Can Rheumatoid Arthritis Trigger Chronic Sinus Infections? Find Out

Can rheumatoid arthritis cause chronic sinus infections? That’s a question I get more often than you’d expect—and one I’ve found myself digging into more than once both professionally and personally. As a Rheumatology Nurse Practitioner, I’ve seen patients raise their eyebrows at the connection between their relentless sinus pressure and their autoimmune condition. If you’ve ever battled both joint pain and non-stop sinus misery, you’re not imagining things. Let’s break this all down in a way that actually makes sense and doesn’t sound like a med school lecture.

Contents show

Wait—What’s the Link Between RA and Sinus Infections?

Let’s start with the basics. Rheumatoid arthritis (RA) is an autoimmune condition. That means your immune system, which is supposed to protect you, gets a little confused and starts attacking your own body. In RA, it primarily targets the joints—but that’s not the full story.

RA can affect so much more than just your knees or fingers. It can reach your eyes, lungs, heart—and yes, even your sinuses. From what I’ve seen in clinic, many patients with RA also deal with stubborn, recurrent sinus infections that just don’t seem to go away. Coincidence? Not really.

The Immunosuppressive Medication Factor

One major piece of this puzzle is the treatment for RA. Most patients are on some form of immunosuppressive medication—whether it’s methotrexate, biologics like Humira, or JAK inhibitors. These meds are amazing for calming down the immune system and reducing joint inflammation, but they come with a trade-off: your immune system isn’t as strong at fighting off infections.

Corticosteroids like prednisone can shrink inflammation but lower your ability to fight bacteria or viruses.
DMARDs (disease-modifying antirheumatic drugs) suppress your immune system to slow disease progression, but also weaken overall immunity.
Biologics target specific immune pathways, which means fewer side effects, but they still increase infection risk—especially sinus and respiratory tract infections.

I can’t tell you how many times a patient has come in with a lingering sinus infection and says, “It’s probably just allergies.” Sometimes it is. But sometimes, it’s their immunosuppressants making them more vulnerable to infection.

RA-Related Inflammation in the Sinuses?

Here’s something that surprised even me a few years back: there’s some evidence that RA-related inflammation can impact mucosal tissues—and yes, that includes the sinus linings. If your body is in a chronic inflammatory state, even your nasal passages can become more prone to swelling, obstruction, and infection.

One of my patients, let’s call her Maria, kept getting sinus infections every few months. We adjusted her RA meds, and with some additional ENT support, she finally got relief. Her case made me rethink how often sinus issues in RA patients are misattributed to seasonal stuff or just “bad luck.”

Chronic Sinus Infections: The Usual Suspects

So what exactly qualifies as a chronic sinus infection anyway? Technically, it’s when the sinuses are inflamed and infected for 12 weeks or more. But honestly, even if it’s not full-blown chronic rhinosinusitis, having 5-6 sinus infections a year is exhausting—and not normal.

Nasal congestion and pressure that never quite goes away
Postnasal drip—that annoying sensation of stuff dripping down the back of your throat
Facial pain, especially around the cheeks, eyes, and forehead
Fatigue (and not just from your RA)
Recurrent need for antibiotics that only work temporarily

All of this can be intensified in someone with RA. And if you’re also on meds that alter your immune system? The sinuses become an easy target.

What I Often Tell My Patients

If you’re an RA patient and you’re constantly dealing with sinus infections, don’t brush it off. I usually recommend getting checked out by an ENT, especially if it’s recurring. Sometimes imaging is needed to rule out structural issues like a deviated septum or nasal polyps.

But equally important? Re-evaluating your RA treatment plan. Maybe your immune system needs a break, or a shift to a different class of medication. And yes, I’ve seen improvement in sinus issues when we’ve made med changes—but it’s a balancing act, and everyone’s body is different.

RA, Chronic Sinus Infections, and the Bigger Picture

This isn’t just about sniffles and sinus pressure. Chronic sinus infections in someone with RA can be a red flag. It might signal that your body is struggling to keep up with infection control, that your meds are hitting your immune system a little too hard, or that your underlying inflammation is running high.

As someone who’s walked patients through these exact scenarios for years, I can tell you—when we look beyond the joints and see the full systemic impact of RA, patients start feeling more in control. Your sinuses might just be trying to tell you something bigger is going on.

