There are lots of issues that can cause nasal congestion. Everyone has experienced a stuffy nose at one time or another. But, many of our patients experience congestion day after day. Nasal congestion can have a big impact on quality of life. Many people with nasal congestion also have trouble getting restful sleep because of the congestion. Here are some of the most common causes of blocked nasal passages we treat in our office.

Sinus infections

Most people have nasal stuffiness when they have a sinus infection. Most routine colds are infections caused by viruses. Sometimes, people experience bacterial sinus infections. Both types of infections can cause swelling in the nose and lead to stuffiness. The good thing is that the stuffiness will get better once the infection resolves.

Deviated nasal septum

The nasal septum is made of cartilage and bone. It separates the two nasal passages. Almost everyone has a little bit of a deviated septum. All that means is that there might be a little curvature or bend in the cartilage and bone of the septum. In some cases, the deviated septum can be more pronounced. This can cause narrowing of one or both nasal passages. Surgery to repair a deviated septum is called septoplasty. This can be an option in cases when the symptoms from a deviated septum are severe.

Enlarged nasal turbinates

Turbinates are normal structures inside of the nose. They are made of bone and soft tissue. They are located next to the nasal septum. There is usually enough space for air to flow through the nose between the septum and the turbinates. Sometimes, the turbinates can become swollen enough to cause nasal blockage. A lot of people also notice that their nasal stuffiness gets worse when they try to sleep. That is often caused by night-time swelling of the turbinates.

Medications can help treat swollen turbinates in some cases. Surgery to reduce the size of the turbinates can be an option if medications do not help.

Nasal valve narrowing

The nasal valve is an area located right at the entrance of each of the nostrils. The size and shape of the nasal valve determines how much air can get through the nasal entrance. A narrow nasal valve can limit how well someone can breathe through the nose. The nasal valve can also “collapse” when someone tries to take a deep breath. Things like Breathe Right strips and Nasal Cones can help stretch the nasal valves open. Surgery can help widen narrow nasal valves if the issue is severe.

Nasal polyps

Nasal polyps are lumps of swollen tissue than can grow in the nose and sinuses. Swelling and inflammation in the sinus areas can lead to polyps. To treat polyps, it is important to treat the inflammation. Different types of medications can help shrink swollen polyps. Surgery to remove polyps can be helpful in cases where medications do not help. Polyp removal can be performed in the office or in the operating room.

Rhinitis medicamentosa

It may sound strange, but using nasal decongestant sprays can actually make nasal congestion worse. Nasal decongestants sprays have names like Afrin, oxymetazoline, and phenylephrine. There are lots of different brands, so it is important to look for the name of the active ingredient on the box or bottle. These sprays do work quickly and can help unplug a stuffy nose. The problem is that using these types of sprays for a more than a few days can make congestion even worse. That’s because using the sprays day after day causes something called rebound congestion. This means that the nasal congestion becomes even worse than it originally was.

The first step in treating rhinitis medicamentosa is stopping the decongestant spray. We sometimes see patients who have been “hooked” on nasal decongestant sprays for years. That can make it really hard to stop the sprays, but it is still an important first step. After the effects of the decongestant spray have worn off, other types of medications or surgery can help treat the issues that caused the nasal congestion in the first place.


Seasonal and environmental allergies are a common cause of congestion. Some people have congestion only when their allergies flare up at different times during the year. Others may have allergy issues year-round. Using over the counter allergy medications can help the nasal congestion that goes along with allergy issues. When that doesn’t work, having an allergy evaluation can be helpful.

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