There are lots of issues that can cause nasal congestion. Everyone has experienced a stuffy nose at one time or another. But, some people 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. Some infections are caused by bacteria. Both types of infections, viral and bacterial, can cause swelling in the nose. This causes nasal stuffiness. The good thing is that the stuffiness will get better once the infection resolves. The problem can become chronic if someone develops chronic sinusitis after viral or bacterial sinus infections.

Deviated nasal septum

The nasal septum is the wall that separates the right side of the nose from the left. It is made of cartilage and bone, covered by a membrane lining. No one has a perfectly flat and straight septum. Almost everyone has a little bit of what’s called a deviated septum. 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 pronounced. That causes narrowing of one or both nasal passages. Sometimes, surgery is necessary to repair a deviated septum. Septoplasty is the name of the procedure to repair a deviated septum. 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. This happens because the turbinates typically swell at night when we’re lying down.

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. Nasal polyp removal can be performed in the office or in the operating room.

Rhinitis medicamentosa

Rhinitis medicamentosa is when someone has nasal irritation and congestion from use of nasal sprays.

It may sound strange, but some nasal sprays excessively can make nasal congestion worse. Using over the counter nasal decongestant sprays can cause this issue. Nasal decongestant sprays have names like Afrin, oxymetazoline, and phenylephrine. There are lots of different brands, so it is important to look for the brand name and the generic name on the box or bottle. These sprays usually work quickly and work really well to unplug a stuffy nose. But, it’s important to not use these sprays for more than a few days. Using these types of sprays for a more than a few days causes worsening nasal swelling and congestion. That’s because these nasal sprays, day after day, cause something called rebound congestion. As soon as the effects of the spray wears off, the nasal swelling and congestion becomes even worse than they originally were.

The first step in treating rhinitis medicamentosa is to stop the decongestant spray. Some patients can become “hooked” on nasal sprays and use them for many years. That can make it really hard to stop the sprays, but it is still the first thing to do. Stopping the nasal spray can help the inside of the nose become healthier again. Some people still have a lot of stuffiness after they stop the sprays. After the effects of the decongestant spray have worn off, other treatments can help treat the nasal stuffiness. This can include other medications in some cases, or nasal surgery in others.


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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