Spring has sprung. The leaves and flowers are in bloom, which can be a beautiful sight, until your eyes seem almost swollen shut and you can hardly breathe through your nose. You've got a severe case of a "stuffy nose" or nasal congestion.
You've been buying the drugstore out of Kleenex and allergy medicine and checking the pollen score online daily. But maybe it's not just allergies. Maybe it's caused by a viral or bacterial infection that's only aggravated by allergies.
Nasal congestion, which causes that chronic stopped up nose, is one of the most common conditions people suffer from. It is also highly treatable if you recognize its symptoms and treat it the right way.
Let's talk about what nasal congestion can mean and how to know if you have a serious infection causing your discomfort. [1,3]
Common symptoms of nasal congestion are:
- Being unable to breathe through your nose. 
- Feeling like there is something in your nose. 
- Clear or yellow discharge from your nose. 
- Clear or yellow discharge in the back of your throat. 
- Cough, especially when lying down. 
- Headache. 
More serious nasal congestion symptoms, especially in kids include:
Most nasal congestion symptoms are caused by viral infections of the upper airways. Allergies and inflammation of the sinuses (air-filled pockets in the bones of the skull) are common causes of nasal congestion as well. Congestion is rarely a sign of a serious illness, but, in rare cases, it can be caused by serious infections like pneumonia or bronchitis. Left to fester, these infections can seriously threaten life and health. Upper respiratory infections can lead to ear infections and pneumonia can be deadly if untreated. 
Infectious nasal congestion causes:
- Viral infections: Probably the most common cause is the common cold. 
- Bacterial infections: Especially sinus infections, these can lead to a stuffy nose and often a thick, yellow discharge from the nose. 
- Influenza: Also caused by a viral infection, the flu can make your nose stuffed. 
Inflammatory and allergic nasal congestion causes:
- Sinusitis: Although many cases of sinusitis are from an infection, the sinuses can be inflamed without an infection and cause severe headache and nasal congestion. This can be acute or chronic. 
- Allergies: Whatever the cause, allergies can make your head feel like it is clogged and it will never get better. 
- Chronic sinusitis: This condition is diagnosed when the nasal passages stay inflamed for 12 weeks or longer. This can be caused by infections or nasal polyps, growths in the nasal passages, or a deviated septum. [1,2]
Other nasal congestion causes:
- Foreign bodies: Kids often attempt to shove foreign objects in their nose or may playfully "sniff" things they shouldn't dirt, sand, flour, powder, etceteraand this can lead to a foul-smelling situation typically stemming from one nostril. 
- Deviated septum: The bone that separates the inside of the nose into right and left nostrils can bend toward one side and lead to chronic stuffiness and even polyps in the nose. 
- Irritation: Dry air, smoke, and chemicals can all lead to congestion. 
- Overuse of decongestants: Abusing nasal decongestants can lead to a "rebound" stuffy nose that is worse than the one you started with. So,use these only as directed. 
10 Possible Congestion Conditions
The list below shows results from the use of our quiz by Buoy users who experienced congestion. This list does not constitute medical advice and may not accurately represent what you have.
The common cold is a viral infection of the upper respiratory tract, which includes the nose, mouth, sinuses, throat, and larynx. There are over 200 viruses that can cause upper respiratory infections, and usually the exact virus behind a cold is never known.
The common cold is, of course, very common. Americans catch over one billion colds per year, with adults averaging two to three per year, and children averaging as many as eight colds per year.
The common cold usually lasts about a week, and is self-limited (meaning it goes away on its own). Although there is no treatment for the common cold, there are many strategies for prevention and improvement of symptoms.
Top Symptoms: fatigue, headache, cough, sore throat, congestion
Symptoms that never occur with common cold: being severely ill, severe muscle aches, rash, severe headache, sinus pain
New-onset seasonal allergies
New-onset seasonal allergies, also called adult-onset seasonal allergies, are sensitivities to pollen, mold, and other irritants that cause nasal congestion, runny nose, sneezing, itchy eyes, and sore throat.
