Why Is My Nose Blocked?

A Specialist ENT Guide to the Most Common Causes

A blocked nose is one of the most common symptoms we see at Hampshire ENT Clinics. For some people it’s occasional — during a cold or allergy season — but for others it becomes a persistent, frustrating problem affecting breathing, sleep, exercise, and quality of life.

The key to effective treatment is understanding what’s actually causing the blockage.

👃 The Most Common Causes of a Blocked Nose

1. Nasal Septum Deviation

The septum is the wall dividing the two sides of the nose. If it is bent or deviated, it can narrow one or both nasal passages.

Typical symptoms:

• One-sided blockage (often worse on one side)

• Long-standing difficulty breathing through the nose

• May follow injury or be present from birth

👉 Treatment: Septoplasty or functional septorhinoplasty if more complex

2. Nasal Valve Collapse (Often Missed)

The nasal valve is the narrowest part of the airway. If it weakens or narrows, airflow becomes restricted.

Typical symptoms:

• Blockage worse when breathing in

• Improves when pulling the cheek sideways

• Often persists after previous septoplasty

👉 Treatment: Functional septorhinoplasty with structural support

3. Enlarged Turbinates

Turbinates are structures inside the nose that warm and humidify air. They can become enlarged due to inflammation.

Typical symptoms:

• Alternating blockage

• Worse with colds or allergies

• Often responds partially to sprays

👉 Treatment: Medical therapy or turbinoplasty

4. Chronic Rhinitis (Allergic or Non-Allergic)

Inflammation of the nasal lining can cause ongoing congestion.

Triggers include:

• Pollen (hay fever)

• Dust mites

• Temperature changes

• Irritants (perfume, smoke)

Typical symptoms:

• Blocked and runny nose

• Sneezing, itching (if allergic)

• Post-nasal drip

👉 Treatment: Nasal sprays, antihistamines, ClariFix® for selected cases

5. Chronic Sinusitis

When sinus drainage pathways are blocked, inflammation builds up.

Typical symptoms:

• Facial pressure

• Thick mucus

• Reduced sense of smell

• Blockage lasting >12 weeks

👉 Treatment: Medical therapy or FESS (sinus surgery)

6. Nasal Polyps

Soft, non-cancerous growths inside the nose and sinuses.

Typical symptoms:

• Persistent blockage

• Loss of smell

• Mouth breathing

👉 Treatment: Steroids, surgery, or biologic therapy in severe cases

7. Acute Causes (Temporary Blockage)

Sometimes the cause is short-term:

• Cold or viral infection

• Sinus infection

• Ear/nose pressure changes

These usually settle within 1–2 weeks.

🔍 When Should You See an ENT Specialist?

You should consider specialist assessment if:

• Blockage lasts more than 4–6 weeks

• You can only breathe through one side

• You have reduced sense of smell

• Symptoms don’t improve with nasal sprays

• You have facial pain or recurrent infections

🩺 How We Diagnose the Cause

At Hampshire ENT Clinics, we use:

• Detailed history and examination

• Flexible nasendoscopy (camera inside the nose)

• Allergy assessment (if needed)

• CT scan for sinus disease

This allows us to identify the exact cause — not just treat symptoms.

🌟 The Key Message

A blocked nose is not just “one condition” — it can be caused by structural problems, inflammation, or sinus disease.

The good news is that most causes are highly treatable, once properly diagnosed.

📞 Book an Appointment

If you’re struggling with a blocked nose, help is available.

At Hampshire ENT Clinics, we provide expert assessment and modern treatments across Portsmouth, Winchester, Salisbury and the South Coast.

👉 Book a consultation today and start breathing properly again.

Blocked Nose – Frequently Asked Questions

Why is my nose always blocked on one side?

Persistent one-sided blockage is often due to a structural issue, such as:

• Deviated septum

• Nasal valve narrowing

• Localised swelling or polyp

Unlike inflammatory causes, this type of blockage is usually constant rather than fluctuating, and often requires structural treatment rather than sprays alone.

Why does my nose feel blocked but nothing comes out?

This is a very common complaint and usually reflects restricted airflow rather than mucus.

Common causes include:

• Septal deviation

• Nasal valve collapse

• Turbinate enlargement

In these cases, the problem is mechanical narrowing, not congestion.

Why do nasal sprays only help temporarily?

Nasal sprays reduce inflammation, but they cannot correct structural problems.

If sprays help but symptoms return quickly, it often suggests:

• A mixed problem (structure + inflammation)

• Underlying anatomical narrowing

This is where specialist assessment becomes important.

Can a blocked nose affect sleep and energy levels?

Yes — significantly.

Chronic nasal obstruction can lead to:

• Poor sleep quality

• Mouth breathing

• Snoring

• Daytime fatigue

Improving nasal airflow often has a noticeable impact on sleep and overall energy.

Why does my nose block more when I lie down?

This is usually due to normal nasal cycling combined with inflammation.

When lying down:

• Blood flow increases in the nasal lining

• Turbinates swell slightly

If your nose is already narrowed, this can make symptoms more noticeable at night.

What is nasal valve collapse and why is it often missed?

The nasal valve is the narrowest part of the airway and a common cause of obstruction.

It is often missed because:

• It doesn’t show on scans

• It requires careful examination

• Symptoms can mimic septal deviation

A key clue is improvement when pulling the cheek sideways.

Can I have more than one cause of a blocked nose?

Yes — and this is very common.

For example:

• Septal deviation + turbinate enlargement

• Nasal valve collapse + inflammation

• Polyps + sinus disease

Successful treatment often requires addressing all contributing factors, not just one.

Why am I still blocked after septoplasty?

This usually means the blockage was not only due to the septum.

Common reasons include:

• Unrecognised nasal valve collapse

• Persistent turbinate enlargement

• Ongoing inflammation

This is where functional septorhinoplasty may be required rather than repeat septoplasty alone.

When is surgery the right option?

Surgery is considered when:

• Symptoms persist despite appropriate medical treatment

• There is a clear structural cause

• Quality of life is significantly affected

The type of surgery depends on the underlying problem — there is no single operation for all cases.

What’s the difference between septoplasty and septorhinoplasty?

• Septoplasty: straightens the internal septum

• Septorhinoplasty: corrects both structure and airflow, including the nasal valve

Many patients with severe blockage actually need septorhinoplasty rather than septoplasty alone.

Can a blocked nose affect my sense of smell?

Yes.

Reduced airflow to the olfactory area or inflammation (e.g. polyps, sinusitis) can lead to partial or complete loss of smell.

Improving airflow and treating inflammation can often restore it.

Do I need a scan for a blocked nose?

Not always.

• Structural problems are usually diagnosed clinically

• CT scans are mainly used for sinus disease or complex cases

A scan is only arranged when it will change management.

Is a blocked nose ever something serious?

In most cases, no — but you should seek assessment if you have:

• Persistent one-sided blockage

• Bleeding from one side

• Facial pain or swelling

• Unexplained weight loss or other concerning symptoms

These are uncommon but important to rule out.

What is the most effective treatment overall?

The most effective approach is accurate diagnosis.

Once the cause is identified, treatment can be targeted:

• Medical (sprays, allergy treatment)

• Minimally invasive procedures

• Structural surgery when needed

There is no “one-size-fits-all” solution — and that’s why specialist ENT input matters.

What’s the biggest misconception about a blocked nose?

That it’s always due to “sinus problems” or “allergies”.

In reality, many patients have structural airflow issues, which require a completely different treatment approach.