The People's Perspective on Medicine

Will Saline Irrigation Ease Sinus Congestion?

A simple saline solution in a spray or a neti pot can help rinse out nasal passages and ease sinus congestion due to allergies.

Sinus congestion can make you miserable. You may have trouble breathing well and you might suffer from headaches. Medications don’t always help much. One reader found a simple way to ease sinus congestion.

Ease Sinus Congestion with Saline Spray:

Q. I have had sinus congestion problems since serving in Saudi Arabia back in 1969. My brother told me about a nasal rinse called NeilMed, but it took me a long time to try it. Now I use it morning and night. It really does work.

This part of the body is a filter, and it needs to be washed out. Is it messy? Yes. Do you need to keep the spray bottle clean? Yes. Do you need to use clean water? Yes.

Try it in privacy of your bathroom. You will be surprised at the results, that is if you actually sniffle the fluids up and down to wash the nasal spaces. Wait a while for the mucus to loosen up. Then wash and rinse again. Blow out the baddies and enjoy life.

My annual health problems associated with pollens and other junk in the air have disappeared since I started this daily regimen.

Saline Rinsing for Allergy Symptoms:

A. Saline nasal rinsing is an effective, inexpensive way to reduce allergy symptoms (Head et al, Cochrane Database of Systematic Reviews, June 22, 2018). NeilMed supplies a variety of nasal irrigation products including rinses that are premixed so you don’t have to locate purified water. An analysis of clinical trials found that irrigating with saline solution could ease sinus congestion in children with allergies (Li et al, Journal of Clinical Medicine, Jan. 9, 2019). 

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Using Saline to Ease Sinus Congestion from Allergies:

Q. Almost three years ago, I was bothered with allergies and took allergy medicines every day. Then I started using a neti pot with a saline solution for the entire allergy season.

Now I do not take any allergy medicines. I only have to use the neti pot when I get congested. I am SO glad to cut my ties to allergy medicines.

I’ve thought: why WOULD there be any studies to combat allergies using saline irrigation when drug companies make bank on sales of the medicines?

Research on Saline Irrigation:

A. You are right that few drug companies would underwrite research on saline solution. There have been a few studies on saline irrigation for allergies, though.

In one pilot study, 25 youngsters with runny nose year round (perennial allergic rhinitis) had fewer symptoms after using saline nasal spray for three weeks (Journal of Biological Regulators and Homeostatic Agents, Jan-Mar., 2016). A review of several earlier studies notes that nasal irrigation with saline can be helpful in cases of chronic sinus irritation (Current Allergy and Asthma Reports, Apr., 2013).

Neti Pot or Saline Spray?

As the studies suggest, you don’t have to use a neti pot to ease sinus congestion. But if you are curious about how to use this Aladdin’s-lamp-shaped implement, you can read more about it here. This ancient Ayurvedic practice appeals to many people and is not difficult to master.

Some folks prefer a more modern system of nasal irrigation, such as one made by NeilMed. Another reader found that using plain saline nasal spray twice a day was helpful in preventing sinus problems.

Bonnie compared using a neti pot and sinus irrigator: 

“I have used both. Both offer great relief from the congestion and runny nose of allergies and colds. The preservative-free nasal sprays such as Simply Saline are convenient and a lot less messy than the neti pot. I stress ‘preservative-free’. It’s also buffered and makes it comfortable as well as effective. If you’re using a netti pot, make sure you use sea salt, kosher salt or pickling salt. They have no preservatives or iodine. And use a pinch of baking soda to buffer your solution.”

Lucy found she had a chronic sinus infection:

“I had chronic nasal congestion (and used saline once a day) and discovered a long-term sinus infection, thanks to a CT scan at the time of a TIA. After the antibiotic treatment my EMT MD told me to use a full bottle (about an ounce) of saline every am and again in the pm. I mix up my own and just use tap water because the risk of parasitic infection is minimal in city water. That clears out the congestion nicely and I almost never need a chemical decongestant.”

Molly added:

“I’ve had post nasal drip 24/7 for several years. A variety of possible causes have been ruled out in doctor visits, tests, and diet changes. I’m 67 and I believe it’s caused by dried out sinus mucus membranes, a matter of aging. What works best is to drink a lot of water, use the NeilMed sinus rinse twice daily along with saline nasal spray. I make my own saline solution for the rinse using 1 part soda to 3 parts pickling salt. I use the commercial spray which is convenient and inexpensive.”

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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  • Head K et al, " Saline irrigation for allergic rhinitis." Cochrane Database of Systematic Reviews, June 22, 2018. DOI: 10.1002/14651858.CD012597.pub2
  • Li CL et al, "Effectiveness of hypertonic saline nasal irrigation for alleviating allergic rhinitis in children: A systematic review and meta-analysis." Journal of Clinical Medicine, Jan. 9, 2019. DOI: 10.3390/jcm8010064
  • Barberi S et al, "Hypertonic saline monotherapy in children with perennial allergic rhinitis: a pilot study." Journal of Biological Regulators and Homeostatic Agents, Jan-Mar. 2016.
  • Achilles N & Mosges R, "Nasal saline irrigations for the symptoms of acute and chronic rhinosinusitis." Current Allergy and Asthma Reports, April 2013. DOI: 10.1007/s11882-013-0339-y
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I use the saline rinse that comes with a large syringe with a tip that seals against the nostril. Works beautifully. I do, however, warn people that if it is for allergies, great, but not for colds. That only pushes infectious mucus further up into the sinuses.

