You wake up feeling heavy-headed. Your ears feel clogged, your voice sounds strange, and your brain’s in a fog. It’s like you’re walking around underwater.
Sound familiar? You might be dealing with more than a cold or allergies—it could be chronic rhinosinusitis (CRS), an often-missed culprit behind persistent sinus and head pressure symptoms.
Understanding Chronic Rhinosinusitis
Chronic rhinosinusitis (CRS) is a respiratory condition characterized by prolonged inflammation of the sinus cavities that persists for three months or longer, even with attempted treatment. Unlike acute sinusitis that typically resolves within weeks, CRS is a persistent inflammatory condition.2
The onset of CRS varies considerably between individuals. Some experience a sudden appearance of symptoms, while others develop the condition gradually after an upper respiratory infection fails to resolve properly. In certain cases, CRS may initially manifest through concerning symptoms like intense headaches, facial discomfort, or visual disturbances, including double vision.2
Key Symptoms
Adults with CRS typically experience four primary symptoms:2
- Drainage from the front or back of the nose
- Nasal blockage or congestion
- Pain, pressure, or fullness in the facial area
- Absent sense of smell
For children, the diagnostic criteria differ slightly, with cough replacing the loss of smell as the fourth major symptom.2
People often report additional symptoms that may accompany CRS, including:2
- Persistent fatigue
- General malaise
- Sleep difficulties
- Ear discomfort or pressure
- Sensation of ear fullness or “underwater” sensation
- Dizziness
- Bad breath
Prevalence and Impact
CRS affects approximately 12.5% of American adults according to the American Academy of Otolaryngology. The condition can significantly diminish quality of life, affecting daily functioning, productivity, and overall wellbeing of those who suffer from it.4
Why CRS Feels Like You're Underwater
CRS often affects the Eustachian tubes, small canals that connect your ears to your throat. When the sinuses are inflamed, it can lead to fluid buildup and pressure changes in the ears. That’s what creates the muffled hearing or “full head” sensation.1
The result: You may feel like you’re underwater, on a plane during descent, or have trouble hearing clearly.
Research published in the Journal of Allergy and Clinical Immunology links CRS to balance problems, dizziness, and cognitive symptoms like poor concentration.1
What Causes CRS?
CRS is often triggered or worsened by:2
- Allergies or asthma
- Nasal polyps (noncancerous, soft growths that develop on the lining of the nose and sinuses)
- Environmental irritants (smoke, pollution)
- Immune system issues
- Recurrent infections
How Is CRS Diagnosed?3
If your head has felt heavy for more than 3 months, it’s time to talk to a specialist.
Diagnosis may include:
- A nasal endoscopy (tiny camera inside your nose)
- A sinus CT scan
- Allergy testing
ENTs (ear, nose, and throat doctors) are specially trained to diagnose and manage CRS.3
Treatment Options
- Nasal irrigation: Saline rinses (like neti pots) help flush mucus and allergens.
- Nasal steroids: Reduce swelling and improve drainage (e.g., fluticasone, mometasone).
- Biologics: Newer injectable meds can help if you have polyps or asthma too (e.g., dupilumab).
- Surgery: In some cases, endoscopic sinus surgery or balloon sinuplasty is needed to open blocked passages.
Conclusion
That “underwater head” feeling isn’t in your imagination—and it might not just be allergies or a cold. Chronic rhinosinusitis is a real medical condition that affects millions and can be managed with the right care.
If your head feels foggy, your ears feel full, and you’re always congested, don’t wait. Talk to your doctor or an ENT about CRS.
To learn more about CRS and to share your personal story, please click here to join the NOWINCLUDED chronic conditions circle.
References
- Brody-Camp, S., Risey, J. A., & McCoul, E. D. (2018). Vestibular Characteristics of Patients with Chronic Rhinosinusitis. OTO Open.
- Holbrook, E. H. (2025). Chronic rhinosinusitis: Clinical manifestations, pathophysiology, and diagnosis. In A. T. Peters, & D. G. Deschler, UpToDate.
- Kwon, E., & O’Rourke, M. C. (2023). Chronic Sinusitis. StatPearls.
- Rosenfeld, R., Piccirillo, J. F., Chandrasekhar, S. S., Brook, I., Kumar, K. A., Kramper, M.,Corrigan, M. D. (2015). Clinical Practice Guideline (Update): Adult Sinusitis. Otolaryngology–Head and Neck Surgery.
You Might Also Like:
Cholesterol-Friendly Taco Bell Hacks for Better Heart Health
Can you really “Live Más” at Taco Bell without sending your cholesterol soaring? Absolutely! With a few smart menu swaps, you can enjoy your Taco Bell favorites while sticking to heart-health guidelines.
Health, Heritage, and Healing at the Dallas Soul Food Festival
The conversations we had at the Dallas Soul Food Festival were both insightful and moving, revealing the diverse ways individuals navigate health challenges and the importance of cultural context in healthcare. Learn more.
