A simple option for a sham procedure would be to give people cotton swabs that you claim are treated with medicine and have them stick one up their nostril for a couple seconds each day instead of using a neti pot. This would likely be enough to invoke a placebo response, which should be sufficient to act as a sham procedure.

That was 12 months ago. I haven’t caught another cold or sinus infection since. I used it every day while being treated with the antibiotics and nasal spray, and then backed down to once a week (on the admittedly half-baked theory that this would keep the crust from re-accumulating). Maybe this was just the magic 83rd time of taking that combination of drugs, but I have to suspect that the wild card of adding the sinus wash played a role in pushing the efficacy of the treatment to a higher level.

I called the doc to discuss it with her, and her take was that the saline wash a) physically clears the sinuses (including gradually removing the crust you mention); b) the baking soda helps make the pH level less hospitable to bacteria, and c) the salt helps shrink swollen mucous membranes.

I had no expectation of the sinus wash working, so I don’t think the placebo effect played a significant role in my recovery; in fact, I only realized after about 3 months that I had been well for the longest stretch of time since my teens, and looked back then and decided there might be something to this sinus wash business after all.

1. I have personally found nasal irrigation very effective during pollen season in Atlanta, which can be brutal for allergy sufferers. In past years, I would need antihistamines every day for three months to avoid acute suffering. Using a neti pot twice a day has alleviated symptoms, to the point that I take antihistamines only one or two days out of the entire season.

2. I have also found it useful for symptom relief when I am suffering from a common head cold. I don’t claim it shortens the duration of the cold (compared to what?), or that it is any way a “cure”. It does help me keep my sinuses clear without decongestants, of which I’ve never been particularly fond.

So what I’m wondering is if pouring the liquid in will clear out my sinuses more efficiently in the weeks after a bad cold, and thus make me more comfortable.

I love my neti pot! I use it to relieve congestion and pressure in my sinuses that result from colds or allergies. I don’t care if it prevents sinusitis or not, just getting that mucous flowing and out of my forehead is worth the price of ten neti pots.

My ENT cautioned me to wash it between uses (duh) because apparently a lot of people let them sit around for a long time and thus culture bacteria.

That said, the other thing I remember from the journal club was that the authors had done a small study looking at nasal saline lavage as a preventative measure. The study was stopped early because the patients were developing ear infections at a higher rate. So it seems that if you’re going to do nasal saline lavage, do it when sick and not healthy.