Final answer:
The most appropriate initial treatment for sinusitis symptoms lasting around 4 days is symptomatic relief with pain relievers and nasal irrigation.
Step-by-step explanation:
The most appropriate initial treatment for a patient presenting with sinusitis symptoms persisting for around 4 days is E) Symptomatic relief with pain relievers and nasal irrigation. Sinusitis is commonly caused by viral infections, and antibiotics are not typically necessary unless there are signs of bacterial infection such as severe symptoms or longer duration of illness. Pain relievers such as acetaminophen or ibuprofen can help alleviate discomfort, while nasal irrigation with saline solution can help relieve congestion and reduce inflammation.