Blocked Nose That Won't Go Away: Common Causes & When to See an ENT

A blocked or stuffy nose occurs when the nasal passages become narrowed because the lining inside the nose is swollen or something physically obstructs the nasal airway.

Nasal congestion can occur with infections, allergies and inflammation. Structural problems can also make breathing difficult. If congestion continues, keeps returning or affects sleep and daily activities, it is worth identifying the cause.

1. Common Cold and Respiratory Infections

A cold can cause inflammation and increased mucus production inside the nose. Congestion usually improves as the infection resolves. If blockage continues after other symptoms disappear, another cause may need to be considered.

2. Allergic Rhinitis

Allergens such as dust mites, pollen, mould or pet dander can trigger nasal inflammation. Symptoms may include sneezing, a runny or itchy nose, watery eyes and postnasal drip.

3. Sinusitis

Sinusitis occurs when the tissues lining the sinuses become inflamed. Possible symptoms include nasal blockage, facial pressure, reduced sense of smell, thick nasal discharge, postnasal drip, cough and headache. Not every blocked nose is caused by sinusitis.

4. Deviated Nasal Septum

The septum separates the two sides of the nose. If it is significantly deviated, one nasal passage may become narrower. This can cause persistent obstruction, particularly on one side.

5. Nasal Polyps

Nasal polyps are soft, non-cancerous growths that can develop inside the nose or sinuses. They may cause persistent congestion, reduced smell, runny nose, postnasal drip and facial pressure.

6. Enlarged Turbinates

Turbinates help warm and humidify the air you breathe. When they become enlarged because of allergies or inflammation, they can narrow the nasal airway and make congestion more noticeable when lying down.

7. Overuse of Certain Nasal Decongestant Sprays

Using some decongestant nasal sprays for longer than recommended can cause rebound congestion, where the blockage returns or worsens after the medicine wears off. Consult a healthcare professional if you regularly rely on these sprays.

Nasal congestion may become more troublesome when lying down. Allergies, sinus problems, enlarged turbinates and structural abnormalities can make nighttime blockage more noticeable.

Nighttime congestion may contribute to:

• Mouth breathing and snoring.
• Dry mouth.
• Poor-quality sleep and frequent waking.
• Feeling tired during the day.

If nasal obstruction repeatedly interferes with sleep, identifying the underlying cause is more useful than relying only on temporary relief.

A chronic blocked nose generally refers to nasal obstruction that persists for a prolonged period or repeatedly occurs over time. Possible causes include ongoing inflammation, allergies, chronic sinus problems and structural abnormalities. An ENT specialist can assess the symptoms and examine the nasal passages to determine the likely cause.

Consider consulting an ENT specialist if:

• Nasal blockage persists or repeatedly returns.
• One side of your nose is consistently blocked.
• You have difficulty breathing through your nose.
• Congestion affects your sleep.
• You have persistent facial pressure or pain.
• Your sense of smell has decreased.
• You frequently experience sinus symptoms.
• You have recurrent nosebleeds.
• You regularly rely on nasal decongestant sprays.
• Symptoms interfere with daily activities.

Treatment depends on the underlying cause, so persistent symptoms deserve appropriate evaluation.

Seek prompt medical attention if nasal obstruction occurs with:

• Severe facial swelling or pain.
• High or persistent fever.
• Significant swelling around the eyes.
• Vision changes or severe headache.
• Repeated or heavy nosebleeds.
• New, persistent one-sided nasal obstruction, particularly with bleeding or other unusual symptoms.

These symptoms do not necessarily indicate a serious condition, but they warrant medical assessment.

An ENT specialist will ask about your symptoms, how long they have lasted and what makes them better or worse. The examination may include the nasal passages, septum, turbinates, sinuses and throat.

Depending on the suspected cause, additional investigations may include nasal endoscopy or imaging. Nasal endoscopy helps the specialist examine areas deeper inside the nose that may not be visible during a routine examination.

There is no single treatment that works for everyone. The appropriate approach depends on the cause of the obstruction.

Treatment for Allergies

Treatment may involve avoiding known triggers and using medicines recommended by a healthcare professional. Depending on symptoms, an ENT specialist may recommend nasal corticosteroid sprays, antihistamines or other appropriate treatments.

Treatment for Sinus Problems

Depending on the cause and duration, treatment may include saline nasal irrigation, appropriate nasal medicines and other measures. Antibiotics are not automatically required for every case of sinusitis because many sinus infections are viral.

Treatment for Structural Problems

Medication may not completely resolve significant structural obstruction. A severely deviated septum may require a procedure called septoplasty when symptoms are significant and other treatments are insufficient. Enlarged turbinates or nasal polyps may also require specific medical or surgical management.

Managing Chronic Nasal Inflammation

Long-standing nasal inflammation may benefit from medical treatment, allergy management and lifestyle measures. An ENT specialist can recommend an appropriate plan after evaluating the cause.

Some measures may help reduce nasal congestion:

• Manage known allergies and avoid triggers where possible.
• Wash your hands regularly to reduce respiratory infections.
• Avoid cigarette smoke and other nasal irritants.
• Stay adequately hydrated.
• Keep indoor environments reasonably clean.
• Use saline nasal rinses appropriately and with safely prepared water.
• Avoid prolonged or inappropriate use of decongestant nasal sprays.

Not every cause can be prevented, particularly structural conditions. If congestion keeps returning, seek evaluation to identify the cause.

No. A blocked nose can occur because of allergies, viral infections, a deviated septum, enlarged turbinates, nasal polyps and other conditions. Sinusitis may be considered when congestion occurs with symptoms such as facial pressure, reduced smell and nasal discharge. A proper diagnosis matters because treatment for allergies may differ from treatment for a structural nasal problem.