Hello James you seem to be suffering from acute
maxillary sinusitis. Signs & symptoms of maxillary sinusitis can appear suddenly & may either resolve on its own or can become severe, necessitating treatment.
The common symptoms are headache (fullness of head), pain over the maxillary sinus & nasal bridge (facial pressure),
nasal obstruction, bad smelling breadth & blood tinged nasal discharge.
Some may complain of
post nasal drip ( involuntary swollowing of mucus / pus).
Sinus normally contains air. When it becomes swollen & inflamed the increased pressure in the sinus cavity causes pain.
The symptoms usually begin in the later part of the day rather than early morning & that is why you feel fine in the morning. Also the symptoms like difficulty in breathing through nose (nasal obstruction) are usually relieved while lying down.
Presence of blood indicates active infection but there will never be an active bleeding. Boring of nose with nails will aggravate bleeding. The line of treatment is
1. X - Ray of paranasal sinus to rule out polyp.
2.
Macrolide antibiotics like
Azithromycin.
3. Anti inflammatory drugs like
Ibuprofen.
4. Anti allergy drugs like Levocetrizine .
5. Mucolytics like
Ambroxol.
If nasal block is severe, then nasal drops will help.