I didn’t even think about my sinuses until I turned 25, got a head cold, and (from my perspective), never got better. After much trial and error (and trips to ENTs, one of which included a fiberoptic camera that allowed me to understand what's happening in my face 100x better than ever before—given the whitish/blueish bumpy surface of some of my turbinates, allergies are definitely at play), I have finally found something that works for me: "power" nasal irrigation with a sinus attachment on a water flosser.
The epiphany came via a suggestion in a book (I'll link to at the bottom of the page) and after actually seeing the lobes of my nasal sinuses via the camera and understanding how much surface area I was actually trying to rinse — it seemed really unlikely that I'd been able to access very much of my sinuses just using gravity and a neti pot, or even a squeeze bottle. After switching, the amount of the saline solution that I could pump into my face after plugging my other nostril before it started to drain out my mouth was eyebrow raising. 😯
So I switched to gently forcing the water through the passageways using a special nasal/sinus attachment on ~a water flosser + a hypertonic (extra salty) saline solution, to draw fluids out using osmosis and thin the mucus secretions. (I use a regular "isotonic" saline solution (or a half packet of the green kind) when I just need to clean my sinuses on days with lots of pollen or dust (or viral) exposure.)
I've actually found that if I get ahead of a cold and flush before bed and again when I wake up in the morning for a couple days, I can often prevent myself from getting sick or dramatically reduce the length of the cold (as well as stop the months' long after-effects which is what I had initially set out to solve). Not sure if it's reducing viral load or just helping my immune system with what it was trying to do in the first place, but it’s great!
(I think it’s useful to remember that basically when something goes wrong — allergens or pathogens — your sinuses have basically one tool: produce mucus. And a lot of the annoying symptoms like a sore throat or even an ear issue, will be caused by that mucus production rather than the invader itself.)
This is the one I use — it was the cheapest one that was well-reviewed that came with the nasal/sinus tip that I wanted.
My guess is that there's something about the smoothness/regularity of the pulsing that has the added benefit of allowing me to use a hypertonic solution without nearly as much burning/tearing up as happened when I was using other methods.
In addition to the irrigator, linked above, I use these premixed saline packets (you can use two regular packets, which are also available on-and-off-brand at Target, to get the same saline content of the hypertonic if you're not ready for the intensity of committing to that route) and I always use a jug of "distilled" or previously boiled and then cooled water to make sure I don't introduce weird microbes into my 🧠.
This is what has worked for me:
- Heat 8oz of the distilled water to roughly body temperature (with my microwave that's usually ~30 seconds, but it took some trial and error).
- Mix in the saline solution until it's completely dissolved and pour it into the irrigator.
- Turn it on to the lowest setting (for me it bubbles up maybe a half-inch when pointed up like a fountain), lean your face over the sink tilted down, and put the sinus nozzle tip in one nostril. Allow the solution to flow into your sinuses until it starts to come out your other nostril, then press that nostril closed and let the solution continue to pump into your sinuses until it starts to drain out of your mouth. At that point, pause the irrigator and gently snort and spit before starting again with the other nostril.
- Afterward, pour another 8 ounces of water into the irrigator and run it until it empties, in order to flush the salt out of the system to prevent corrosion (there are many reviews about machines not lasting long and I suspect this might be the culprit) — I will often switch to the flosser head and give my teeth a once-over to kill two birds with one stone.
Note: Your sinuses are surprisingly extensive and oddly shaped, and (especially if you're having trouble with them) water can get trapped in various pockets. It's never bothered me, but while I'm in a treatment phase, I do always keep a tissue in my pocket just in case I lean over to tie my shoes later and saline solution drips out(!)
Update: My GP (a DO) has turned me onto a nasal spray that I use after I’m done rinsing and have taken a first pass at blowing my nose/snorting and spitting whatever remains in there. If I’m not up for a full flush, I’ll use this before my nightly routine when getting ready for bed—it seems to loosen things up and cause more drainage/snorting and spitting (which is why I don’t do it right before bed.
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It's integral enough for me that I also have a portable one that I travel with just in case I feel a cold coming on — always good to have something to entertain your friends' kids! It's very convenient, but not as gentle, so I wouldn't use it as a beginner.
NeilMed also now makes their own battery operated version.
For people looking for more information:
Before my deep-dive, my GP had recommended nasal flushing and had given me the squeeze bottle version of the traditional neti pot to try (I think many people have realized that some force is better than just relying on gravity). After seeing a specialist and trying various sprays and medications (I think there might be some merit in the idea of breaking a bad cycle by using things to help with inflammation so that you stop over-producing, even if it doesn't make sense to lean on those things longer-term, and when someone in my household is congested I tend to offer guaifenesin (an expectorant) for chest gunk as well as phenylephrine for nasal/sinus congestion; I’m more wary of steroid sprays like nasonex, but they might help break a cycle), a caring friend got me a book called "The Sinus Cure." I think this was the first professional I'd run into who talked about powered/pulse irrigation — the author recommends his own proprietary machine and suggests that there's something special about the pulse frequency and how it interacts with your cilia; that might be true, but I got the results I was looking for with a multi-purpose unit for a fraction of the price. 🤷♀️ (He's also the one that turned me on to hypertonic vs. isotonic when I'm having a flareup.)
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Remember: I'm not a doctor and this is not medical advice, I'm just sharing what worked for me in hopes that it helps someone on their sinus journey!