Seasonal allergies commonly begin in childhood but can start at any age, especially among those with a family history. Moving to a different geographic location may trigger the allergy in someone with a genetic predisposition. Anyone with asthma is more likely to experience adult-onset seasonal allergies.
Sometimes the symptoms are actually from "pregnancy rhinitis" – nasal congestion and sneezing due to the effects of pregnancy hormones on the nasal tissue.
A new-onset allergy is often thought to be a cold, but a cold will clear up without treatment. Allergies persist, never getting better or worse, and can interfere with quality of life.
Diagnosis is made by an allergist, who will use skin tests and blood tests.
There is no cure for seasonal allergies but the symptoms can be managed for greater comfort and relief. Antihistamines, corticosteroid nasal sprays, and immunotherapy or "allergy shots" can be very effective.
Top Symptoms: sore throat, congestion, cough with dry or watery sputum, mucous dripping in the back of the throat, fatigue
Symptoms that never occur with new-onset seasonal allergies: fever, yellow-green runny nose, chills, muscle aches
Chronic sinusitis is also called chronic rhinosinusitis. It is an inflammation of the sinuses, or open spaces of the skull, above and below the eyes. "Chronic," in this case, means the condition has persisted for weeks in spite of treatment and has probably followed several cases of acute sinusitis.
The condition may start with a viral, bacterial, or fungal upper respiratory tract infection; asthma; allergies; or nasal polyps.
Symptoms include facial pain, swelling, and nasal congestion. There is often fatigue; greenish or yellowish nasal discharge; loss of sense of smell; ear pain; cough; and sore throat.
Chronic sinusitis should be seen by a medical provider, especially if symptoms worsen. The condition interferes with quality of life and the ongoing infection can become serious.
Diagnosis is made through patient history; physical examination; sinus cultures; skin tests for allergies; CT scan of the head; and nasal endoscopy (rhinoscopy.)
Treatment may involve saline nasal irrigation; nasal spray corticosteroids; oral corticosteroids; antibiotics for bacterial infection; immunotherapy for allergies; and, in some cases, surgery to remove polyps or other obstructions.
Top Symptoms: fatigue, headache, trouble sleeping, congestion, runny nose
Symptoms that always occur with chronic sinusitis: chronic sinusitis symptoms
Urgency: Primary care doctor
Acute viral sinusitis
Acute viral sinusitis, also called viral rhinosinusitis or "sinus infection," occurs when viruses take hold and multiply in the sinus cavities of the face.
It is most often caused by the same viruses that cause the common cold and spreads the same way, through an infected person's coughing or sneezing.
Because children have small, underdeveloped sinuses, this illness is far more common in adults.
Symptoms include clear nasal discharge (not greenish or yellowish,) fever, and pain if facial sinuses are pressed.
If there is rash, severe fatigue, or neurologic symptoms (seizures, loss of sensation, weakness, or partial paralysis,) see a medical provider to rule out more serious conditions.
Diagnosis can usually be made through history and examination alone.
Antibiotics only work against bacteria and cannot help against a viral illness. Therefore, treatment consists of rest, fluids, and fever/pain reducers such as ibuprofen. (Do not give aspirin to children.) Symptoms of viral sinusitis last for about seven to ten days. As with the common cold, the best prevention is frequent and thorough handwashing.
Top Symptoms: headache, cough, sinusitis symptoms, sore throat, congestion
Symptoms that always occur with acute viral sinusitis: sinusitis symptoms
Symptoms that never occur with acute viral sinusitis: being severely ill
Acute bacterial sinusitis
Acute bacterial sinusitis, also called bacterial rhinosinusitis or "sinus infection," has symptoms much like viral rhinosinusitis but a different treatment.
Any sinusitis usually begins with common cold viruses. Sometimes a secondary bacterial infection takes hold. Like cold viruses, these bacteria can be inhaled after an infected person coughs or sneezes.
