Always Stuffy? Why Your Deviated Septum Could Be the Reason — and What to Do Next

If you constantly feel congested — even when you don't have a cold — a deviated septum may be the hidden cause.

Many people live for years with chronic stuffiness, mouth breathing, sinus pressure, or frequent sinus infections without realizing the structure inside their nose may be contributing to the problem.

Let's break down what a deviated septum is, how it affects your breathing, and what medically approved next steps actually work.

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What Is a Deviated Septum?

The septum is the thin wall of cartilage and bone that divides your nose into two nostrils. Ideally, it sits in the center.

A deviated septum happens when that wall is shifted to one side. In fact:

• Up to 80% of people have some degree of septal deviation.
• Most mild deviations cause no symptoms.
• More severe deviations can block airflow and lead to chronic problems.

You may be born with it, or it can happen after:

• A childhood injury
• A sports accident
• A car accident
• Even minor trauma you don't remember

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Signs Your Septum May Be Deviated

A deviated septum doesn't always cause symptoms. But when it does, the most common signs include:

• Constant nasal congestion (often worse on one side)
• Difficulty breathing through one nostril
• Frequent sinus infections
• Facial pressure or sinus headaches
• Postnasal drip
• Snoring or mouth breathing
• Nosebleeds
• Noisy breathing during sleep

If you notice congestion that never fully clears — even when you're not sick — that's often a clue.

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Why a Deviated Septum Causes Chronic Stuffy Nose

When the septum is off-center, it can:

• Narrow one nasal passage
• Disrupt normal airflow
• Interfere with sinus drainage
• Cause the lining of the nose to swell more easily

This makes you more prone to:

• Chronic inflammation
• Recurrent sinus infections
• Worsening allergy symptoms
• Sleep disturbances

Over time, blocked sinus drainage can lead to sinusitis — an infection or inflammation of the sinus cavities.

If your symptoms include facial pressure, recurring infections, or thick nasal discharge, you can use Ubie's free AI-powered symptom checker for Sinusitis to help identify whether sinusitis may be contributing to your ongoing congestion.

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How Is a Deviated Septum Diagnosed?

Diagnosis is usually straightforward.

A doctor (often a primary care physician or ENT specialist) will:

• Ask about your symptoms
• Examine your nose with a lighted instrument
• Possibly use a small nasal scope (a thin camera) for a clearer view

In some cases, a CT scan may be ordered if chronic sinus infections are involved.

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Can a Deviated Septum Get Worse Over Time?

In most adults, the deviation itself does not continue to worsen. However:

• Swelling from allergies can make symptoms feel worse.
• Repeated infections can increase inflammation.
• Aging can change cartilage flexibility.

So while the structure may stay the same, symptoms can fluctuate.

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Medically Approved Next Steps

Treatment depends on how much your symptoms affect your quality of life.

1. Start with Conservative (Non-Surgical) Treatment

For mild to moderate symptoms, doctors often recommend:

✅ Nasal Steroid Sprays

• Reduce inflammation
• Improve airflow
• Help control allergy-related swelling

Examples include prescription or over-the-counter corticosteroid sprays.

✅ Saline Nasal Rinses

• Flush out mucus and irritants
• Improve sinus drainage
• Safe for daily use

✅ Antihistamines (If Allergies Are Present)

• Reduce allergy-related congestion
• Help control swelling in nasal tissues

✅ Decongestants (Short-Term Only)

• Temporarily reduce swelling
• Should not be used longer than 3 days in spray form

These treatments do not "fix" the structural deviation, but they can significantly reduce symptoms.

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2. When Surgery May Be Considered: Septoplasty

If conservative treatments fail and symptoms are ongoing, a procedure called septoplasty may be recommended.

Septoplasty:

• Straightens the septum
• Removes or reshapes obstructing cartilage or bone
• Is usually done outpatient
• Takes about 30–90 minutes
• Has a recovery period of 1–2 weeks for most daily activities

Studies show septoplasty can significantly improve:

• Nasal airflow
• Sleep quality
• Frequency of sinus infections
• Snoring related to obstruction

However, surgery is typically recommended only when:

• Breathing is persistently blocked
• Sinus infections are frequent and severe
• Quality of life is clearly affected

It's not cosmetic surgery — it's functional.

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Could Your Symptoms Be Something Else?

Not every chronic stuffy nose is caused by a deviated septum.

Other common causes include:

• Allergic rhinitis
• Chronic sinusitis
• Nasal polyps
• Enlarged turbinates
• Viral infections
• Environmental irritants

Sometimes, multiple factors exist at once. For example, someone may have both allergies and a deviated septum, which together worsen symptoms.

That's why evaluation by a healthcare professional is important.

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When to Speak to a Doctor Promptly

While a deviated septum is usually not dangerous, you should speak to a doctor right away if you experience:

• Severe facial swelling
• High fever
• Vision changes
• Persistent nosebleeds
• Severe headache with stiff neck
• Difficulty breathing

These could signal a more serious condition that needs immediate medical attention.

Even if symptoms aren't urgent, it's wise to speak to a doctor if:

• Congestion lasts longer than 10–14 days
• You have repeated sinus infections
• Sleep is disrupted
• Over-the-counter treatments aren't helping

Getting evaluated early can prevent long-term complications.

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Living with a Deviated Septum: What Helps Day-to-Day

If you're managing symptoms without surgery, small habits can make a big difference:

• Use a humidifier in dry climates
• Stay hydrated
• Avoid smoking or secondhand smoke
• Manage allergies proactively
• Sleep with your head slightly elevated

These strategies won't correct the deviation, but they may reduce inflammation and improve airflow.

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The Bottom Line

A deviated septum is extremely common. For many people, it causes no issues. For others, it can contribute to:

• Chronic stuffy nose
• Frequent sinus infections
• Sleep disruption
• Persistent facial pressure

The good news is that treatment options are effective — whether that's medical therapy or surgery.

If you're always congested and not sure why, don't ignore it. Persistent symptoms deserve attention. Before your doctor visit, you can get personalized insights by using Ubie's free AI-powered symptom checker for Sinusitis to better understand your symptoms and what might be causing them.

Most importantly, speak to a qualified healthcare professional about your symptoms — especially if they are severe, persistent, or worsening. While a deviated septum is rarely life-threatening, complications from untreated infections or significant obstruction can become serious if ignored.

Breathing clearly is not a luxury — it's essential. If you've been "always stuffy," it may be time to find out why.