Naranch, K, Park, Y-J, Repka-Ramirez, M S et al. · Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2002 · DOI
This study measured how sensitive people's sinuses and skin are to pressure pain across different groups: healthy people, those with sinus infections or allergies, and people with ME/CFS. The researchers found that people with ME/CFS had much more sensitive sinuses and skin overall compared to healthy people, suggesting that ME/CFS causes widespread pain sensitivity rather than actual sinus infection.
This study provides objective, quantitative evidence that sinus tenderness in ME/CFS may reflect generalized pain amplification rather than actual sinus disease, which could help clinicians avoid unnecessary sinus treatments and redirect focus toward ME/CFS-specific mechanisms. Understanding that ME/CFS causes widespread heightened pain sensitivity helps validate patient symptoms while clarifying that reported sinus symptoms may not require sinus-targeted interventions.
This study does not prove that sinus tenderness in ME/CFS is purely psychological or non-organic; it only shows that mechanical pressure sensitivity is globally elevated. The cross-sectional design cannot establish causation or whether hyperalgesia precedes ME/CFS onset. It also does not address whether ME/CFS patients have concurrent true rhinosinusitis requiring specific treatment.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Naranch, K, Park, Y-J, Repka-Ramirez, M S, Velarde, A, Clauw, D, & Baraniuk, J N (2002). A tender sinus does not always mean rhinosinusitis.. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery. https://doi.org/10.1067/mhn.2002.129038
BibTeX
@article{mecfsatlas-naranch-2002-tender-sinus,
author = {Naranch, K and Park, Y-J and Repka-Ramirez, M S and Velarde, A and Clauw, D and Baraniuk, J N},
title = {A tender sinus does not always mean rhinosinusitis.},
journal = {Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery},
year = {2002},
doi = {10.1067/mhn.2002.129038},
note = {PubMed: 12447232},
url = {https://www.mecfsatlas.com/evidence/naranch-2002-tender-sinus},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/naranch-2002-tender-sinus
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