Anyone with viral sinusitis, upper-respiratory allergy, nasal passage abnormality, lung illness, or a weakened immune system is more prone to bacterial sinusitis.
Symptoms include thick yellowish or greenish nasal discharge; one-sided pain in the upper jaw or teeth; one-sided sinus pain and pressure; fatigue; fever; and symptoms that get worse after first improving.
See a doctor right away for severe headache, high fever, stiff neck, or vision changes. These can indicate a medical emergency.
Diagnosis is made with a simple examination in the doctor's office.
Bacterial sinusitis can be treated with antibiotics, but this is not always necessary. Often rest, fluids, and over-the-counter pain relievers and decongestants are enough.
Prevention is done through good lifestyle and hygiene to keep the immune system strong.
Top Symptoms: fatigue, headache, cough, sinusitis symptoms, muscle aches
Symptoms that always occur with acute bacterial sinusitis: sinusitis symptoms
Symptoms that never occur with acute bacterial sinusitis: clear runny nose, being severely ill
Urgency: Primary care doctor
Sarcoidosis means the growth of tiny granulomas, which are collections of inflammatory cells. They are most common in the lungs, skin, and eyes.
The condition is thought to be an autoimmune response, meaning that the body turns against itself for unknown reasons.
Sarcoidosis can affect anyone. It is most common in women of African descent from age 20 to 40.
Symptoms include fatigue, fever, swollen lymph nodes, and unexplained weight loss. There is often dry cough, shortness of breath, wheezing, and chest pain. The skin may show unusual sores or bumps. Eyes may be reddened and painful, with blurred vision.
These symptoms should be seen by a medical provider, since sarcoidosis can cause organ damage if left untreated.
Diagnosis is made through careful physical examination, blood tests, lung function tests, eye examination, and sometimes biopsy and chest x-ray.
Treatment involves corticosteroid medication; drugs to suppress the immune system; and sometimes surgery. There is no cure for sarcoidosis, but it can be managed. Some cases will clear up on their own.
Top Symptoms: fatigue, headache, shortness of breath, loss of appetite, joint pain
Urgency: Primary care doctor
Viral throat infection
A viral throat infection is an infection of the throat, or pharynx, that is caused by viruses. Viruses are different from bacteria such as Streptococcus pyogenes (which causes "strep throat"). Viral infections are the most common cause of sore throats in children and adults.
Symptoms include a sore throat, fever, fatigue, congestion, runny nose, cough, or others depending on the specific virus. Less common symptoms that sometimes present in children include fluid-filled bumps on the hands, feet, or mouth, or, in adults, painful mouth ulcers.
Treatment focuses on rest, hydration, and over-the-counter methods to alleviate symptoms. Some cases require antiviral medications.
Top Symptoms: sore throat, cough, congestion, fever, hoarse voice
Symptoms that always occur with viral throat infection: sore throat
Symptoms that never occur with viral throat infection: being severely ill
Rhinitis simply means "inflammation of the nose." When it is caused by something other than allergies, it is called vasomotor rhinitis. "Vasomotor" simply refers to the constriction or dilation of blood vessels.
Different substances can trigger the vasomotor reaction, even though it is not an allergic reaction. Common causes are certain medications; air pollution; and chronic medical conditions.
Symptoms include runny nose, sneezing, congestion, and postnasal drip. Since no allergy is involved, there will not be the scratchy throat or itchy eyes and nose of allergic rhinitis.
A medical provider should be seen for ongoing symptoms, since they can interfere with quality of life. Also, using over-the-counter medications meant for allergic rhinitis will not help in a case of vasomotor rhinitis.
Diagnosis is made through patient history, physical examination, and allergy tests, in order to rule out allergies as a cause of the symptoms.
Treatment involves using the appropriate medications to ease the symptoms, and avoiding any triggers as much as possible.
