We breathe air through the nostrils of the nose. However, the nostrils are just the external tip of the air passages that lead to a chamber located inside the skull known as the nasal cavity. The nasal cavity is a big air chamber that is located in the middle of the face and behind the nose. It is divided into two cavities by a thin nasal septum and is separated from the brain cavity above and the mouth cavity below by thin bones.
The nasal cavity continues into the throat (pharynx) and this junction is known as nasopharynx. The mouth cavity also empties into the throat through a junction known as the oropharynx. The nasopharynx and the oropharynx thus provide connectivity between the nasal cavity and the mouth through the back of the throat or pharynx.
What does the nasal cavity do?
The surface of the nasal cavity is covered with a layer of hairs and mucus. These filter the air coming in from the nostrils and also warms and humidifies it before it passes down to the lungs. Thus, the nasal cavity has an important protective role in breathing. The receptors for smell are also located within the nasal cavity. This makes it an important region for the detection of various airborne chemicals.
Signs and Symptoms
Pain can occur either over the nose or inside the nose. It is a symptom of some underlying problem and may be accompanied by other symptoms such as:
- Bleeding from the nose
- Redness or swelling over the nose
- Lack of smell sensation
- Nasal tone of the voice
- Difficulty breathing
- Throat problems
- Runny or stuffy nose
A host of other non-nasal symptoms may also be present, since conditions in surrounding regions could also manifest as pain in the nasal cavity. For example, pain in the nasal cavity could arise if there is a problem in the throat or the sinuses since these cavities are continuous with the nasal cavity.
Causes of Nasal Cavity Pain
Injury to the nose
Severe pain can result from injury to the nose or the nasal passages. An example of such a painful injury is nasal fracture or broken nose. A nasal fracture happens when the bones of the nasal cavity are broken due to physical impact. It can occur due to accidents, falls, contact sports injuries and assaults to the face.
Some cases may result in a nasal septal hematoma, in which the blood accumulates in the nasal septum. This is an emergency in which the blood needs to be drained from the nasal septum as soon as possible. Failure to do so may result in blockage of breathing, nasal collapse, and infections.
Injury and pain may also caused by cosmetic procedures such as nose piercing. Not all injuries that cause nasal pain have to be violent. Constant rubbing or wiping of the nose could also result in painful external injuries.
Foreign body inside the nose
Pain in the nose could also occur when some foreign body is inserted into the nostrils and it gets stuck in the nasal passages or cavities. Such occurrences are common in small children who playfully stick things up their noses. Besides pain, a stuck object in the nose can cause other symptoms such as local swelling, nasal congestion, difficulty in smelling or breathing. Bleeding might also occur.
However, no symptoms may be apparent in some cases of a small foreign object being lodged inside the nasal cavity. Regardless of what object gets stuck in the nose, it is advisable to let a doctor remove it using special instruments. Trying to remove the object in any other way may worsen the problem by pushing it deeper into the nasal cavity.
A variety of infections caused by viruses, bacteria and even fungi can result in painful nasal cavities. Common cold or flu virus is very likely to cause nasal symptoms such as a burning or sore feeling. Frequent wiping of the nose in these conditions could aggravate the condition further and result in a painful nose.
Pain is also a symptom of bacterial infections of the nasal cavity and the sinuses. The ethmoid sinuses that lie between the corner of the eyes and the nasal bridge are commonly infected regions. Fungal infection of the nasal cavity is uncommon but it can occur in individuals with weakened immune system. Mucormycosis is an example of such a fungal infection.
Boils or abscesses that develop at the roots of hairs in the nasal cavity or the nasal septum are also quite painful.
Inflammation of the nose in a variety of non-infectious conditions is known to cause pain. Such inflammation could occur in conditions such as excessive drying of nasal passages, excessive nose picking, sniffing drugs such as cocaine, and inhalation of irritants in polluted or toxic air. Use of certain nasal sprays could also result in painful inflammation in the nasal cavities.
Formation of inflammatory granulomas in Wegener’s granulomatosis and lethal midline granuloma also cause pain in the nasal cavities. However, these are relatively rare conditions. Not all inflammatory conditions in the nose are painful. For example, inflammation caused by allergic rhinitis or hay fever does not usually result in a painful nose.
Nasal polyps are the most common non-cancerous growths in the nose that are usually painless to begin with. These polyps become painful when they grow in size. It is believed that chronic irritation of the nasal mucosa leads to polyp formation. However, the exact cause remains uncertain. Along with pain, nasal polyps also cause other symptoms such as a stuffy or runny nose and a disrupted sense of smell.
Nasal carcinoma or cancer in the nose is an uncommon disease. When it does occur, it is usually due to the spread of cancer cells from other nearby regions such as the orbits. Cancers that occur in paranasal sinuses and nasopharynx do cause pain. These cancers also display symptoms such as bleeding from the nose, disrupted sense of smell, and a nasal tone while speaking.