Nasal pain

Posted by Alaethia @alaethia, Nov 27, 2020

Hello, I had nasal surgery about 4-5 months ago to remove extra bone and cartilage so I could breathe properly, and understandably so my nose has been sensitive. However that was a few months ago and the surgery part has healed long ago. Now I find the cartilage at the front bit of my nose, the septum area right at the front, is in a lot of pain. It hurts to touch the outside nostrils, and it feels almost loose? Its wiggly and whenever I swallow or suck I feel it bending with the roof of my mouth. Im almost afraid it will break into my mouth cause I tend to overthink, but idk. It hurts. A LOT. Even without touching it it hurts. Please help?

@alaethia– do you know exactly what you had done?
I’m assuming you have had follow up appts and they’ve told you you healed fine? It can be structural/nerve related.
If you push up from the outside of the front of nose do you get a relief of pain? There are many nerve endings that run through the cartilage/bone of the nose. The surgeon has to be very skilled to remove cartilage/bone without weakening the overall structure. Have you asked the surgeon to check for septal perforation? A weakening to the structure of the cartilage and mucosa that covers it, can cause a leaning type flapping affect upon inhilation.
The nasal septum, weather having breathing issues or not, is a strong support system to the nasal cavity. A change to this, even to improve breathing, can weaken the original structure, causing pain upon the new airflow dynamic breathing.
Your ENT or surgeon, would most likely refer you to a Neuro as they don’t treat pain, even if it is caused by them. They will tell you 4-5 months is to soon to tell and tell you to be patient. You know your body and how you feel. Don’t let them make you think it’s all in your head.
Many people experience this pain as a result of septum/bone surgery. They will most likely prescribe you Gabapentin.

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@nrd1

@alaethia– do you know exactly what you had done?
I’m assuming you have had follow up appts and they’ve told you you healed fine? It can be structural/nerve related.
If you push up from the outside of the front of nose do you get a relief of pain? There are many nerve endings that run through the cartilage/bone of the nose. The surgeon has to be very skilled to remove cartilage/bone without weakening the overall structure. Have you asked the surgeon to check for septal perforation? A weakening to the structure of the cartilage and mucosa that covers it, can cause a leaning type flapping affect upon inhilation.
The nasal septum, weather having breathing issues or not, is a strong support system to the nasal cavity. A change to this, even to improve breathing, can weaken the original structure, causing pain upon the new airflow dynamic breathing.
Your ENT or surgeon, would most likely refer you to a Neuro as they don’t treat pain, even if it is caused by them. They will tell you 4-5 months is to soon to tell and tell you to be patient. You know your body and how you feel. Don’t let them make you think it’s all in your head.
Many people experience this pain as a result of septum/bone surgery. They will most likely prescribe you Gabapentin.

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Thank you @nrd1 for the advice, and yes we had follow up appointments and it was healed nicely, they said it would be a bit tender but thats it. When I push up like you suggested it actually hurts a touch more, and its wobbly. Any advice from there? I'll try to talk to my ent about it as well.

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@alaethia-If that causes more pain then don’t do that.
Sometimes with a decrease of strength in the front, it can cause tension/pulling feeling. It really all depends on where your incision was made, and what part of the septum/bone was taken out. Anterior/Posterior. Is it affected by temperature or just movement? Did you have anything else done to the nasal cavity or was it just septum related? Any nasal mucosa tissue, like turbinates?

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@nrd1

@alaethia-If that causes more pain then don’t do that.
Sometimes with a decrease of strength in the front, it can cause tension/pulling feeling. It really all depends on where your incision was made, and what part of the septum/bone was taken out. Anterior/Posterior. Is it affected by temperature or just movement? Did you have anything else done to the nasal cavity or was it just septum related? Any nasal mucosa tissue, like turbinates?

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I believe it was anterior? I'm not sure what its called. Its a little after the bridge. I mean I've had congestion for a long while. The pain is affected my movement more? But it already hurts on its own. Like a dull ache, a bit of sting occasionally. And no nothing else done, I just had access bone and cartilage so I couldn't breathe properly. The ENT compared it to drinking with a coffee stir straw instead of a normal straw.

