Sinusitis - An Eastern Medicine Perspective

If you have already read the partner to this post, What is sinusitis? *A Western Approach*, you’ve learned a lot about exactly what is happening to the structures and tissues that comprise your sinuses.  This is such a great contribution from Western Medicine, to evaluate and understand the parts of our bodies and make changes to them when necessary. Eastern Medicine looks at the body quite differently and is artful in exploring why the body is acting the way it is acting.

For sinusitis, there are three big fields of inquiry that Eastern Medicine explores. First we look to see what External pathogens might be at work on the body. We look to see the condition of the Internal state of the body, and we look to see the landscape or location of the problem. I’m going to now delve more deeply into each of these.

First, we look to see what External factors are influencing the body. We identify those factors with names like Wind and Cold and Heat and Damp. What we name them is based on how the body presents itself and to what external environment each person has been exposed. External factors are almost always involved in acute sinusitis - when sinusitis has been present for three weeks or less. In Eastern Medicine colds and flus are considered External Wind conditions.  How they present in the body creates a modifier of Heat, Cold or Damp, to that Wind diagnosis. If someone comes in with a sinus infection with thick yellow mucous and a slight fever, we will call that presentation a Wind Heat invasion - things that appear hot or colorful are usually a sign of Heat. Conversely, if the person has an aversion to being cold and their mucous looks very clear or white, we consider that a Wind Cold presentation. Dampness can exist alone or with either Wind Heat and Wind Cold, and presents with copious amounts of mucous.

In more chronic cases of sinusitis, we usually have to evaluate the internal factors that are at work. Though this is a big generalization, sinus conditions most often reflect the status of what Eastern medicine calls our Metal energy and our Earth energy. Our Metal energy, strongly aligned with our respiratory system, describes how our body receives, filters and ultimately alchemizes the outside environment and turns it into the nourishment we receive from breath. This Metal energy can be lacking in strength, which we call deficient; or it can be too hot or too dry. When sinusitis is coupled with a weak immune system, difficulty breathing, or general fatigue and weakness, we might explore how to get more strength to the Metal aspects of our body. When sinusitis is coupled with a constant low grade fever, constant recurring sore throat, sharp pain, or mouth, nose and throat dryness, we consider this hot and look to cool and moisten the Metal Energy.

The mucous that is often present with sinusitis is most often a manifestation of our Earth energy. Earth energy is best correlated with our digestive processes. It is the energy that transforms and transports nutrients brought in through our diet to the rest of the body. If its power to transform food is weak, pathological Dampness is formed. This is an interior source of Dampness which differs from the Exterior Dampness mentioned above.  Interior Dampness can take the form of heaviness in our body, fuzziness in our thinking, or excess mucous in our respiratory and digestive processes. When mucous is present we routinely look to strengthen the digestive processes to minimize the Internal Dampness.  The Earth energy might also be in a state of disharmony or counterflow, causing what is supposed to go up to go down, and vice versa.  If sinusitis shows up when stress is exacerbated, harmonizing this directional aspect of Earth energy will be required.

In addition to Metal and Earth energy examinations, we also look to see how balanced the patient’s Yin and Yang are.  Yin and Yang are the energies represented by that black and white circle symbol that has become ubiquitous in pop culture. The basics of Yin and Yang theory are that everything in the Universe exists ideally with a balance of cool, still, nourishing (yin) energy and warm, dynamic, active (yang) energy. In Dr. Vaughn’s article about Sinusitis he describes the microscopic condition of the sinuses.  The goblet, mucous producing cells are very representative of the Yin aspects of the sinuses. If Yin is diminished, which it often is in a stressed out, over worked patient, or in someone post-menopausal, these goblet cells may dry and stop producing mucous.  Without Yin to offer it’s cooling energy, the sinus tissue will be over represented by Yang energy and might get too warm. If this happens the sinus tissue can get dry, or swollen, or inflamed.  On the other side, the Yang energy of the sinuses is represented by the hair-like cilia and their rhythm and movement that maintains normal mucous flowing and keeps the sinuses clean. If a patient becomes Yang deficient, often times from long term illness, aging or - again - the stress of too much work, the cilia will stop moving, allowing the mucous to build up and go nowhere. Additionally, without Yang energy the sinus might become to cool allowing a Cold pattern to form causing pain and tightness in the sinuses.

Finally, the landscape. Exactly where the sinus pain or pressure shows up for a person helps Eastern Medicine practitioners determine how to treat it. There are specific channels that regulate energy in the face and sinuses. The front of the face, next to the nose and under the eyes, is dominated by channels that carry full strong energy.  When pain is here, chances are that the sinusitis is Excess or Heat is involved. Wind is often implicated when pain is more prevalent on the back or sides of the head. Cold energy often lodges in the back of the head.  Pain behind the eyes is often a more internal condition and frequently a sign that there is some deficiency or weakness in the pattern.

While there is quite a bit of art and science that goes into understanding sinusitis from an Eastern perspective, the treatment tools are pretty consistent.  While different herbs and acupoints will be chosen based on the pattern, treatments will typically include one or more of acupuncture treatments, topical herbal treatments with massage, internal herbal remedies, herbal steam therapy, neti pot irrigation, and dietary therapies.

Hopefully this helps you understand another way of working with your sinuses.  At Exhale Sinus, TMJ, Headache & Sleep, we work together to figure it out, so you can feel better faster!

Lisa C. Decatorsmith, L.Ac., MSOM