What should you know about air pressure ear pain?

It is often noticed during aircraft descent, mountain travel or diving. Congestion from a cold or sinus problem can narrow the eustachian tube, leaving fullness, muffled hearing, popping or sharp discomfort as the surrounding pressure changes.

The eustachian tube normally opens between the middle ear and the back of the nose, balancing pressure on both sides of the eardrum. If it stays closed, the eardrum stretches inward or outward and may not vibrate normally, causing pain and temporary hearing reduction.

Severe imbalance can injure the eardrum or middle ear. An infection, wax blockage or another ear disorder may also explain pain, so discomfort that persists after the pressure event deserves examination rather than repeated forceful attempts to clear it.

Stay awake during aircraft descent and swallow frequently by sipping water, chewing or yawning. A gentle pressure-equalising manoeuvre may help: close your mouth, pinch your nose and breathe out very softly. Stop immediately if this causes pain.

Avoid flying or diving when heavily congested if the trip can be postponed. Do not dive deeper to overcome ear pain, and do not insert objects into the ear. Ask a pharmacist or clinician before using a decongestant, especially if you have high blood pressure, heart disease, glaucoma, pregnancy or take other medicines.

Seek urgent assessment for sudden or marked hearing loss, spinning dizziness, severe persistent pain, bleeding or fluid from the ear, facial weakness, or symptoms after a diving emergency. Breathing difficulty, confusion or weakness after a dive requires emergency care.

Arrange a routine appointment if blockage or reduced hearing continues, pain recurs on journeys, or you have fever or ear discharge. A clinician can inspect the canal and eardrum and decide whether hearing or middle-ear pressure testing is useful.

Ask whether congestion, infection, wax or eustachian tube dysfunction is contributing; whether planned flying or diving is appropriate; and which preventive measure is safe with your health conditions and medicines. Mention any previous eardrum surgery or repeated pressure injury.