Ear Barotrauma: Pressure in The Ears (Causes, Symptoms & Treatment)

Ranjeet KumarReviewed by Mr. Ranjeet Kumar Sr. Audiologist, Speech Therapist & Cochlear Implant Specialist, BASLP on Jul 26th, 2019 written by Editorial Team
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During a flight or a deep sea diving, Do you ever feel pressure in your ear? If yes, then what is the reason behind?

The buildup of ear pressure difference around the eardrum perhaps is the reason behind it. The pressure in the ear is also known as “ear-popping” or “blocked ear“. There are many names for ear sensation: Ear barotrauma, Ear fullness, Stuffy ear and many more.

You can purchase the latest hearing aids at a fair price through HearingSol, If you need any assistance or you have a query regarding Ear Barotrauma or Hearing Loss, feel free to call us at 1800-121-4408. We are always here to help you.

Ear barotrauma is a critical condition that may cause pain and discomfort in the middle ear due to changes in the surrounding water or air.

It usually clears up by itself, but some patients may need to consult with a doctor. It is very important to understand barotrauma so that can seek medical attention if necessary.


What is Ear Barotrauma?

It is a condition that causes discomfort in the ear as the pressure changes.

Remember the last time when you were flying and you just landed, and during this ascent and descent, you started experiencing some kind of discomfort due to the change of pressure in the atmosphere.

This disturbing sense of pressure change around the ear is Ear barotrauma.

People also experience this pressure behind the ear during deep sea diving. Barotrauma can sometimes lead to pain in the ear or damage of the eardrum. You might think “Why do I feel a lot of pressure in my ears?

 

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The time you start flying a negative pressure in the ear and the jaw starts building up due to a change of pressure in the eustachian tube.

The Eustachian tube, an inner ear tube is present in the lower right corner of the ear. This tube connects to the nasopharynx and helps in equalizing the ear pressure between the outside surrounding and the middle ear.

To equalize the pressure in the middle ear, air must pass through the eustachian tube.

Can’t equalize ear pressure ?

The Reason Behind the Change in Ear Pressure in the Eustachian Tube

Eustachian Tube Dysfunction

The eustachian tube helps in maintaining the ear pressure on both sides of the eardrum by permitting the air to enter your middle ear.

When the air cannot reach the middle ear, the eustachian tube gets blocked and as a result, the air pressure in the ear gets decreased.

This leads to the difference in air pressure in the ear canal and the middle ear. As a result, this decreased pressure in the middle ear makes the eardrum bulges inward as shown in the image.

This pressure difference can also lead to rupture of the eardrum, bruise or ear pain. In case this negative pressure difference is more, then the oval window (entrance of the inner from the middle ear) can also begin to rupture. This can also result in leakage of fluid to the middle ear from the inner ear (a perilymph fistula).

Illnesses such as ear infection and colds can lead to the swelling of the membranes around the eustachian tubes.

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Symptoms are also shown such as vertigo or hearing impairment when a person goes down(descent) in a deep sea dive propose that this leakage is going on in the ear. In the same way, when you start going up(ascent), you will feel some air bubble is starting building in your ear.

Most of the answers behind relieving this weird ear pressure or pain and what causes the ear pressure revolves around the Eustachian tube to some or the other degree.

To learn in more detail about how does ear pressure works pooping your ears do watch this video –

In most of the environment where the altitude is very high, the negative pressure in the ear is very common. Although this condition is not harmful in some individual, while there are some repeated cases of further complications.

Therefore, it becomes very important to know the difference between chronic (occasional) and acute (recurring) cases. So, a person understands when to consult a doctor for medical treatment.


