Steam inhalation is not effective in relieving symptoms of chronic sinus congestion, according to new research.

The study, published in the CMAJ (Canadian Medical Association Journal), also showed that advice to use nasal irrigation, which is when the nasal cavity is washed to flush out mucus, did help relieve symptoms but had less impact than previous studies have shown.

Millions of people a year suffer from chronic rhinosinusitis or sinus infections.

To alleviate symptoms and as an alternative to the common treatment of antibiotics, which are often not effective and contribute to antibiotic resistance, steam inhalation and nasal irrigation are widely suggested.

The research team, led by Paul Little, professor of primary care research at the University of Southampton, conducted a trial involving 871 patients from 72 primary care practices in England who were randomly allocated the alternative treatments.

Little said: “The threat of global antibiotics resistance is very real and we need to find alternative ways of educating and treating people who do not need to have antibiotics. We have found that even a very brief intervention of a video showing patients how to use saline nasal irrigation can improve symptoms, help people feel they do not need to see the doctor to manage the problem and reduce the amount of over the counter medication the get.”

Patients who were instructed to use nasal irrigation showed improvement at three and six months as measured by the Rhinosinusitis Disabilty Index.

Steam inhalation did not appear to alleviate sinusitis symptoms apart from reducing headaches.

Given that the impact was less than in previous studies, which had used more intensive coaching in the use of nasal irrigation, the study authors suggested that further research was needed to understand how much coaching of patients is required.

Little added: “We found potentially important changes in other outcomes – particularly reduced headaches, reduced use of over the counter medication and reduced medicalisation, for example the belief in the need to see the doctor in future episodes.

“The evidence of reduced medicalisation is important in the longer term given most consultations result inan antibiotic prescription and the attendant dangers of antibiotic resistance.”