Because multiple sclerosis (MS) impacts neurological function, most people living with the condition experience a wide array of symptoms. Although sinus issues and congestion are not typically symptoms of MS, people who have multiple sclerosis may get runny noses and sinus infections more often than those in the general population.

Fortunately, this is rarely a serious problem, but it can worsen quality of life if the infections become serious. Scientists are still trying to fully understand the connection between MS and sinus problems.

How Does MS Affect the Sinuses?

MS causes demyelination of the nerves, a process that erodes the protective fat (myelin) that covers the nerves. Demyelination causes interruptions or breaks in the communication between the nerves in the central nervous system (CNS), which lead to the symptoms of MS.

Increased congestion and sneezing have been connected with MS symptoms and flares. And, according to a report by scientists from the Infection and Immunity Group at King's College, London, the upper respiratory tract (including the sinuses) seems like the logical main point of entry for infection-producing irritants and germs in people living with multiple sclerosis. As for the causal relationship between sinus infections and MS flares? That is still under investigation.

Sinuses

The sinuses are air-filled cavities that take up a large amount of space in the skull. These cavities may become inflamed due to infections, the common cold, environmental allergies, nasal polyps, or autoimmune problems.

Once a sinus cavity becomes blocked, fluid fills the cavity and causes sinus infection (sinusitis) symptoms, such as pain and nasal congestion. Sinusitis is described as either acute or chronic, depending upon the severity and length of disease.

As a rule:

• Acute sinusitis — Sinus infection lasting fewer than four weeks
• Chronic sinusitis — Sinus infection lasting more than 12 weeks

Nasal Polyps

Nasal polyps are drop-shaped growths attached to one’s nasal passages and/or sinuses. Soft to the touch, the polyps are noncancerous and don’t hurt. They develop due to chronic inflammation and are often associated with certain immune disorders. Scientists do not completely understand the biological connection between MS and the development of nasal polyps.

Small nasal polyps usually do not cause symptoms. When nasal polyps grow larger, they may block part of the sinus cavity, which can then lead to sinus infections.

Common signs and symptoms of chronic sinusitis with nasal polyps include:

• Aching teeth in the upper jaw
• Pressure in the sinuses
• Snoring
• Chronic nosebleedsLessened (or non-existent) sense of smell
• Chronic stuffiness
• Runny nose
• Drainage from the sinuses that runs down the throat

Since many of the symptoms of nasal polyps are similar to sinusitis symptoms, consult your doctor to determine if you have sinusitis with or without nasal polyps.

Are Sinus Issues Related to MS Itself?

Sinus issues may be related to the MS disease itself or may be a side effect from MS treatments. There are three main categories of MS treatments — disease-modifying therapies (DMTs), medications used to treat relapses, and medications for managing MS symptoms.

Disease-modifying therapies are taken long-term to help prevent MS disease flares and slow disease progression. Since DMTs suppress, or weaken, different parts of the immune system, these MS treatments may increase your risk of contracting infections.

Since MS treatments may weaken your immune system, it is important to try to avoid the risk factors for sinus infections:

• Viral infections, such as the common cold
• Smoke (secondhand or otherwise)
• Obstructions to drainage (for example, nasal polyps)
• A compromised immune system
• Allergies (especially seasonal ones)

If you have seasonal allergies or nasal polyps, talk with your health care provider about ways to manage them so you can reduce your risk of sinus infections.

How Can You Manage Sinus Infections and Other Problems?

Sinus infections can be a major inconvenience due to the symptoms, including:

• Facial tenderness and pressure
• Headache
• Nagging cough
• Runny, stuffy nose
• Drainage from your sinuses down your throat
• Sore throat

One review of existing studies noted that infections may trigger MS flare-ups. With that in mind, do your best to prevent sinus issues by cleaning your hands and avoiding close contact with people who have colds or other upper respiratory infections. Also, do not smoke and avoid breathing secondhand smoke.

How To Manage Sinus Problems

Fortunately, most mild cases of sinusitis can be managed with over-the-counter (OTC) and at-home treatments. Antibiotics are not needed for all sinus infections. To determine the best treatment options, consult your doctor.

Here are some ways to relieve sinus pain and pressure:

• Get rest — It helps your body fight infection and speeds recovery.
• Drink fluids — Being hydrated can keep your sinus cavities moist.
• Relieve sinus pressure — Place a warm compress over your nose and forehead.
• Moisten your sinus cavities — Breathe in steam from a bowl of hot water or shower, and use a clean humidifier to add moisture indoors.
• Rinse your nasal passages — Use a specially designed squeeze bottle or neti pot.
• Relieve pain — Try OTC pain relievers such as acetaminophen, ibuprofen, or aspirin, if your doctor clears them.
• Nasal corticosteroids or decongestants — Talk with your doctor, since these are not designed for long-term use.
• Saline nasal spray — Clear your nasal cavity quickly with a soothing mist of water and salt.

Be sure to seek medical care if you have severe symptoms, such as:

• Extreme headache or facial pain
• Symptoms that get worse after initially improving
• Symptoms lasting more than 10 days without improvement
• Fever lasting longer than three to four days

How To Manage a Runny Nose

A runny nose can be a major inconvenience and it may leave you with a raw, painful nose. Exposure to cold temperatures, environmental allergens such as pollen, and viruses are common causes of a runny nose. If you have MS, you may find that you get a runny nose more often.

Generally, a runny nose will stop on its own once your immune system clears the virus or when allergen levels decrease (like when pollen subsides). To ease the inconvenience of a runny nose, get enough rest and drink enough fluids. Rest and proper hydration help your body heal more quickly. Using a saline nasal spray may also help relieve your symptoms.

How To Manage Sneezing

Anything that irritates your nose can make you sneeze. Learning your triggers — and avoiding them as much as possible — is one of the best ways to prevent excessive sneezing. Common triggers include dust, pollen, mold, pet dander, spicy foods, and common cold viruses.

If you find yourself sneezing a lot and are not able to determine the cause, blowing your nose may help remove the irritant that is causing you to sneeze.

Talk With Others Who Understand

On MyMSTeam, the social network for people with multiple sclerosis and their loved ones, more than 185,000 members come together to ask questions, give advice, and share their stories with others who understand life with multiple sclerosis.

Do you have multiple sclerosis and sinus problems? Share your experience in the comments below, or start a conversation by posting on your Activities page.