Ear Barotrauma Symptoms

The severity of all the symptoms mainly depends on the impact of the pressure on the eardrum and the time duration of the pressure. Some of the common symptoms, occurring in the early stages of mild or moderate cases are-

  • Fullness or stuffiness in the ear,
  • Difficulty in the hearing,
  • Dizziness,
  • Ear discomfort.
  • Muffled hearing because your eardrum can’t vibrate and make a sound the way it should
  • A busted eardrum — fluid or blood leaking from your ear is a sign
  • Hearing loss

In the case of all the above symptoms, if the person didn’t consult for medical help, there is a greater possibility that symptoms may increase. But after treatment, all the symptoms go away. Here is a list of additional symptoms that can occur in some of the cases –

  • Nosebleed,
  • Ear pain,
  • Moderate to severe hearing impairment,
  • Injury in the eardrum,
  • In the case of underwater, a feeling of ear pressure.

It becomes sometimes very challenging to diagnose the accurate cause of ear pressure. Depending on the cause ear pressure can be from an ear infection or hearing loss. In most of the cases, it can also be from a sinus infection.

Also, most of the constant and severe cases of ear infection such as cholesteatoma or Externa and otitis media can result in meningitis. However, a cyst that is not diagnosed or treated can spread their infection inside the ear bones which can lead to permanent hearing impairment.

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Causes of Ear Barotrauma

Most of the ear pressure results from the eustachian tube. Giving attention to your body signals help in identifying the causes at an early stage.

One of the main cause of Ear barotrauma or building of ear pressure is the blockage or obstruction of the Eustachian tube. This tube helps in restoring the equilibrium during the time when pressure changes. As a result of rapid changes in the surrounding air pressure or high atmospheric pressure, the eustachian tube opening closes. Therefore symptoms develop a change in pressure.

Especially during airplane taking off or landing and at high altitudes this condition occurs more often. Sometimes this condition is also known as Airplane ear. There are some other conditions that can also cause ear barotrauma such as –

  • Hiking,
  • Underwater water sports or scuba diving,
  • Driving in mountains.

When driving through mountains or getting involved in elevated activities. Therefore, air is unable to reach your middle ear, as the eustachian tube is closed.

This causes the eardrum to bulge because of the lower pressure in the middle ear as compared to the pressure in the outer surrounding. This can cause ear pain and sometimes additional injuries.

Barotrauma also happens if the throat swells up which prevents air from entering through the eustachian tube. It also occurs with the pain in the ear. In some of the severe situations, the barotrauma causes the eardrum to rupture resulting in the nose or ear bleeding.

Other Causes of Pressure in Ear and Head

Sinus Infection

Ear infections occur when fluid is buildup occurs in the sinus cavities and most respiratory conditions occur simultaneously including bronchitis.

Everyone’s sinus cavities are linked to each other which imply that anything present in your ear can also affect your head too.

This change in ear head pressure leads to a change of the body’s own pressure. This, in turn, affects your brain and it gets stimulated due to the sinus infection.

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All this internal confusion cause dizziness as your brain is finding it difficult to process the incoming information.

1. Ear Congestion

One of the other function of the Eustachian tube is to drain mucus or fluid of the ear. In case, because of infection, the Eustachian tube becomes inflamed then as a result fluid get to build up. This build up fluid creates eardrum pressure and pressure on the surrounding.

This fluid not only causes pressure inside the ear, hearing difficulty, loss of balance, ringing in the ear(tinnitus). In addition, it also breeds bacteria and additional infections.

Can flying cause Eustachian tube dysfunction?

2. Eustachian Tube Dysfunction

As a result of a cold or similar infection, eustachian tube dysfunction occurs. Usually, people with sinus pressure go through middle ear blockage due to eustachian tube congestion.

Therefore, the inner ear membrane gets swollen and inflamed because of the plugged nose or ear and mucus build up. As a result, now the eustachian tube is unable to drain mucus or circulate air as it was used to.

Usually, this mucus build up and swelling take a few weeks to go away. In some of the cases, high fever can also be the cause.

Eustachian tube dysfunction occurs mainly with a feeling of fullness in the ear, dulled or muffled hearing, ringing or buzzing in the ear, dizziness, and pain in the ear as the eardrum is tensed and stretched from the pressure inside the ear.

