Why Nasal Congestion Happens—And How to Treat It

Depending on what’s causing your stuffy nose, there are at-home, over-the-counter, and prescription remedies available as treatment.

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Nasal congestion is commonly known as stuffy nose. It can cause an uncomfortable feeling and difficulty breathing through your nose.

Congestion happens when tissue lining the inside of the nose swells up due to inflammation or engorged blood vessels. This inflammation is the body’s way of reacting to something like a virus, bacterial infection, allergen, or medication. 

Though most cases of nasal congestion go away on their own within a relatively short period of time, it’s helpful to know that there are various treatment options that can help you clear up unpleasant stuffiness as quickly as possible. 

Causes


Experiencing a stuffy nose is typically associated with common illnesses like a cold, but having nasal congestion doesn’t automatically mean you’re sick. There are many causes of nasal congestion, a symptom that drives millions of healthcare outpatient visits per year in the U.S.

Cold


Nasal congestion is one of the hallmark signs of the common cold.

When you’re exposed to a cold virus, the nasal passages can get irritated and inflamed—leading to congestion that usually lasts up to two weeks. You’ll likely realize your stuffy nose is the result of a cold when you also experience other common cold symptoms like sneezing, sore throat, and coughing.

Flu

Similar to how they can cause a cold, viruses can also cause influenza, or the flu, and prompt a stuffy nose.

But while both illnesses share nasal congestion as a common symptom, flu symptoms overall tend to feel more severe than a cold. With the flu, you might also experience a high fever, fatigue, and body aches or pains in addition to the stuffiness. 

Sinus Infection

A sinus infection—medically known as sinusitis—happens when there are bacteria and fluid buildup in the sinuses, which are pockets of air just behind the face. The resulting inflammation irritates the nasal passages, which is why you end up with congestion. 

Other symptoms you might notice with a sinus infection can include facial pain or pressure, headache, runny nose, sore throat, cough, and postnasal drip (when excess mucus from the sinuses drips down the back of your throat).

Allergies

For the roughly 50 million people in the U.S. who live with allergies, nasal congestion is a familiar occurrence.

Allergies are an immune system response to external substances like dust mites, mold, pet dander, grass, and pollen. When these allergens enter the nasal passages, it causes the inflammation that leads to congestion.

Other telltale signs of allergies can include sneezing, watery eyes, runny nose, rash on the skin, and swelling.

Nasal Polyps

Nasal polyps are noncancerous tissue growths inside the lining of the nose and are the result of chronic inflammation. When they grow large enough, nasal polyps can block the nasal passages and cause stuffiness. 

Additional common symptoms of nasal polyps can include headache, loss of smell and taste, runny nose, sinus pressure, postnasal drip, and facial pain. 

Certain Medications

There’s also the chance that your stuffiness is the side effect of a medication. Research suggests that long-term use of medications that affect the nervous system—like blood pressure regulators, ibuprofen and similar pain relievers, and certain nasal decongestant sprays—can bring on congestion. 

If you think this might be the culprit, be sure to check with a healthcare provider before stopping any prescribed medications. 

Treatment 


Before treating a stuffy nose, it’s a good idea to find out the cause of the congestion. Specific treatment options—like home remedies, over-the-counter (OTC) medications, or prescription drugs—can differ slightly based on the cause. 

Home Remedies for Congestion

You might start by trying one or two of several simple home remedies that can help manage nasal congestion. At-home treatments for congestion include:

  • Drinking plenty of water and other fluids to stay hydrated, making mucus thin and easier to drain
  • Inhaling hot steam in the shower to help open up the nasal passages and clear congestion
  • Using a humidifier to keep nasal passages moisturized
  • Staying elevated by standing or sitting up instead of lying down whenever possible to help drain mucus
  • Placing a warm, damp washcloth along the face to gently ease inflammation
  • Trying ginger extract in hot tea for congestion due to allergies
  • Avoiding triggers (like pollen or pet dander) if your stuffiness stems from allergies
  • Prioritizing rest and sleep for cases of viral congestion to speed up the healing process

Over-the-Counter Remedies

Several OTC remedies boast stuffiness-clearing properties. Consider the following options if they align with the cause of your congestion: 

  • Saline nasal decongestant spray or steroid nasal spray: These can help ease inflammation in the nasal passages. Just be sure to follow instructions on decongestant nasal spray use and limit its use to three days to avoid triggering a rebound of your congestion that is even worse than the original congestion—also known as rhinitis medicamentosa.
  • Neti pot rinse: Fill the container with purified, filtered, or boiled water to help clear nasal passages.
  • OTC decongestants: These medications can shrink inflamed blood vessels and drain the sinuses. If you have hypertension, speak to a healthcare provider first because these medications can raise blood pressure. 
  • OTC antihistamines: These medications can mitigate the immune system reaction. For sinusitis cases, steer clear of this option, which may dry out the sinuses too much. 
  • Nasal adhesive strips: Wearing the strips, particularly while sleeping or lying down, can help open nasal passages and alleviate congestion. 

Prescription Drugs 

Depending on the cause of the congestion, you might need a prescription medication to relieve your stuffiness.

For instance, if your congestion is due to allergies, your healthcare provider might prescribe a prescription allergy medication. If you have nasal polyps due to bacteria, your healthcare provider might prescribe you antibiotics for treatment. 

When it comes to nasal polyps, medications alone might not successfully treat the polyps and clear up congestion. If that’s the case—or if the polyps are very large—you might need surgery to remove them.

Should I Be Worried About Congestion?

Experiencing a stuffy nose isn’t always cause for concern. Nasal congestion is often the result of a minor cold or might signal seasonal allergies.

But if you still can’t get rid of your stuffiness after three weeks of home and OTC strategies, it’s likely time to check with a healthcare provider. Long-lasting congestion might be hiding undiagnosed allergies, a bacterial infection, nasal polyps, nasal tumor, or another underlying condition.

See a healthcare provider if your nasal congestion is getting worse or happens along with:

  • High fever
  • Head injury
  • Blurred vision
  • Throat swelling or severe pain
  • Yellow-green, gray, or foul-smelling nasal discharge
  • Severe flu symptoms
  • Chest pain or trouble breathing

To get to the bottom of the congestion's cause, a healthcare provider will perform a physical exam before deciding if other tests, such as an allergy or blood test, throat culture, or sinus X-ray, are necessary. From there, a diagnosis and tailored treatment plan can follow. 

A Quick Review

Nasal congestion happens when the lining inside the nose becomes swollen, usually due to viruses, allergies, infection, nasal polyps, or the use of certain medications. 

Though many cases of nasal congestion are easily treated with home or OTC remedies, any stuffiness lasting longer than three weeks should be discussed with a healthcare provider. That’s because this common symptom can sometimes mask a more serious underlying issue, like an undiagnosed allergy or infection. 

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