Do you know a home remedy for a stopped up ear?

I have had seasonal allergies for my entire life. I was put on way too many different allergy medications for years, then I was put on allergy shots, for over 10 years. I started using a generic saline spray, morning, and night, and even sometimes when I’ve been outside for a while. It has saved me entirely! I no longer need allergy shots or any other medication at all! I buy a store brand of Saline Spray, with no other additives, it’s inexpensive, and no mess at all. I carry one in my purse at all times.

I’ve had allergic rhinitis all my life starting with a deviated septum and surgery to correct it as a teen. In my early thirties I went to an ENT specialist and had minor surgery to increase the airways which helped quite a lot. Since then I have been able to decrease my use of decongestants and use commercial nasal saline spray mostly daily especially in the spring oak pollen season.

My question / observation is about the Neti pot method. I used it before saline spray, and it burned so badly even though I used R O water, warmed and mixed with the prepackaged saline powder. It felt like a wasabi burn but much worse?

I too have been using Neilmed sinus rinse for years, and it is the best I have tried thus far. Thank you for all your good information. At age 87 all GOOD help is very appreciated. May you and yours have a blessed day every day.

I use the sinus rinse daily but use regular warm tap water with the prepackaged saline. I have never had a problem, and the rinse works wonders. My question is do I need to use purified water? I haven’t had a problem so far.

I can’t sing high enough praises for NeilMed. I get really congested from allergies in the spring and summer and I hate taking allergy meds because they make me feel terrible, disrupt my sleep, and do little more than temporarily dull the symptoms. I’d tried a conventional neti pot and disliked it for the awkwardness and messiness. Then I tried NeilMed and it was so easy and different. Most of all, when I get congested and use the NeilMed, not only do I feel better immediately, but the effectiveness of cleansing my nasal passages and sinuses last much longer than what I experienced with allergy meds without the negative impact of the meds. I haven’t used allergy meds for years now.

I have used the a popular OTC sinus rinse for years. It is a real life saver during allergy season. All it does is squirt saline water up your nose. No drugs. It even seems to help when I feel a cold coming on.

Please use boiled water that is cooled down when using your Neti-pot. We had an incident in the Seattle area a few months ago when a woman used tap water and later died because of an amoeba infection. It was thought to have come from her use of the neti-pot with tap water, and the microbes migrated to her brain. Boil the water! Thanks

I use the Sinugator, a product made by NeilMed, that uses a pump to help push the saline solution (I buy their convenient prepackaged mix of salt and sodium bicarbonate). It is my go to when I get a cold and really helps me breathe and removes the build up of the phlegm . I had not considered it for allergy prevention, but will do so now! Thank you for your always-worth-reading emails!

Re: the comment about using tap water in a netti pot. I am wondering IF is safe to do so. I had read articles , as I understood it, not to use tap water (it was not safe). I buy distilled water for this. It would definitely be economical and easier to use tap water.

NOTE: I had sinus congestion for years. Interesting that this year I got a runny, drippy nose. My throat was getting sore etc. I tried the Nasacort that was recommended here. Wow!! It worked. Such a wonderful steroid- free product. Not easy to find in stores, but worth the search.

Found that using a neti pot also relieved ear congestion. Don’t know how, but was grateful for the relief.

Everytime I went to bed and laid down flat my nose would clog up. Using Afrin was a disaster if used more than 1 or 2 days in a row. When I stopped using it my nose clogged up worse than ever. Had to sleep in a recliner chair for two months to get the nose to stay open at night. This also happened to someone I know. It took him over 2 months in a chair to recover.
Now my ENT Dr. told me to use a pressurized saline spray 2 or 3 times a day. After about 3 days my nose stayed open by itself. Worked great. I use the spray now once or twice a day–the nose is fine now at night. One can of spray was cheap and will last for months.

I’ve had sinus and allergy problems for years. For about $1.50, you can buy a small bottle of saline spray. I’ve found that it helps my symptoms, though I often still need to take an antihistamine.

About 10 years ago I attended a lecture on nasal irrigation where an MD reported on greatly-reduced sinus infections in children who irrigated daily. I bought a unit which I use daily. No more nasal congestion for me. Now I make my own mixture using 7 parts sea salt to 5 parts baking soda, and I add this to the lukewarm water in my Neilmed squeeze container. Yes, it is noisy and messy but this really makes life so much easier, especially in allergy season.

I found that when I stopped reclining in my recliner and started only sitting in an upright position that my allergies AND asthma improved tremendously. When I do get a stuffy/itchy nose, I use NasalCrom.

Definitely works!!! I went from chronic sinus infections to ZERO sinus infections or colds.

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