3. Otitis media (middle ear inflammation or infection)

Fluid starts accumulating inside in the middle ear as the sinus congestion cause the eustachian tube blockage. Also, if the sinus infection starts spreading into the eustachian tube then might cause middle ear infection(otitis media).

This sinus ear fullness condition causes swelling and more accumulations of fluid. This middle ear inflammation also causes ear pain.

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4. Obstruction

Obstruction occurs when there is a blockage in the ear that prevents the surrounding air to enter your ear. The main reason behind the blockage is the buildup of ear wax and sometimes a bone overgrowth.

This overgrowth of tissues present inside the back of the nose (such as nasal polyps or the adenoids) is also termed as a Mechanical blockage.

Nasal passages are the non-cancerous, fleshy sac like transparent tissues that are present inside the nasal passage lining and along with the sinuses. In the beginning, they don’t cause any kind of problem but if by any chance they start growing and increasing in number and size then it can lead to health-related issues.

The nasal congestion leads to the blockage of the natural irrigation pathway and air passages inside the ears, nose, and throat which might cause pain in the ear, ear infection and deafness if not diagnosed and treated at the right time.

This obstruction is more common in children as compared to adults. Adults also need various type of lifestyle change such as avoiding spicy food and smoking, reduce exposure to cold climate and infection, remain in a clean and unpolluted environment, etc.

Read more:- How to Remove Earwax Naturally?

5. Allergies cause ear pressure

Allergies to specific airborne substances such as pollens, dust start releasing chemicals known as histamines from your body to fight these intruders. Some of the allergies symptoms are sneezing, sinus congestion, cough or itchy throat.

When you start experiencing symptoms in your ear, like clogged ear, then your eustachian tube gets blocked with the mucus.

And as a result, the eustachian is unable to equalize the pressure around the ear. All these middle ear disturbances lead to dizziness for those who all those who are suffering from these allergies.

Moreover,  if any person previously has diseases of the dental pulp then change in cabin pressure might affect those individuals.

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This unique condition can occur when any amount of air present inside the diseased tooth leads to changes in the barometric pressure present in the atmosphere.

6. Cerumen Buildup & Blockage

Ear wax is also known as cerumen. It is made by the body for the protection of ears. The cerumen has both the lubricating and antibacterial properties.

If it is left untreated can lead to hearing loss, pain in the ear, irritation, ringing in the ear, dizziness and other problems.

Excessive ear wax may cause symptoms of ear wax impaction to become worse.  Ear wax buildup and blockage often happen when people use items like cotton swabs or bobby pins to try to clean their ears.

This only pushes the ear wax farther into the ears and can also cause injury to the ear.


Risk Factors

Individuals who have colds, allergies, or infection are at high risk of experiencing ear fullness. Kids and young adults are more prone to this condition.

As a child eustachian tube is much smaller as compared to adults and it is also positioned differently. Therefore, the eustachian tube can block easily in children.

Most of the time you find baby cries while landing or taking off, the main reason behind is the effect of negative ear pressure.


Diagnosis

In most of the cases, ear barotrauma effects are temporary and one needs to consult a physician if the symptoms got severe. In case of severe symptoms people generally experience bleeding from the ear or ear pain.

Therefore, one needs to go through a medical examination to rule out an ear infection.

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Health professionals usually suggest a physical exam. People take otoscopy, an examination involving looking closely into the ear which can sometimes reveal changes in the eardrum.

Change in pressure also pushes eardrum inward or outward from its normal position.

Sometimes your physician also squeezes air into the ear (insufflation) to inspect whether there is a fluid buildup behind the eardrum or not.

In case, there are no results found from the physical exam then your doctor will prescribe you some other method for the correct diagnosis.


Can You Go on a Plane with a Blocked Ear?

This question often comes to your mind before you go on a plane.

