Gravity therapy for sinusitis

When I say no it causes a scene

Because the truth is not what it’s been

     It’s a plus or a minus

     Antibiotics for sinus

Whether or not the mucus is green.

Sinusitis hit me in the winter and then spring of 1973.  At that time I lacked money for a car or for a doctor.  A bicycle carried me from point A to point B, and for weeks and then months the cold Colorado wind drove spikes of pain into my inflamed sinuses.

Poverty loves company more than even misery does.  I fixed a friend’s bike and in return I got the yoga treatment for sinusitis: hang your head upside down for five minutes.

It seemed hokey to me, but even if I had no money I had time, and per instructions I lay crossways on my bed, face down, with my mid-chest hitting the edge of the bed.  I relaxed and, sure enough, the top of my head pointed at the floor.  Four minutes later I felt a pop around my eyes and gross brown liquid drained out my nose by the teaspoon.  When I stood up my sinus headache had disappeared.

At the time I knew no anatomy nor physiology; I had no idea that the sinuses under the eyes drain uphill, and when a cold or allergies attack the outflow becomes blocked by swollen tissue. 

Medical school physical exam taught us to apply pressure on the cheekbones if we suspected sinusitis; if the patient experienced relief, they said, antibiotics would probably cure the problem.  One day in the late ‘80’s while performing that maneuver, I heard a loud squeak, gurgle, gurgle, and the patient experienced immediate relief.  Since then I’ve tried the same technique hundreds of time and never replicated the results, though about a third of the patients will experience some improvement.

Decades ago the truth about sinusitis ran something like this: antibiotics only help if the mucus is green.  Since then, we’ve found out that sinusitis gets better 85% of the time with antibiotics and 75% of the time without them.  Which means that for every one person I really help with amoxicillin, seven others took the medication for no good reason.  Oh, and color of mucus doesn’t make any difference.

In my current position I’m seeing a lot of “sinusitis” and I don’t prescribe antibiotics.  The medical profession did such a great job selling the public on the need for those drugs for this diagnosis that unselling becomes problematic. 

I can write a prescription for the latest -cillin or -mycin much faster than I can explain to a patient why they don’t need it; naturally there are those docs who find themselves behind schedule and cave in to the pressure from the patient.

Re-education for physicians and the population will take time.


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18 Responses to “Gravity therapy for sinusitis”

  1. commorancy Says:

    Letting gravity do the work alone to drain sinuses is only about half the answer. If there is no pressure in the sinus, it may not drain on its own. The only way to make that happen is if you force pressure into the sinuses through the Valsalva maneuver with the head pointed downward. This will force pressure into the sinus like blowing up a balloon. The pressure going in will force the liquid out. Eventually, all of the liquid will vacate and the pressure will equalize to normal leaving a drained sinus.

    I have to do this at the end of every sinus cold to clear out my lower sinuses. There is no other way to do this easily. Sometimes it is even necessary on upper sinuses. If I try gravity alone, it won’t work. I combine gravity (moves the liquid towards sinus exit) with the Valsalva maneuver (insert pressure to force it out). This is guaranteed to clear the sinuses as long as the sinuses aren’t so inflamed that the Valsalva won’t work, in which case you’ll need something to reduce the inflammation first (i.e., Flonase).

    • Blaise DeAngelo Says:

      How exactly do you perform the Valsalva technique?

      I just hung upside down for 5 minutes and experienced no drainage or movement.

      I tried the Valsalva technique, exhaling for as long as I could without fainting, and still experienced zero drainage or movement.

      Now I have a bunch of bursted blood vessels all over my eyes and face.

      Please please please, any information whatsoever is helpful.

      I have been suffering these daily sinus headaches and constant throbbing pressure for my entire life and can’t bear it any longer.

      Feel free to email me at if that is easier.


      • walkaboutdoc Says:

        You need to see your doctor. Burst blood vessels in response to 5 minutes upside down is not normal. I would not recommend the Valsalva maneuver at all for sinusitis.

  2. M Hobbs Says:

    Thank you for this concise and well written article. Over the years I’ve taken antibiotics many times to treat sinusitis, and I’ve found I do just as well to inhale steam, take an anti-inflammatory, and find a position that facilitates drainage. I’ll try hanging face-down off my bed this morning.

  3. ericjs Says:

    You might also try a 90 degree angle instead. One theory is that the maxillary sinus is still built for a quadrupedal posture.

