Chronic rhinosinusitis is an inflammatory condition of the nasal and sinus lining that lasts
longer than twelve weeks. It’s estimated that roughly 10–12% of adults in the United States are living
with chronic rhinosinusitis at any given time, with many experiencing symptoms for years. Managing
the condition can be challenging, as it’s driven by a mix of contributing factors that may include
chronic inflammation of the sinus lining, immune dysregulation, lingering microbes, structural
factors, and environmental exposures such as air pollution and cigarette smoke. Because the
accumulation of fluid and inflammatory material in the sinuses is a key component of the disease
process, treatments that help facilitate drainage may provide symptom relief. To that extent, therapies
provided by doctors of chiropractic may have a role in caring for some patients with chronic
rhinosinusitis.
Manual therapies performed by chiropractors can help address fluid build-up both directly
and indirectly. Specific techniques such as lymphatic drainage use gentle manual pressure and
stretching to stimulate lymphatic vessels that help move excess fluid out of tissues, which may
reduce pressure and congestion. Tightness in the muscles and soft tissues that attach to the head and
neck can also restrict normal fluid movement. For this reason, myofascial release, mobilization, and
manipulative therapies aimed at restoring normal motion in the face, head, neck, and upper back may
be beneficial for some individuals.
This potential benefit is illustrated in a case series involving 14 patients with chronic
rhinosinusitis who also experienced craniofacial pain. Those who received manual therapy to address
craniofacial dysfunction over a seven-week period reported improvements in both craniofacial pain
and the severity of their sinus symptoms, while patients in a comparison group that did not receive
hands-on care reported no meaningful improvement.
Additional studies suggest that manual therapies may help improve sinus drainage, reduce
facial pain and pressure, enhance nasal airflow, and improve quality of life—particularly when
chronic rhinosinusitis is accompanied by neck muscle tension or headaches associated with cervical
spine dysfunction. Other reports indicate that some patients who have not responded to conventional
medical management, including those who have undergone sinus surgery or who wish to avoid
surgery, may experience symptom relief with conservative manual therapy treatment.
While current evidence does not support chiropractic care as a first-line treatment for chronic
rhinosinusitis, manual therapies provided by doctors of chiropractic may play a supportive role as
part of a comprehensive care plan. This may be especially relevant for patients who have difficulty
managing symptoms with usual care alone. Individuals interested in this approach should speak with
their healthcare provider to determine whether a trial of chiropractic care may be appropriate for their
situation.
Brent Binder, D.C.
4909 Louise Dr. Suite 102
Mechanicsburg, PA 17055 (717) 697-1888
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