Well, flying with an ear blockage will ruin your flight. If your ears area unit blocked, you are undoubtedly suffering from negative pressure in the ear or ear barotrauma which may cause discomfort and pain. In a very worst-case situation, your eardrums might crack.

If your ears area unit blocked due to a cold, sinus or nose infection. You will think about suspending your journey if it is not essential that you just travel.

If you experience ear barotraumas, without wasting time contact a medical professional (1800-121-4408). If your ear remains uncomfortable for many hours even after your flight.

There are many of us who experience ear barotrauma or ear fullness but if it didn’t get diagnosed at the right time. It eventually, result in losing their hearing in the afflicted ear.

But the good news is if you experience hearing loss due to ear fullness. You can have your hearing back and the loss will only be temporary and is also reversible.

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Inner Ear Decompression Sickness

Inner ear decompression sickness (IEDCS) is a type of injury which is similar to the inner ear barotrauma, but the treatment is not similar.

According to NCBI, this condition is incompletely understood and most of the time found in compressed- air drivers as they breathe a compressed mixture of oxygen and helium.

Its symptoms are similar such as deafness, tinnitus or dizziness during ascent or also after the same duration.

IEDCS occurs most of the time during ascent or after some time after diving. However, negative ear pressure occurs in most of the cases during compression (ascent) or after a smaller dive.

Patients having IEDCS need to immediately shift to the hyperbaric chamber for recompression. There is a correlation exist between early recompression and recovery.

It is almost a necessity to diagnose an exact cause of the ear pressure, as the treatment process varies according to the cause.

Negative Ear Pressure Treatment

If Eustachian tube is blocked then it isolates the middle ear space from the outside environment. The middle ear creates a negative ear pressure which pulls the eardrum inward.

The eardrum is thin and pliable, like a plastic wrap. When it becomes stretched inward, patients often experience pain, pressure, and hearing loss.

If the blockage of Eustachian is long term then it leads to the accumulation of fluid in the middle ear space that further increases the pressure and hearing loss. A blocked eustachian tube can be a major issue.

To get relief from negative ear pressure you can do the following things:

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  • Chew gum
  • Inhale, and then gently exhale while holding the nostrils closed and the mouth shut
  • Suck on candy
  • Yawn
  • Try an over-the-counter pain reliever

How to Relieve Ear Pressure Naturally?

There are some known methods that can open Eustachian tube and restore pressure balance to your ear. Although there are only a few natural solutions to restore fullness in the ear or relieve ear pain from the ear infection.

If the pain is from inflammation, then one need to wait for your doctor consult. Making any kind of self-applying technique, whether herbal or otherwise is not prescribed without doctor’s suggestion.

Although it is important to know how to relieve pressure from your ear so, here are some of the methods for the treatments.

Some of the patients get relief without medication. Here are a few natural tips for immediate relief of fullness in the ear.

1. Valsalva Maneuver Techniques

Valsalva maneuver
Valsalva Maneuver Technique

Everyone should learn maneuver techniques as they help in equalizing the air pressure inside the ear. Here are some steps to perform this maneuver technique –

  • Pinch your nose
  • Close your mouth
  • Try to breathe out air forcefully with a closed mouth.

This will accelerate your heart rate and after that slows down your heartbeat.

Then, you will suddenly hear and feel a popping sound in the ears. Or if you’re congested then you will hear a high pitched sound inside your ears after performing this technique.

Another alternative apart from Valsalva maneuver is the Toynbee maneuver. This technique involves swallowing while pinching your nose.

In case both the techniques don’t work, then apply the Lowry technique, it is a combination of both maneuver and Toynbee maneuver technique.

In Lowry technique pinch your nostrils close, then blow and swallow at the same time. By any chance you are unable to use your hands, then wrinkle your nose as if you begin to smell something very bad and then try blowing and swallowing at the same time.

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2. Frenzel Maneuver

Frenzel maneuver is also an option if you are running out of alternate options. During this technique try to close your nostrils with fingers or your facial muscles.