  4. midwest Says:

    I’ve had dozens of acute sinusitis infections in the past; I still get them all the time. They *never* go away on their own. In fact, they get so bad that I start blowing copious amounts of blood out of my nose

  5. midwest Says:

    and the only way to make it go away is a course of antibiotics. Sure, I can wait a week or two or three and be miserable the entire time. Or I can take an antibiotic right away and feel better in 48 hours. I think you are doing your patients a disservice by letting them suffer through an acute sinusitis infection by telling them it’s just going to go away.

    • walkaboutdoc Says:

      We will agree to disagree. Large scale studies show that number need to treat (NNT) to help one case of sinusitis with antibiotics is 8, but the number needed to harm (NNH) is 5. So that the chances of hurting the patient with antibiotics is greater than the chance of helping. Current recommendations are to avoid antibiotics in sinusitis in the absence of fever, symptoms longer than 7 days (some studies say 10 days), or second sickening (where the patient had been getting better and started to get worse).

      If you really have had dozens of sinus infections, you should probably see an ENT specialist. And, by all means, if you smoke, you should stop.

  6. Blaise DeAngelo Says:

    HELP! I am a longtime sinus sufferer and was hoping this method would help me.

    I hung upside down as you described for 5 minutes and nothing.

    Then I Tried the Valsulva technique as one commenter described and still nothing (after a few seconds of the Valsulva the pressure became too much and I feared I would faint so I stopped).

    I did some massage of the maxillary sinuses and returned to hanging upside down and still nothing.

    I remained upside down for probably 30-45 minutes, thinking it may just take longer since I’ve never done it before.

    I experienced zero drainage, did not feel any mucus moving around whatsoever, and now I have tons of bursted blood vessels all over my eyes and face.

    What am I doing wrong?

    Please help – I can’t bear the daily headaches and constant throbbing pressure all around my head any longer.

    Thank you all for your time

    • walkaboutdoc Says:

      My experience with gravity drainage is that if it hasn’t helped in the first 5 minutes it’s not likely to. You really need to see your doctor, and soon. Your headaches are probably not sinus related.

  7. Blaise DeAngelo Says:

    Thank you for your response. I should have mentioned this earlier, but I am fairly certain the headaches are sinus-related because I have a constant post-nasal drip and I get sinus infections 3-5 times per year. I feel the most pressure in the maxillary sinus area. It is good to know that the upside-down technique is not recommended longer than 5 minutes. I can’t figure out why no “self-draining” techniques are working for me, yet I still have sinus pressure.

    • Blaise DeAngelo Says:

      I also should have mentioned that I hung upside down for about 45 minutes, not just 5. I’m sure the bursting came from the 45 minute duration and alternating Valsalva breathing.

      • walkaboutdoc Says:

        Please, as soon as possible, go see your doctor. We cannot be certain your headache is from sinus problems. Even if your headache is from sinus problems, failure to resolve promptly may mean a more serious, possibly life-threatening condition.

  8. Gloria Says:

    Sinus headaches are also relieved by flushing sinuses with a salt water solution. This helps clear out the gunk and also restores moisture to the area. At the first sign of allergy season, using a sinus rinse clears things up 9 out of 10 times for my family. Not recommended to just use water, as this will burn and not be the proper PH needed to restore balance. There is plenty of online information about making your own salt water solutions, or you can buy the kits that come with Netti Pots or other containers at most major stores or pharmacies.

  9. Jane Says:

    Hi! I have had sinus pressure/dizziness and post-nasal drip for 4 months now. I saw two ENTs who gave me two rounds of antibiotic and 1 round of steroid, still nothing. Scan shows that my right maxillary is full of gunk and etmoid/spenoid are partially thickened. The head fullness is driving me crazy… I have balance problems too.
    I research for every technique that would help me drain my blocked maxially sinus, so far no success. My ENT said the gunk cant come out on its own, because it is not liquid, but a gel-like substance. I will try your 5 min downhead tonight after the neti-pot treatment.

    I have been operated 3 times, so surgery is not an option. The sinus passage is sufficiently large according to the scan.

    Is there a way to thin out the gel in my sinuses? I drink and drink…

    • walkaboutdoc Says:

      It sounds like my usual standby for thinning nasal secretions, saline nose drops/horseradish/hydration, would not be appropriate for you. If you’ve already had sinus surgery 3 times, you really need to stick with the specialist.

  10. John Johnstom Says:

    I breath the steam of boiled pot of water that has 3 drops of oil of oregano for 5 minutes. Then nasal rinse. Then hang head down over the side of a bed and blow nose. This gets it all cleared out for me.

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