Top Symptoms: congestion, mucous dripping in the back of the throat, runny nose, frequent sneezing, eye itch
Symptoms that never occur with non-allergic rhinitis: fever, sinus pain, facial fullness or pressure
A cluster headache is a type of recurring headache that is moderate to severe in intensity. It is often one-sided head pain that may involve tearing of the eyes and a stuffy nose. Attacks can occur regularly for 1 week and up to 1 year. Each period of attacks (i.e. each cluster) is separated by pain-free periods that last at least 1 month or longer. Other common headaches may also occur during these cluster-free periods.
Top Symptoms: severe headache, nausea, throbbing headache, history of headaches, sensitivity to light
Symptoms that always occur with cluster headache: severe headache
Urgency: Hospital emergency room
Influenza, or "flu," is a contagious respiratory illness caused by viruses. It is spread through the air by coughing, sneezing, or even talking.
Anyone can get the flu, but those who are very young, over 65, and/or have pre-existing medical conditions are most at risk for complications.
Symptoms include fever, chills, cough, sore throat, body aches, and extreme fatigue. The symptoms may appear very suddenly.
Flu can bring on secondary bacterial infections in the lungs or ears. Dehydration is a great concern because the patient rarely wants to eat or drink.
Diagnosis is usually made by symptoms. There are tests that use a swab taken from the nose or throat, but they are not always accurate or necessary.
Treatment consists mainly of good supportive care, which means providing the patient with rest, fluids, and pain-relieving medication such as ibuprofen. Do not give aspirin to children.
Antibiotics cannot help with the flu, since antibiotics only work against bacteria. There are anti-viral medications that a doctor may prescribe.
The best prevention is an annual flu shot.
Top Symptoms: fatigue, headache, loss of appetite, cough, muscle aches
Symptoms that never occur with influenza: headache resulting from a head injury
Urgency: Phone call or in-person visit
Congestion Treatments and Relief
There are many effective home remedies for nasal congestion as long as you keep your therapies focused on moisture not dry forms of nasal congestion treatment. Many people think you need to "dry out" a runny nose, but you really need wet heat and steam to sooth your nasal passages. 
Good remedies for nasal congestion symptoms include:
- Drinking hot, steamy fluids (think hot tea). 
- Staying hydrated. 
- Humidifying the air, especially in your bedroom. 
- Taking a long, hot shower or bath. 
- Nasal rinses with saline solution or using a Neti-pot salt water actually hydrates nasal passages. 
There are several over-the-counter medications and remedies that can help you feel less congested as well.
- Pseudoephedrine pills. 
- Decongestant nasal sprays be sure not to over-use these or you will get worse. 
- Acetaminophen or ibuprofen if your stuffiness is giving you a headache. 
- Antihistamines such as Benadryl or loratadine. 
- Nasal steroid sprays, helpful for chronic sinusitis and congestion from allergies. 
- Minimize exposure to smoke and allergens. 
In the event you have a bacterial infection, which your doctor can diagnose, a short course of antibiotics is often needed. 
If you have a foreign body in your nose, obviously you need to seek medical care to have the foreign body removed.  Likewise, if your nasal congestion symptoms are chronic and possibly due to a deviated septum, that requires seeing an otolaryngologist (an ear, nose, and throat doctor) to discuss appropriate treatment. 
FAQs About Congestion
Here are some frequently asked questions about congestion.
What causes congestion?
Mucosal inflammation (inflammation of the inner lining of the nose) is the primary cause of nasal congestion. Congestion is described as the feeling of reduced airflow through the nose and a sense of facial fullness.  Inflammation of or around the nerves of the face can also lead to changes in sensation and altered perception of both taste and smell.  Reduced airflow can occur when inflamed and swollen mucosa (lining of the inner nose) block adequate drainage of the nose. [1,2]
What causes a stuffy nose?
A stuffy nose is caused by an increase in mucus creation by the nasal mucosa as well as swelling of the nasal mucosa. This increase in mucus and swelling can cause a blockage of the nasal pathway. It is often accompanied by an uncomfortable feeling of nasal fullness causing individuals to try to expel mucus from the nose by blowing into a tissue. It may be accompanied by the loss of taste or smell and increased pressure along the maxillary sinuses. [1,2,11]
What causes head congestion?
