Understanding nasal blockages: Causes, symptoms and treatments (2025)

Nasal congestion is a common issue that can affect your quality of life, from difficulty breathing through the nose to sleep disturbance and chronic sinus issues.

In this article, consultant ENT surgeon Professor Jaydip Ray explains what causes nasal blockages, what symptoms to look out for, and the treatment options available.

What is a nasal blockage?

A nasal blockage, or nasal obstruction, refers to any condition that reduces or prevents normal airflow through the nose. It may affect one or both nostrils and can be temporary or persistent.

Common causes of nasal congestion

There are several underlying reasons why nasal passages become blocked, ranging from temporary infections to long-standing structural or inflammatory issues.

1. Viral infections

The most frequent cause of temporary nasal blockage is a viral upper respiratory infection, like the common cold or flu, as swelling of the nasal passages and increased mucus production can block airflow.

2. Allergic rhinitis

Allergic rhinitis is caused by allergens like pollen, dust mites, mould spores, or animal dander. The immune response leads to swelling of the nasal passages, sneezing, itching, and congestion.

3. Deviated nasal septum

The nasal septum is the cartilage and bone that divides the nasal cavity. A deviation in the septum, whether from birth or injury, can obstruct airflow on one or both sides of the nose.

4. Nasal polyps

These are soft, non-cancerous growths that develop inside the nasal passages, often due to chronic inflammation. Nasal polyps can grow large enough to significantly block airflow.

5. Sinusitis

Infection or inflammation of the sinus cavities (sinusitis) can result in nasal congestion, facial pressure, headache, and postnasal drip.

When symptoms persist for more than 12 weeks, the condition is classified as chronic sinusitis.

6. Enlarged turbinates

Turbinates are small structures inside the nose, lined with tissue that humidify the air we breathe. They can become enlarged due to allergies or irritation, and block the nasal passage.

What are the typical symptoms?

Nasal blockage may be accompanied by:

• Mouth breathing
• Reduced or altered sense of smell
• Facial pressure or headaches
• Snoring or disturbed sleep
• Postnasal drip (mucus dripping down the throat)

Diagnosis: When to see a specialist

If your nasal blockage lasts more than a few weeks, recurs frequently, or is associated with facial pain, recurrent infections, or nosebleeds, a referral to an ENT specialist is advisable.

Diagnosis may involve:

• Nasal endoscopy (a small camera to view inside the nose)
• Allergy testing
• CT scan of the sinuses

These investigations help determine the root cause and guide treatment.

Treatment options for nasal blockage

Treatments depend on the underlying cause and severity of symptoms and can be grouped into lifestyle measures, medical management, and surgical options.

1. Lifestyle measures

Allergen avoidance in allergic rhinitis is a key first step in managing nasal congestion. These measures aim to reduce mucosal inflammation by limiting exposure to known triggers:

• Minimise exposure to known allergens (pollen, dust mites, pet dander, and mould).
• Use allergen-proof bedding, maintain low indoor humidity, and consider air filtration where appropriate.
• Avoid environmental triggers that worsen symptoms like tobacco smoke and strong odors.

2. Medical treatments

For many patients, symptoms can be effectively managed with non-surgical treatments, such as:

• Decongestant sprays: for short-term relief, but not recommended long-term to avoid rebound congestion.
• Nasal steroid sprays: effective in reducing inflammation due to allergy or polyps.
• Antihistamines: useful in managing allergy-related symptoms.
• Saline rinses: help clear mucus and allergens from the nasal passages.

3. Surgical treatments

If medical management is ineffective, surgery may be considered:

• Septoplasty: to correct a deviated septum.
• Polypectomy: to remove nasal polyps.
• Endoscopic sinus surgery: to openup blocked sinus passages.
• Turbinate reduction: to shrinkenlarged turbinates andimprove airflow.

In some cases it may be necessary to continue with the medical treatment after surgery to clear the mechanical blockage of nasal air passages.

In summary, nasal blockages can stem from a variety of causes, some more serious or persistent than others. With timely and accurate diagnosis, effective treatments can help restore clear, comfortable breathing.

If you are experiencing persistent nasal congestion, consult with Professor Ray via his Top Doctors profile to explore the most appropriate treatment options for your condition.