How the Sinuses React to Chronic Inflammation

Now here’s something I’ve learned after working with countless autoimmune patients—chronic inflammation doesn’t stay in its lane. It’s sneaky. And your sinuses? They’re sensitive little cavities lined with mucosa that absolutely hate being chronically inflamed.

RA isn’t just about the joints swelling and hurting. When the immune system is constantly revved up, it spills over into other systems. Over time, this can actually lead to inflammation of the sinuses themselves, even without a classic infection. So yes, your immune system might be irritating your sinuses just because it’s confused and overreacting.

I had one patient who came in with dry eyes, a runny nose, and pressure around her cheeks. At first glance, it looked like allergies—but she wasn’t reacting to any known allergens. It turned out to be part of a bigger systemic inflammation picture, driven by her RA. Once we tweaked her treatment and added in some nasal anti-inflammatory options, her symptoms finally eased.

Chronic Sinus Issues or Secondary Sjögren’s?

Let’s not forget another major player here—secondary Sjögren’s syndrome. Many RA patients also end up with this sneaky co-condition. It’s another autoimmune disorder that affects moisture-producing glands. The result? Dry sinuses, dry mouth, dry eyes—and a perfect storm for chronic irritation and infections.

When the nasal passages are dry, the mucus membranes don’t function properly. Normally, they trap and flush out bacteria and irritants. Without that moisture, bacteria just hang out and multiply. It’s a great recipe for chronic sinus infections.

Increased crusting in the nose
Frequent nosebleeds
Persistent dry cough or sore throat
Feeling “stuffy” even when nothing is draining

I’ve had patients bounce back dramatically just by addressing their dryness. That might mean prescribing pilocarpine, using nasal saline regularly, or humidifying the heck out of their bedrooms. It’s not always about throwing antibiotics at the problem.

Diagnostic Clues: Is It RA, Infection, or Both?

One of the toughest things about these overlapping issues is figuring out what’s causing what. Is the chronic sinus congestion from inflammation? Infection? Medication side effect? Or maybe a mix of all three?

Here’s how I usually sort through it in clinic:

Look at timing: Is the sinus pressure seasonal or year-round?
Medication review: Have they recently started or increased an immunosuppressant?
Check for other autoimmune symptoms: dry mouth, joint swelling, fatigue
ENT referral: CT scans or nasal endoscopy can confirm chronic sinusitis or structural blockages
Labs: CBC to check white count (infections will usually cause it to rise), ESR/CRP for inflammation levels

One thing I always remind patients: don’t self-diagnose. You’d be surprised how many people assume sinus pressure = sinus infection, then get stuck in an antibiotic loop that doesn’t help at all. Sometimes it’s inflammation. Sometimes it’s medication-related dryness. And sometimes it’s actually bacterial—but knowing which is key.

When Antibiotics Aren’t the Answer

So many of my RA patients have told me things like, “I’ve been on five rounds of antibiotics this year and nothing changes.” That’s a major red flag for chronic non-bacterial sinusitis. Throwing more meds at it can actually cause more harm—like antibiotic resistance, gut issues, and masking the real issue.

If you’re constantly being told “just another sinus infection” and handed a script without a proper evaluation, it’s worth pushing for more. Don’t be afraid to ask for imaging, ENT referrals, or a deeper look into your immune status.

Tips I Share with My RA Patients Who Struggle with Sinuses

I’ve collected a little toolbox of strategies over the years that I share with patients struggling with sinus symptoms. Not everything works for everyone, but here’s a list I usually start with:

Use a saline nasal spray daily (especially during dry or cold months)
Get a humidifier for your bedroom—game-changer for many
Stay hydrated to keep mucous membranes functioning
Avoid overusing decongestants—they can actually make dryness worse
Talk to your rheumatologist about your meds if sinus infections are getting frequent
Ask your ENT if intranasal corticosteroids or antihistamines might help

And hey—if nothing else, keep a journal. I had one patient start tracking her sinus flare-ups and realized they were tied directly to when she took her methotrexate dose. That kind of self-awareness is gold when adjusting treatment plans.

The Emotional Toll: It’s Not Just Physical

I’d be remiss if I didn’t mention how mentally draining this can be. Living with RA is already tough. Add chronic sinus pressure, fatigue, and endless doctor visits on top of that? It can start to feel like a never-ending battle.

Some of my patients have told me they feel “high-maintenance” or “like a burden” because they’re constantly seeking help for something new. Let me be clear—you’re not a burden. Your symptoms are valid. And the sooner we figure out what’s driving them, the sooner you get relief.

