Nasal obstruction is a feeling that air is not flowing freely through one or both sides of the nose. It may feel like congestion, tightness, or fullness inside the nose. Some people experience temporary symptoms during a cold or allergy flare-up. Others experience a blockage that persists because of inflammation or a structural problem within the nose.

Nasal obstruction may affect your breathing, sleep, sense of smell, and ability to exercise comfortably. Identifying the cause is important because different nasal conditions may cause similar symptoms but require different treatment.

What Does Nasal Obstruction Feel Like?

Nasal obstruction may affect one side, alternate between sides, or involve both sides of the nose.

Possible symptoms include:

• A persistently blocked or stuffy nose
• Difficulty breathing through one or both nostrils
• Uneven airflow between the nostrils
• Mouth breathing
• Snoring or noisy breathing
• Reduced sense of smell
• A runny nose or post-nasal drip
• Dryness or crusting inside the nose
• Facial pressure
• Difficulty sleeping comfortably
• Feeling more breathless during exercise

The symptoms may be constant or worsen at night, show up when lying down, during exercise, or flare up with exposure to allergens and irritants.

What Causes Nasal Obstruction?

Nasal obstruction can be caused by allergies, soft tissue swelling, structural narrowing, or a combination of conditions.

Allergic Rhinitis

Allergies are a common cause of a blocked nose. Dust mites, pollen, pet dander, smoke and strong fragrances may cause the nasal lining to swell.

Symptoms may include sneezing, itching, a runny nose, and congestion.

Enlarged Turbinates

Turbinates are structures inside the nose that warm and humidify the air. They may become swollen due to allergies, infection, or irritation, making the nasal passages narrower.

Deviated Nasal Septum

The nasal septum is the wall between the two sides of the nose. If it is bent or has shifted to one side of the nose, it may reduce airflow through one or both nostrils.

A deviated septum may be present from birth or develop after a nasal injury.

Nasal Valve Narrowing

The nasal valve is the narrowest part of the nasal airway. If it is weak or narrow, the side of the nose may pull inwards when breathing, especially during exercise, thereby restricting airflow.

Sinus Inflammation or Nasal Polyps

Long-term sinus inflammation and nasal polyps may block airflow and cause facial pressure, nasal discharge, or a reduced sense of smell.

More than one condition may be present at the same time. For example, a patient with a deviated septum may also have allergies, and this can cause airflow to feel even more blocked.

Is It Normal for One Nostril to Feel Blocked?

Airflow naturally changes between the left and right nostrils throughout the day. This is known as the nasal cycle.

However, you should consider an assessment if:

• The same nostril remains blocked most of the time
• The blockage affects sleep or exercise
• Symptoms continue after a cold has cleared
• The nose appears crooked
• Symptoms started after an injury
• Nasal medicines do not provide enough relief

How Is Nasal Obstruction Diagnosed?

An ENT specialist will ask about your symptoms, such as:

• Which side of the nose feels blocked
• How long the blockage has lasted
• Whether it comes and goes
• Whether it worsens at night or during exercise
• Whether you have allergies, sinus symptoms or a previous nose injury
• Which treatments you have already tried

The specialist will then examine the inside and outside of your nose to look for swelling, narrowing, or structural changes.

How Is Nasal Obstruction Treated?

Treatment depends on what is causing the blockage. If allergies or swelling are narrowing the nasal passages, treatment may include saline rinses, antihistamines, or a prescribed nasal spray. These can reduce inflammation and improve airflow.

However, medicines may not fully relieve nasal obstruction caused by structural changes to the septum, nasal valve, cartilage, or supporting framework of the nose. When these areas are affecting airflow, surgical treatment such as septoplasty or septorhinoplasty may be considered.

When May Septorhinoplasty Be Considered?

Septorhinoplasty may be considered when nasal obstruction is caused by structural problems affecting the internal airway, supporting structures, or shape of the nose.

This may include:

• A deviated septum with a crooked nose
• Nasal valve narrowing or collapse
• Changes following an old nasal injury
• Weak or poorly positioned nasal cartilage
• Persistent structural blockage that has not improved with appropriate medical treatment

The procedure may involve surgically repositioning the septum and adjusting the nasal bones or cartilage to improve airflow and support.

An ENT specialist will assess whether the obstruction is caused by swelling, structural narrowing, or both before discussing surgery.

When Should You See an ENT Specialist?

Consider seeing an ENT specialist if:

• Your nasal blockage does not improve
• You often breathe through your mouth
• You have frequent nosebleeds or sinus problems
• Your nose looks crooked or pulls inwards when you breathe
• Nasal sprays or allergy treatment have not helped

If you are struggling with persistent nasal blockage or breathing difficulties, the team at Nobel ENT is here to help. Dr Fung Chak Yuen provides comprehensive assessment and treatment for a wide range of nasal and sinus conditions.