A blocked nose is a symptom rather than a diagnosis. It can occur with a cold, allergies, sinus inflammation, enlarged turbinates, a deviated septum, nasal polyps, or overuse of decongestant sprays. The duration, side affected, associated symptoms, and response to previous treatment help narrow the possibilities.
Look at the pattern and associated symptoms
Congestion that starts with a cold often improves as the infection settles. Itching, repeated sneezing, watery eyes, and symptoms that follow a season or exposure suggest allergy. Facial pressure, reduced smell, and nasal drainage may occur with sinusitis, while a persistent one-sided blockage deserves examination rather than repeated treatment without a diagnosis.
Ask yourself whether the obstruction switches sides, is worse when lying down, affects sleep, or is accompanied by bleeding, pain, or loss of smell. These details do not prove a cause, but they help the clinician understand the pattern. A single symptom, including the colour of mucus, cannot reliably tell whether antibiotics are needed.
How an ENT assessment helps
Assessment may include a review of allergy history, medicines and sprays, a nasal examination, and sometimes nasal endoscopy. Depending on symptoms, the clinician may evaluate the sinuses or other conditions. CT imaging is not routinely needed for simple congestion, but can help when chronic sinus disease or surgery planning is relevant.
Treatment is directed at the cause: allergy care for allergic inflammation, appropriate saline or prescribed sprays for selected conditions, or structural treatment when anatomy is the main problem. Repeatedly switching over-the-counter products without reviewing how they are used can delay the right diagnosis.
When persistent blockage should be checked
Arrange an assessment when symptoms persist for weeks, repeatedly return, disturb sleep, reduce smell, or do not respond to appropriate measures. A persistent one-sided obstruction, recurrent one-sided bleeding, facial numbness, or blood-stained discharge needs timely medical review, especially if it is new or worsening.
Seek urgent care for severe swelling around the eye, vision changes, severe headache with fever, confusion, or rapidly worsening illness. These are not typical features of uncomplicated nasal congestion.
Common questions
Does green mucus always mean a bacterial infection? No. Mucus colour can change during a viral illness and does not by itself establish a need for antibiotics.
Should I keep using a decongestant spray? Use it only for the period stated on its label or by a clinician; prolonged use of some sprays can worsen congestion.
Explore our ENT consultation page for more information about this care option. A clinician can advise based on the individual history and examination findings.
Related reading
- Deviated Septum: Symptoms, Diagnosis and Treatment Options
- Nasal Polyps: Symptoms, Diagnosis and Treatment Options