Head congestion or sinus pain is caused by moderate to severe rhinitis or congestion that causes blockage of the sinuses of the skull. The sinuses are empty spaces or cavities within the skull existing most notably behind the cheekbones. When they are blocked, because they are unable to drain, fluid builds up increasing pressure which often causes discomfort. Lowering one's head moves this fluid further irritating nerves and causing pain. [2,11]
How to reduce nasal congestion?
Nasal congestion can be reduced by decreasing inflammation or allowing mucus to leave the sinuses. Steam from tea, soup, or a warm shower moistens mucus membranes and heats and thins mucus allowing it to drain. In moderate cases of sinus congestion, nasal spray or oral decongestants, antihistamines, or intranasal steroids can be used to decrease inflammation and allow mucus drainage decreasing sinus pressure. [1,3]
How to relieve severe nasal congestion?
Severe nasal congestion due to allergies can be treated with antihistamines, which decrease production of mucus and inflammatory compounds in the body;  with intranasal steroids like mometasone, which decrease inflammation;  or with saline irrigation (saltwater nasal rinses.)  Non-allergic rhinitis can be treated with decongestants, either oral or nasal.  Additionally, pain may be treated with over-the-counter pain medications like acetaminophen.  Bacterial sinusitis which is severe and is accompanied by pus drainage from the nose may require prescribed antibiotics. 
Questions Your Doctor May Ask About Congestion
To diagnose this condition, your doctor would likely ask the following questions:
- Any fever today or during the last week?
- Do you have a cough?
- Are you experiencing a headache?
- Do you have a runny nose?
The above questions are also covered by our A.I. Health Assistant.
If you've answered yes to one or more of these questions
Take a quiz to find out why you're having congestion
Congestion Symptom Checker Statistics
People who have experienced congestion have also experienced:
- 12% Cough
- 8% Mouth Breathing
- 7% Sore Throat
People who have experienced congestion were most often matched with:
- 60% Chronic Sinusitis
- 20% Common Cold
- 20% New-Onset Seasonal Allergies
People who have experienced congestion had symptoms persist for:
- 45% Less than a week
- 17% Less than a day
- 13% One to two weeks
Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).
- Congestion, Stuffy Nose, & Nasal Obstruction. MUSC Health. MUSC Health Link.
- Naclerio RM, Bachert C, Baraniuk JN. Pathophysiology of Nasal Congestion. International Journal of General Medicine. 2010;3:47-57. NCBI Link.
- Relief for Nasal Congestion. Kaiser Permanente. Published October 10, 2011. Kaiser Permanente Link.
- Influenza (Flu). Centers for Disease Control and Prevention. Updated October 26, 2016. CDC Link.
- Bishop S. Pay Close Attention to Symptoms to Determine if Cause is Sinus Infection or Allergies. Mayo Clinic. Published April 12, 2013. Mayo Clinic Link.
- Haizul I, Umi Kalthum M. Dangerous Diplopia: A Case of Pansinusitis. Malaysian Family Physician. 2013;8(1):38-41. NCBI Link.
- Head and Neck Cancer. American Speech-Language-Hearing Association. ASHA Link.
- Alkan G, Emirolu M, Kartal A. Two Different Life-Threatening Cases: Presenting with Torticollis. Case Reports in Pediatrics. 2016;2016:7808734. NCBI Link.
- Dextromethorphan, Guaifenesin, and Pseudoephedrine. University of Michigan: Michigan Medicine. Updated December 14, 2016. UofM Health Link.
- Antihistamine/Decongestant Combination (Oral Route). Mayo Clinic. Updated October 1, 2018. Mayo Clinic Link.
- Kingdom T. Sinusitis Medications. National Jewish Health. Published February 2013. National Jewish Health Link.
- Malaty J, Malaty IAC. Smell and Taste Disorders in Primary Care. American Family Physician. 2013;88(12):852-859. AAFP Link.