Nasal irrigation offers better sinus relief than steam inhalation

When needing to clean your nose, is nasal irrigation better than the natural power of steam? Yes, suggests a recent study.

Advising patient with chronic sinus congestion to use nasal irrigation, a popular nonpharmacologic treatment, improved their symptoms, but steam inhalation did not, according to the randomized controlled trial.

More than 25 million people in the United States and about 2.5 million Canadians suffer from chronic rhinosinusitis, or sinus infection, and experience compromised quality of life. To alleviate symptoms, steam inhalation and nasal irrigation are widely suggested as an alternative to common treatment with antibiotics, which are often not effective and contribute to antibiotic resistance.

The study involved 871 patients from 72 primary care practices in England who were randomly assigned to 1 of 4 advice strategies: usual care, daily nasal and saline irrigation supported by a demonstration video, daily steam inhalation, or combined treatment with both interventions.

"We have found that even a very brief intervention of a video showing patients how to use saline nasal irrigation can improve symptoms, help people feel they do not need to see the doctor to manage the problem, and reduce the amount of over-the-counter medication they need to use," said Dr Paul Little of the University of Southampton.

Patients who were instructed to use nasal irrigation showed improvement at 3 and 6 months, as measured by the Rhinosinusitis Disability Index. Steam inhalation did not appear to alleviate symptoms of sinusitis.

The authors wrote, "Although there was no significant difference in either physician visits or antibiotic use, as might be expected over only a 6-month follow-up period, our findings concerning consultations are important in the longer term, given antibiotic use increases the risk of antimicrobial resistance."

The study is published in Canadian Medical Association Journal (CMAJ).