Nasal Blockages: Causes, Symptoms and Treatment Options

Struggling with constant nasal congestion, a runny nose, post-nasal drip, or sinusitis? Inflammation within the nasal cavity is very common in the United Kingdom and can have a significant impact on your quality of life. Fortunately, there are a number of effective treatment and management options. Getting the best result from any treatment first requires an accurate diagnosis of the underlying cause and identifying which symptoms are affecting you most.

What are the common causes of nasal blockage?

Nasal blockages can be caused by a variety of conditions, including allergies, sinus infections, structural issues (such as a deviated septum), nasal polyps, or long-term inflammation. The primary cause or combination of causes can be determined using a mix of diagnostic tests.

The most common causes include:

• Environmental allergens (allergic rhinitis)

• Persistent or slow-to-resolve blockage following a severe viral infection

• Recurrent infections occurring on a background of nasal obstruction

• Nasal polyps

• Structural deformities, sometimes as a result of previous trauma

How can the cause of my nasal symptoms be diagnosed?

Diagnosis always begins with a detailed discussion of your medical history. I’d ask about the duration of your symptoms, factors that make them worse or better, any previous injuries or trauma, and treatments you've already tried.

A physical examination would follow, including:

• Inspection of the outside of your nose

• Examination of the front part of the nasal septum

• Assessment of the anterior turbinates (the internal tissues within the nose)

Further investigations might include:

• Flexible nasendoscopy (a small fibreoptic telescope passed into the nose)

• Blood tests or skin prick tests to assess for allergies or inflammatory markers

These additional tests can provide valuable insights and help guide treatment decisions.

What are the treatment options once I have a diagnosis?

The specific treatment recommended depends on the root cause. Below are some common scenarios and approaches:

Allergic Rhinitis

• Allergen identification and avoidance

• Saline nasal washes

• Oral antihistamines

• Antihistamine or steroid nasal sprays

• Eye drops (if symptoms involve the eyes)

• Surgery to reduce excess tissue (note: surgery is not curative in allergic rhinitis and medical therapy is still required long term)

Chronic Rhinosinusitis

• Topical steroid nasal sprays

• Saline nasal rinses

• Occasionally antibiotics

• Stronger steroid drops when needed

• Surgery may be recommended if medical therapy does not sufficiently relieve symptoms

Nasal Polyps

• Caused by inflammation in the lining of the nose and sinuses, often linked to eosinophils (also involved in asthma)

• Long-term steroid therapy (usually via nasal sprays or drops) is the mainstay of treatment

• Oral steroids may be prescribed short-term to reduce polyp size, but they can have significant side effects and offer only temporary relief

• Surgery can be highly effective for large or obstructive polyps and may significantly improve quality of life

• Post-operative use of steroid sprays is important to reduce inflammation and reduce the risk of recurrence

Structural Deformities (e.g., deviated septum)

• In some cases, symptoms can be managed medically

• If necessary, surgical options include:

• Septoplasty – reshaping the nasal septum

• Functional septorhinoplasty – improving nasal function through reshaping the cartilage and bone

There are many other potential causes of nasal symptoms, each requiring tailored management plans. Treatment often follows a stepwise approach, starting with avoidance of triggers, moving through mild and stronger medications, and escalating to surgery if needed. Surgery is usually considered only after medical treatments have been tried.

Will a nose operation cure my snoring?

Snoring is a complex issue and usually involves multiple parts of the upper airway. However, many people will have experienced how snoring worsens during a heavy cold when the nose is completely blocked.

If you:

• Snore or have sleep apnoea

• Breathe through your mouth at night

• Have a severely blocked nose

…then unblocking your nose may improve your breathing and sleep quality. While snoring may not be fully cured, it’s likely to be reduced.

If you're struggling with CPAP (Continuous Positive Airway Pressure) therapy for sleep apnoea and also have nasal obstruction, ENT input is strongly recommended. The NICE guidelines (2021) suggest ENT review in patients with nasal blockage who are unable to tolerate CPAP.

If you have:

• Very large tonsils

• BMI <35

• Sleep apnoea

• Poor CPAP tolerance

…consider seeing an ENT surgeon. Tonsil removal can often provide significant relief. If you have nasal blockage, this should also be optimised.

Is mouth breathing bad for my health?

There’s a growing amount of discussion in the media around the potential negative effects of mouth breathing, and emerging evidence supports some of these concerns.

Mouth breathing—especially when it is secondary to nasal obstruction—has been linked to:

• Poor sleep quality

• Some behavioural issues in children (linked to disrupted sleep)

• Oral and dental health issues

Nasal breathing is important for filtering, humidifying, and warming air—and plays a key role in healthy sleep.

Summary

Nasal blockage is very common. It’s usually best to try to manage the condition without surgery where possible. The key to effective treatment lies in diagnosing the cause, then providing targeted and individualised therapies.

At an ENT appointment, we can:

• Discuss your symptoms in detail

• Examine your nose and sinus openings

• Make a diagnosis

• Create a personalised treatment plan

The goal is to maximise the health of your nose and sinuses—providing both short-term symptom relief and long-term care advice to help you stay well.