The common cold is caused by a viral infection in the upper airways, sinuses, throat and nose, although most apparent in the latter area. Uncommonly there may also be a fever. Despite the discomfort from the sneezing, sore throat, cough, and runny nose, happily it gets better on its own without requiring any special treatment, usually within a week—but sometimes a bit longer. At present there is no cure for this common illness. So, while waiting for it to disappear, what can we do to ease the symptoms without making things worse?
First, since they have no effect on the culprit viruses, contrary to the almost universal misconception, antibiotics should not be employed. Using them will neither shorten the cold’s duration nor prevent its spread to others. Moreover, the more we take antibiotics, the greater chance of producing resistant bacteria that could create mischief to others at a later time. Although delayed complications such as pneumonia are occasionally encountered in elderly individuals, an article published in the British Medical Journal counsels that fear of complications is not a good enough reason to prescribe antibiotics for the common cold. A better approach would be to consult a physician if the cold seems to persist for over a week, causes a moist cough, or produces a fever for more than one or two days.
What about echinacea, an herbal product that supposedly treats the common cold. Although there are only a limited number of controlled trials, there is no convincing evidence it is effective. The herb is probably safe, for prior studies show rates of side effects to be similar in echinacea and placebo groups. Thus with or without it, the cold will resolve within 1 to 2 weeks anyway. The same can be said for vitamin C, which has been extensively studied and offers no significant benefit.
Given the absence of any cures, what can we do to relieve symptoms during the illness? First, take plenty of liquids, especially water, to combat dehydration that may result from the cold, especially in children. Although I am a great believer in chicken soup, which can help to combat dehydration and help relieve subjective symptoms, there is little evidence that real benefit will accrue.
Another often overlooked simple method is the use of salt water gargle – if you make a solution consisting of ¼ teaspoon of salt dissolved in 8 ounces of warm water and gargle, your sore throat symptoms may be temporarily relieved, probably resulting from salt water’s ability to draw excess fluid from inflamed tissue. Applying saltwater to the nasal passages, done with nasal drops, may be useful for loosening thick mucus, making it easier to expel, especially for young babies. Nasal saline drops may be a useful alternative to salt solutions for gargling, a futile endeavor for babies and very young children.
Another old trick is the use of steam inhalation, which usually helps alleviate symptoms of congestion. You can half fill a pan with water and bring it to the boil. Place the pan on a sturdy table; make sure there is a towel or heat-resistant mat under it. Then sit with your head over the pan and cover yourself with a towel. Mechanical humidifiers, either with cold are warm steam, are also effective and easier to use.
Getting plenty of rest will not only help alleviate some of the symptoms, and make you feel less miserable, it may also reduce the duration of your cold. One should get plenty of rest for as long as symptoms persist, at least until abatement of the general sense of fatigue and malaise that often accompanies the cold. Remaining at rest is also important to prevent the spread of infection. As a rule of thumb, stay away from work or school while you do not feel well. When you can’t avoid proximity to others, cover your mouth with a tissue when you cough or sneeze, and throw it away into a trash can immediately, and wash your hands with warm water and soap.
What else can we do to relieve the symptoms? First, antihistamines have been a time-honored method to relieve the nasal congestion and promote easier breathing. Sedating (first generation) antihistamines may alleviate some cold symptoms, such as the watery eyes, runny nose, coughs and sneezes, but the newer agents, such as Allegra, Zyrtec and Claritin are less sedating and can be more useful.
Decongestants are medications that shrink the swollen membranes in the nose, allowing for easier breathing. There are oral or nasal decongestants, I prefer the nasal form, oxymetazoline (AfrinR) because each application lasts for several hours and tends to produce less “rebound” nasal congestion upon withdrawal. Nevertheless, persistent use for more than about five days might produce excessive nasal blockage. Patients with high blood pressure should use decongestants with caution, best accomplished under a doctor’s supervision.
Cough medicines, available in numerous forms, are generally not effective and, therefore, their use should be discouraged.
Although a high fever may not be desirable, a slight fever is not such a bad thing – it helps the body fight off infections more rapidly. When your body temperature rises, viruses (and bacteria) find it harder to reproduce, and this also seems to ramp up the body’s defense mechanisms. With the exception of very young patients, physicians no longer recommend trying to bring a slight fever down.
Painkillers (analgesics) may be helpful. The standard analgesics such as aspirin, acetaminophen (TylenolR), or ibuprofen (AdvilR), used for many years, produce relief of general aches. Aspirin should only be taken by adults, not children, especially very young ones.
So, the bottom line is simple: Hang in there; the cold will go away by itself. Just don’t make matters worse by over treating with useless remedies!