After a seemingly two-year lull, non-COVID respiratory viruses are making a comeback. Many of us were able to avoid the common cold or the flu during the pandemic, thanks to the benefits of masking and social distancing. However, as restrictions drop, there has been an uptick in seasonal illnesses — caused by rhinoviruses, respiratory syncytial virus and other coronaviruses — that typically hit hard in the winter months.
Compared to COVID-19, the common cold doesn’t seem so bad — but it can still put you out with a sore throat, stuffy nose and malaise. Most colds only last a week, but even after you recover, your nose and sinuses can remain stuffed up with phlegm. And that lingering congestion can feel like it goes on forever.
Otolaryngologists call this a postnasal drip. During a head cold, your body produces a ton of mucus to soothe your sinuses and clear out the infection. That mucus doesn’t disappear overnight — it takes time for your body’s immune response to wind down and chip away at the build-up of phlegm.
Here’s what causes all that congestion.
When a pathogen enters our airways, it latches to cells deep inside our noses and begins to multiply. As the virus does this, it irritates our nasal passages and sinuses, triggering inflammation, said Dr. Christopher Thompson, an otolaryngologist with Providence Mission Hospital in Orange County, California.
“This signals your immune system to create mucus to wash the virus out of your system,” Thompson said. That mucus, which builds up and creates sinus pressure, also moistens our irritated nose and and sinuses. We actually always have some mucus draining down the back of our throat, but the mucus produced during a cold is much thicker and stickier. It also becomes yellow and green — a sign that our body is, in fact, fending off a virus.
Most people will recover from a cold within about seven days, but the congestion sometimes lingers even when the infection itself has cleared, and you might find yourself blowing your nose or clearing your throat for a week or two longer.
“This is because your body produces a lot of extra mucus to flush the cold virus out of your system,” Thompson said. It takes time for your body to clear out all that mucus, even after the virus itself is no longer in your system.
How much mucus your body produces is influenced by a mix of factors, including genetics, the type of virus, and the viral load you were exposed to, said Dr. Brian Kaplan, an otolaryngologist and the chair of the department of otolaryngology at the Greater Baltimore Medical Center.
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Are there ways to clear out the congestion?
There is no magic bullet to flushing out phlegm, according to Kaplan, but there are a handful of tricks to expedite the process.
First thing: Drink plenty of fluids. Doing so will thin the mucus in your nasal and sinus passages and reduce some of that head pressure.
“The goal is to increase the fluid to put in to the mucous to thin it out and allow it to drain more easily,” Kaplan said.
Rest — a step that’s often overlooked — is key to helping your body bounce back quicker. It helps your body allocate more energy toward recovering and less energy toward other tasks or activities.
Taking a steam shower or using a humidifier can thin your mucus, reduce inflammation and open up your sinuses. If you have sinus pain or pressure, Thompson recommended placing a warm compress over your nose and eyes.
Nasal saline spray and nasal irrigation tools (like a neti pot) can help clear out some of the phlegm, too. There are also a variety of over-the-counter decongestants and mucolytics that can help thin the mucus — but be mindful of how long you use them for. Taking over-the-counter decongestants for more than three days can actually worsen your symptoms.
If your post-nasal drip hasn’t improved within 10 days of your cold, see a doctor. Left untreated, postnasal drip can collect germs and turn into a sinus infection, so you’ll want to have it checked out.
“The most important thing is to give your body what it needs as it recovers from fighting the infection,” Kaplan said. “Making sure to keep yourself well hydrated, get plenty of sleep, and ensure good nutrition is key.”
