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.