While steam inhalation is widely adopted in an attempt to ease a blocked nose, a new study suggests it is unlikely to work for chronic nasal congestion.
However, saline nasal irrigation - a technique used to "flush out" excess mucus from the nasal cavity - may be beneficial for chronic nasal congestion, according to the researchers.
Study leader Dr. Paul Little, professor of primary care research at the University of Southampton, United Kingdom, and colleagues recently published their findings in the Canadian Medical Association Journal.
Nasal congestion is a common complaint, often caused by the common cold, flu, or sinus infection. Hay fever and other allergies, nasal polyps, and chronic sinusitis are some other causes of the condition.
While nasal congestion is just an irritation for the most part, it can cause other symptoms, such as headaches and blurred vision.
Steam inhalation and nasal irrigation are among the most commonly recommended techniques for the alleviation of nasal congestion; the National Institutes of Health recommend inhaling steam two to four times daily, through sitting in the bathroom with the shower running, for example.
But how effective are such methods for easing symptoms of nasal congestion? This is what Dr. Little and colleagues wanted to find out.
Nasal irrigation may reduce need for antibiotics
To reach their findings, the team enrolled 871 patients from 71 primary care practices across England, all of whom had sinusitis - a common condition characterized by inflammation of the sinuses.
The participants were randomized to receive one of four treatments: usual care, daily steam inhalation, daily nasal irrigation supported by a demonstration video, or a combination of daily nasal irrigation and steam inhalation.
During 6 months of follow-up, the researchers found that patients who engaged in daily steam inhalation alone showed no improvements in symptoms of nasal congestion - as determined by scores on the Rhinosinusitis Disability Index.
However, patients who used daily nasal irrigation supported by a demonstration video showed improvements in nasal congestion at both 3 and 6 months of follow-up.
"We found potentially important changes in other outcomes - particularly reduced headaches, reduced use of over-the-counter medication and reduced medicalization - for example, the belief in the need to see the doctor in future episodes," notes Dr. Little.
Based on their findings, the researchers say nasal irrigation - alongside coaching on how to use the technique - may be an effective way to ease nasal congestion, reducing the need for antibiotics.
"The threat of global antibiotics resistance is very real and we need to find alternative ways of educating and treating people who do not need to have antibiotics.
We have found that even a very brief intervention of a video showing patients how to use saline nasal irrigation can improve symptoms, help people feel they do not need to see the doctor to manage the problem and reduce the amount of over-the-counter medication they get."
Dr. Paul Little
The team notes that the effectiveness of nasal irrigation in this study was less than that seen in previous studies that used more intensive coaching of the technique.
As such, the authors say more research is needed to identify just how much training patients need in order to get the most from nasal irrigation.