BLUF: Can anyone suggest a good remedy/sinus decongestant for sinus barotrauma?

I've experienced mild sinus barotrauma a couple of times and, what I'll call a severe occurrence once (felt as though someone was stabbing me in the forehead with an ice pick), over the past three years.

All times have been on commercial airliners only on descent from over an hour long flight. The most severe occurrence was on an overnight flight from the States to Europe; the entire descent was downright debilitating.

I've probably taken about 150 commercial flights over the last three years and only noticed it on about three of them. I've also piloted Cessnas below 8,000ft regularly over that period and had no issue. I don't remember being noticeably sick or congested during any of the occurrences. The pain is focused to just the area above my right eye, my right sinus frontalis.

I'm slightly concerned about a random severe episode with the more rapid altitude/pressure changes during UPT.  I've tried Afrin, which helps slightly, but not greatly.

Anyone else experience this or suggest a remedy?

Edited May 5, 20169 yr by Jumpseat18
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Afrin and Phenylephrine (Sudafed), but require temp DNIF--talk to your local Flight Doc.

7 minutes ago, deaddebate said:

Afrin and Phenylephrine (Sudafed), but require temp DNIF--talk to your local Flight Doc.

Thanks deaddebate. So if I go to the Flight Doc with symptoms, I'll be placed on temp DNIF, then what's the criteria to get flying again, just let time pass and try again?

Take the medicine, get better, stop taking the medicine, see the flight doc.

Have you tried using a sinus rinse?  Life changing as a pilot. Doing a sinus rinse every day really helps cut down on sinus issues as it flushes out most the allergens and junk that can lead to a sinus block when you don't have a cold.