Try to engage your throat muscles for closing the back part of your throat as if you are trying to lift some heavy weight and try to make a sound with a letter “K”.

This will begin to push your tongue upward and backward and automatically it will push air into your eustachian tube, which is connected to your ear.

To learn in detail Ear Equalization Techniques watch the video –

3. Drinking or Yawning

The way one person yawn involves the opening of his Eustachian tube. Also, yawning forcefully can also relieve mild barotrauma which helps in cases of dysfunction or congestion.

The eustachian tube also opens when you eat, drink or swallow something or even when you dry swallow. Drinking water can also help in most of the cases of dysfunction or ear congestion.

The water helps in making thin the mucus in the ear or eustachian tube, or nose, or in sinuses which is the source of creating the pressure.

4. Indulging Your Sweet Tooth

Chewing gum or candy can lead to the opening of the eustachian tube. In case you don’t like sweets, you can suck on a mint, that can also work.

5. Medications

If you frequently experience blocked ears and therefore the associated negative ear pressure once flying, you may concern taking medicine about an hour before your flight to stay the tubes in your internal ear open.

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You may attempt each a medicine administered orally or sprayed into your nose. If your ears stay blocked when your flight, your doctor could recommend a medicament or steroids. In terribly rare cases, surgery is also necessary.

6. Ear Planes

For providing relief to the airforce pilots, a product was develop called “Ear Planes”. They are the earplugs used for the protection of eardrum from sudden to high ambient changes in ear fullness.

These earplugs allow the pressure changes in the ear to remain slow throughout the passage in the earplugs. This slow rate of ear pressure help in minimizing the pressure difference around the eardrum.

Other Treatments which help to relieve sinus pressure

  • Humidifiers It adds moisture to the air in spite of the humidity level and the moisture in the surrounding air. They are the best option if you want to keep your sinuses moist throughout the whole day. In case you live in the dry area then using humidifiers is the easiest way to support heat to your body and also keeps your skin moist.
  • Taking Decongestants by Mouth or Spray or Antihistamines – To get relief from ear pain and a lot of pressure in the ear, you can use nasal saline spray. Nasal sprays or Over-the-counter tablets help in relieving clogged ears. You can apply this spray several times a day. Also, you can use warm and moist washcloth by holding it against your face.
  • Avoid Temperature Extremes – Extreme temperature can make clogged ear sinus pressure worse with time. if you have any kind of ear problem avoid going for a run on a hot sunny day.
  • Apply Cold Pack – You can apply a cold pack to the affected area, for instant relief from the ear pressure popping. You can use this cold pack all around your head or sinuses. Keep the pack for not less than 20 minutes. To prevent yourself from freezer burns, try not to apply ice directly to your face.
  • Steam to Clear the Sinuses – Steam helps to release fullness in the ear. Professional suggest to sit in a warm shower for around 15 minutes but you can opt for a hot bath or head sauna also. Although in a hot bath you need to protect your skin from the heat.
  • Keep Your Head up – Try not to bend your head downwards in case your feeling ear pressure, by keeping the head down will increase pressure on your sinuses as well as on your ear.
  • Acupuncture for Clogged Ears – Although Acupuncture is not recommended as a cure still it helps in the release of clogged ear pressure. It is performed in various sessions, which takes a week or a two. Your practitioner can select certain pressure points depending on your symptoms.

Read also – Acupuncture Therapy & Message Points For Hearing Loss

Note – Do not use nasal decongestant sprays more than 3 days as they will make you feel more congested.

