Blowing your nose is a common, almost reflexive action when dealing with congestion from a cold, allergies, or a sinus infection. This simple act offers immediate relief by clearing obstructed nasal passages. However, the manner in which this is done can dramatically impact health outcomes. Forceful blowing can introduce unexpected medical complications, so understanding the mechanics of nasal clearance is important to ensure the practice is effective and safe.
How Forceful Blowing Affects the Sinuses and Ears
The risk of blowing the nose too hard is the creation of excessive pressure that can injure surrounding tissues. This pressure can lead to barosinusitis, a pressure injury that damages the delicate mucosal lining of the sinuses. Symptoms of this trauma often include facial pain, headaches, and a discharge of cloudy mucus.
Infected mucus can also be forced backward into the paranasal sinuses, pushing bacteria or viruses deeper into these cavities. This reverse flow of fluid can lead to the development or worsening of a secondary bacterial sinus infection. The intense pressure can also strain the small capillaries lining the nasal cavity, resulting in a nosebleed, medically known as epistaxis.
The ears are vulnerable because the nasal cavity, throat, and middle ear are interconnected. Blowing too vigorously can transmit high pressure up the Eustachian tubes, the narrow passages linking the back of the nose to the middle ear. This intense pressure can cause barotrauma to the eardrum or force bacteria toward the ear, potentially triggering an infection.
Understanding Pressure Dynamics in the Nasal Cavity
The explanation for these risks lies in the amount of pressure generated during a forceful blow. Studies measuring intranasal pressure during a typical nose blow have recorded mean maximal pressures around 66 millimeters of mercury (mmHg). This pressure is significantly higher than the pressure generated by a sneeze or a cough, which explains why blowing carries a greater risk.
This high positive pressure propels air and fluid backward into the body’s interconnected cavities rather than solely outward. The nasal cavity connects to the paranasal sinuses through small openings called ostia, and links to the middle ear via the Eustachian tubes. Because these connections are narrow, the high-pressure air and mucus are easily driven into these spaces instead of draining out of the nostrils.
Research confirms that a single, forceful nose blow can propel a measurable volume of viscous fluid, up to about one milliliter, directly into the maxillary sinuses. This mechanism physically introduces mucus and potential pathogens into the sinuses, providing a clear pathway for infection. The pressure can be particularly high in individuals with significant nasal obstruction, sometimes reaching pressures equivalent to over 9,000 Pascals.
Safe Techniques for Nasal Clearance
To minimize pressure-related injury, the strategy is to adopt a gentle and controlled method of clearance. The best practice is to blow the nose lightly, avoiding the tendency to forcefully squeeze and expel air at maximum velocity. This gentle approach greatly reduces the amount of pressure transmitted to the sinuses and ears.
It is recommended to clear one nostril at a time, rather than attempting to blow through both simultaneously while pinching the nose closed. By keeping one nostril open, the pressure built up during the blow is released through that passage. This prevents a dangerous pressure spike in the nasal cavity and significantly lowers the total intranasal pressure generated.
Alternative methods are often the safest way to address severe congestion. Using a saline nasal rinse or a spray can help thin and loosen thick mucus before attempting to blow the nose. This process involves using a sterile solution, mixed with distilled or previously boiled water, to gently wash the nasal passages. By making the mucus less viscous, only a very gentle blow is needed to achieve clearance following the rinse.