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@alaethia-sometimes the nasal mucosa will congest to compensate for the new unrecognized airflow that you’re body is trying to register/get familiar with. Anytime the nasal airway is made more open, like from a coffee stir straw into a “normal” straw. I put normal in quotes because, our bodies are complex and when doctors use the term “normal”, your normal might be different to the next person. If you were perceiving difficulty breathing, that size of a coffee straw was normal to your sensory nerves, nasal mucosa etc…now that it is more “open” the air can be hitting your septum and adjacent nasal musosa in a different, uneven way than it didn’t before. I would ask to see a comparison of your CT scan pre/post surgery. If one side of your nasal cavity is more open than the other, that is enough to cause pain and discomfort as it is no longer a laminar/even flow. Often times when we have a deviated septum to one side, the opposite side will compensate to still make it an even flow if that makes sense. Congestion is often a reactionary/protective response. So the nasal mucosa could be compensating by congesting, where it didn’t used to before. The feeling of congestion is like your nerves sensing for that feeling of air resistance that it was used to feeling. On the side that was made more open, are you breathing better, feeling stinging on that side?

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@nrd1

@alaethia-sometimes the nasal mucosa will congest to compensate for the new unrecognized airflow that you’re body is trying to register/get familiar with. Anytime the nasal airway is made more open, like from a coffee stir straw into a “normal” straw. I put normal in quotes because, our bodies are complex and when doctors use the term “normal”, your normal might be different to the next person. If you were perceiving difficulty breathing, that size of a coffee straw was normal to your sensory nerves, nasal mucosa etc…now that it is more “open” the air can be hitting your septum and adjacent nasal musosa in a different, uneven way than it didn’t before. I would ask to see a comparison of your CT scan pre/post surgery. If one side of your nasal cavity is more open than the other, that is enough to cause pain and discomfort as it is no longer a laminar/even flow. Often times when we have a deviated septum to one side, the opposite side will compensate to still make it an even flow if that makes sense. Congestion is often a reactionary/protective response. So the nasal mucosa could be compensating by congesting, where it didn’t used to before. The feeling of congestion is like your nerves sensing for that feeling of air resistance that it was used to feeling. On the side that was made more open, are you breathing better, feeling stinging on that side?

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I actually do feel way better. I don't have the fear of running out of air all the time or suffocating when other wouldn't. Its kinda on both sides, the sting. Like almost when your nose is dry and air stings it, but not. And thank you! I will try to do that!!

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@alaethia-you’re welcome. Try not to focus on it too much, as it will excite the nerves even more. This is a very common sensation that a lot of people get after septoplasties. It has something to do with the nasal mucosa that lines the septum. It can form really small tears or scars. This will make the air feel dry and cause a burning like sensation. I would try to use some nasal gel like Ayr to see if it helps. Be well

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Pain at the nasal base cartillages (nose tip) upon touching, COVID?

I found out accidentally and by means of an antibody test that i was COVID-19 positive (asymptomatic) last December. However one thing that has been reoccurring throughout the past year both before and after the test is that i just wake up realizing that the very base of my nose (usually only one side + nose tip/ columella ) is painful upon touching. i guess i have had this experience over 20 times or more in the past year and every time it usually goes away by itself in few days. So since this recurring experience has been only happening since the COVID-19 era I wonder if anybody else has been experiencing something similar and whether it can be attributed to COVID-19? I tried a lot googling this sensation but without any luck.

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@curiousguy

Pain at the nasal base cartillages (nose tip) upon touching, COVID?

I found out accidentally and by means of an antibody test that i was COVID-19 positive (asymptomatic) last December. However one thing that has been reoccurring throughout the past year both before and after the test is that i just wake up realizing that the very base of my nose (usually only one side + nose tip/ columella ) is painful upon touching. i guess i have had this experience over 20 times or more in the past year and every time it usually goes away by itself in few days. So since this recurring experience has been only happening since the COVID-19 era I wonder if anybody else has been experiencing something similar and whether it can be attributed to COVID-19? I tried a lot googling this sensation but without any luck.

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@curiousguy Welcome to Mayo Clinic Connect, a place to give and get support.

20 times in the past year is a lot. You'll notice that I moved your question to an existing discussion on nasal pain. I did this so you could connect with members like who have discussed this topic in the past @nrd1 @alaethiadoctor and may be able to offer support.

If you are particularly interested in discussing COVID-19, below I have linked the COVID-19 group. You may wish to scroll through the posts of this group. If you do not find what you are looking for you may wish to post a new discussion there.
https://connect.mayoclinic.org/group/covid-19/
May I ask if you have seen a provider/doctor for your nasal pain?

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