If you’re dealing with this dual frustration of autoimmune pain and sinus misery, know that you’re not alone—and there is a path to feeling better. It just might take some detective work, teamwork between specialists, and a little bit of persistence.

When It’s Time to Rethink Your RA Management

Let’s be real—living with RA is already like juggling flaming swords. Now throw in a sinus issue that just won’t quit? It’s exhausting. But when chronic sinus infections become frequent visitors, it may be a sign that your current RA treatment plan needs a second look.

I’ve worked with plenty of patients who feel like they’re walking a tightrope. On one hand, their joint pain is under control. On the other, they’re constantly battling sinus infections or feeling “sickly.” It’s not an easy decision to change up a regimen that’s helping the joints, but if it’s impacting your quality of life in other ways, it’s worth reevaluating.

Here’s what I often suggest to patients when we reach this point:

Consider tapering steroids if you’ve been on them long-term—they can blunt immune defenses significantly.
Ask about switching biologic classes—some affect different immune pathways and may be gentler on your upper respiratory tract.
Use infection-prevention strategies like nasal hygiene, vaccinations, and routine ENT follow-ups.

One of my long-time patients, Carl, had amazing joint results on a TNF blocker, but he was getting sinus infections every 6 weeks. We ended up transitioning him to a different biologic, and not only did his sinuses calm down, his RA flares stayed at bay too. It took a few months to dial it in, but the improvement was night and day.

Could Surgery Ever Be an Option?

This is a question I hear occasionally—especially from those who feel like they’ve tried everything else. And the short answer is: sometimes, yes. If you’ve got chronic sinusitis that’s not responding to medications, and imaging shows blocked drainage pathways, endoscopic sinus surgery might help.

But—and this is a big one—RA patients need a careful surgical plan. Healing can be slower due to immunosuppression, and infection risk is higher. That’s why I always collaborate with the ENT and the rheumatologist before giving it the green light. It’s definitely not a first step, but it can be a game changer for the right person.

Is There Anything You Can Do at Home?

Absolutely. I’m a big believer in giving patients tools they can use outside the clinic. Managing RA and sinus issues doesn’t always require big interventions—sometimes the small, consistent changes are the ones that really stick.

Neti Pot or Sinus Rinse: Use sterile or distilled water only. Clears allergens and keeps passages moist.
Warm compresses: Helps with sinus drainage and feels pretty amazing when you’re stuffy.
Stay ahead of allergens: If allergies play a role, talk to your doc about antihistamines or allergy testing.
Support your immune system: Think balanced diet, sleep, and managing stress—your body notices when these are off.
Limit exposure to irritants: Smoke, strong scents, and air pollution can all flare up the sinuses.

Also, I always remind patients that managing RA isn’t just about physical health. Chronic illness can wear you down emotionally too, especially when you’re also dealing with overlapping conditions. If you’re feeling overwhelmed, don’t hesitate to speak with a therapist or join a support group. You’re not in this alone.

So… Can Rheumatoid Arthritis Cause Chronic Sinus Infections?

At this point, I think you know the answer: yes, it absolutely can. Between immune dysfunction, inflammation, medications, and secondary conditions like Sjögren’s, there’s a clear and complex connection.

But the good news is, once we recognize the link, we can start to tackle it. The key is working with providers who look at the whole picture—not just your joints or your sinuses in isolation. You deserve a treatment plan that takes all of you into account.

If you’ve been brushing off your sinus symptoms or stuck in a loop of antibiotics, let this be your sign to speak up. You deserve to breathe clearly—literally and figuratively.

Helpful Resources and Trusted References

Disclaimer

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with your healthcare provider or a qualified specialist about any medical condition or health concerns. The views expressed are based on clinical experience and research but should not replace personalized medical guidance.

Tarra Nugroho

Tarra Nugroho is a dedicated Nurse Practitioner with a strong foundation in family and preventive care. She brings both compassion and clinical expertise to her practice, focusing on patient-centered care and health education. As a contributor to Healthusias.com, Tarra translates medical knowledge into clear, empowering articles on topics like women’s health, chronic disease management, and lifestyle medicine. Her mission is simple: help people feel seen, heard, and informed—both in the clinic and through the content she creates. When she’s not caring for patients, Tarra enjoys weekend hikes, plant-based cooking, and curling up with a good health podcast.

Can Rheumatoid Arthritis Trigger Chronic Sinus Infections? Find Out