and Pishu (BL20) to strengthen the spleen and resolve dampness. With moxibustion and saline rinsing, the aim is to break the "swelling–obstruction–infection–re-swelling" loop and cut relapse frequency.
Common patterns and treatment directions
| Pattern | Typical presentation | Approach |
|---|---|---|
| Wind-heat invading the nose | Acute stage, thick yellow discharge, congestion, distending headache, fever with aversion to wind, sore throat | Vent wind, clear heat, open the nose: Hegu (LI4), Lieque (LU7), Yingxiang (LI20), Yintang — superficial, quick needling |
| Gallbladder heat flaring upward | Copious yellow-green sticky discharge, morning bitter taste, marked cheek pressure, irritability | Drain gallbladder heat: Fengchi (GB20), Yanglingquan (GB34), Taichong (LR3), with local points to open the nose |
| Lung-spleen qi deficiency | Chronic stage, scant white sticky discharge, fluctuating congestion worse in cold, fatigue, poor appetite | Tonify lung and spleen, resolve dampness: Zusanli (ST36), Pishu (BL20), Feishu (BL13), Fenglong (ST40), with gentle moxa |
| Damp turbidity obstructing the nose | Sticky discharge hard to blow out, heavy wrapped head, chest tightness, poor appetite, thick greasy tongue coating | Transform damp and drain turbidity: Fenglong (ST40), Yinlingquan (SP9), Zhongwan (CV12), with Yingxiang (LI20), Quanliao (SI18) |
| Long-standing stasis | Years of disease, enlarged dusky turbinates, fixed pain, dark-red mucosa | Invigorate blood and unblock: Geshu (BL17), ashi points, with long-term gentle moxa and saline rinsing |
Patterns are determined in person. This list is for orientation only and is not a self-diagnosis tool.
What to expect: first visit to follow-up
- First visit · about 40 minutesWe map the history: onset, character of discharge, allergies, past medication and imaging. Pulse and tongue establish the pattern; nasal endoscopy or CT may be advised first to exclude structural disease.
- Plan discussion · same dayWe clarify how acute and chronic stages are handled differently, treatment frequency, rinsing technique, and which situations must return to ENT first.
- Weeks 1-4After the acute phase, care moves to regulation: 1-2 sessions weekly combining local and tonifying points, with daily rinsing and a symptom log.
- Week 4-8 · first reviewDischarge volume, congestion and flare frequency are reviewed to decide: consolidate, adjust the pattern plan, or lengthen intervals into maintenance.
Course of care and follow-up
- Chronic sinusitis care runs in 4-8 week cycles, then maintenance every 2-4 weeks once stable
- Boost regulation ahead of peak cold season to break the "cold-to-sinusitis" chain
- Annual or relapse-triggered pattern review; repeat endoscopy if indicated
- Ongoing coordination with ENT: prescribing antibiotics or nasal steroids remains the specialist’s call
When to Seek Care
Before your visit:
- Saline nasal rinse once or twice daily to help drainage
- If a cold lasts beyond 10 days, or symptoms improve then worsen again, get assessed
- Manage underlying allergy; keep indoor humidity moderate and air circulating
Consider an in-person consultation if:
- Symptoms beyond 12 weeks, or multiple flares per year
- Fever, marked facial swelling, severe headache or visual change — seek care immediately
- Pus and pressure persisting despite proper treatment — further ENT evaluation advised
Supportive Care
- Nasal rinsing is the most underrated tool: body-temperature saline, gentle technique
- Blow the nose gently, one side at a time — forceful blowing pushes pus toward the middle ear
- Quit smoking and avoid second-hand smoke: smoke directly worsens mucosal swelling
- In chronic stages, regular sleep and a lighter, less greasy diet reduce internal "accumulated heat"
FAQ
Can acupuncture replace antibiotics for chronic sinusitis?
No. During an acute bacterial infection, antibiotics must be used properly — that belongs to ENT care. TCM support comes after the acute phase and during chronic recurrence: improving drainage, adjusting constitution, reducing relapses — alongside, never instead of, specialist treatment.
Why does my sinusitis keep coming back?
Relapse usually has three layers: drainage problems (structural abnormality, allergic swelling), constitutional factors (immunity and metabolic state), and lifestyle (smoke, alcohol, late nights, dietary heat). TCM pattern care mainly addresses the latter two; if structure is suspected, ENT imaging is needed.
Want your situation assessed? Book a consultation.
Prepared by licensed TCM physicians · Updated 2026-09