Essential Oils for the sinus infection and ear pressure

  • Chamomile and lavender – Always use them separately. These oils not only reduce the pain causing infection but also treat the infection.
  • Eucalyptus, Pine, and Peppermint – These essential oils help in reducing sinus congestion.
  • Tea Tree Oil – It is one of the best choices to kill ear infection. In order to get the best results, use tea tree oil in steam inhalation, it will increase its antiseptic action. Steam inhalation helps in reaching the infection location faster as it spreads the vapors all around the sinuses and respiratory system.
  • Basil Essential Oil – This oil is analgesic which means it relieving inflammation and pain in the ear. Individuals with seizures,  asthma, seizures, and diabetes should consult a doctor before using basil essential oil.
  • Lemon Eucalyptus Essential Oil – Its powerful anti-inflammatory property reduces the inflammatory response of your ear to otitis media. It is prescribed that one should not use this oil by more than 20 percent.

Is The Use of Decongestants And Nose Sprays Recommended?

There are many air travelers who use over the counter nasal spray or decongestant pill an hour before the descent. These decongestants help in shrinking the membrane and therefore very beneficial when you want to pop your ear.

Decongestants tables can be bought without any kind of prescription from the doctor.

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Patients of heart disease, irregular heart rhythms, high blood pressure, excessive nervousness or thyroid disease should try to avoid decongestants tablets or consult a specialist before taking them.

Also, a pregnant woman also needs to consult their doctor before taking these pills.

Try not to sleep while landing on a flight. You can also try about listed treatment methods. For toddlers and young adults, taking small sips of any drink can also help during a flight.

In some cases of scuba diving when the diver has any kind of allergies or respiratory infection, barotrauma can be dangerous.

In case any of the treatment doesn’t work then your doctor might suggest surgery to locate tubes in the eardrum.

Read also:- Airplanes and ear pain – What to do and Why it happens?


Surgery

According to health professionals, surgery is one of the best options, if your ear barotrauma is severe. Surgery is must if the negative ear pressure has not healed ever after the treatment of two months.

Ear tubes are the small cylinder which is located through the eardrum and it encourages the airflow into the middle of the ear. These tubes are also called grommets or tympanostomy rubes.

Ear tubes are mostly used in preventing infection from ear barotrauma in children. They usually keep in place for 6 to 12 months. The second choice for surgery is a tiny slit made into the eardrum to equalizing the ear fullness.

This slit will heal quickly and also helps in removing the fluid accumulated in the ear. Although it is not a permanent solution.

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Ear Barotrauma in Kids

Mostly kids and young adults are more prone to ear barotrauma. At this young age, their eustachian tube is very small in size and have difficulty in equalization.

If your child is experiencing pressure in the ear, he must be showing symptoms of distress, discomfort, pain, and agitation.

Health professionals suggest that drinking fluid is a good option while experiencing any kind of change in altitude. For pain relief, doctors prescribe eardrops for infants.

Tympanostomy tubesAlso, in case your children who have tympanostomy tubes inserted inside eardrums as a result of congestion or ear infection, they will protect your child from the symptoms of ear barotrauma.

Most of the time tympanostomy tubes are used for the treatment of chronic ear effusions in young adults and infants whereas in adults need these tube for major otitis media or eustachian tube dysfunction.

HOW TO HELP BABIES UNBLOCK THEIR EARS?

Children are not able to pop their ear on their own but popping can happen if they start sucking a pacifier or a bottle. Try to feed your baby during the flight journey and also try not to make him/her sleep during descent.


Outlook (Prognosis)

Ear barotrauma in most of the cases found out to be noncancerous (benign) and get cure with self-care. Although, deafness is a temporary symptom caused by ear fullness in your ear.

Possible Complications

In many individuals symptoms of ear barotrauma are temporary. Although some people experience chronic cases. In case it is left untreated, then it results in some potential complications such as –

  • Hearing impairment
  • A perforated or ruptured eardrum
  • Acute ear infection
  • Bleeding from the nose and the ear
  • Recurring pain
  • Feeling of unbalance (vertigo)
  • Chronic dizziness.

When to Contact a Medical Professional

If you experience any kind of hearing difficulty or ear pain then consult a doctor immediately before the symptoms turn out to be chronic. As repeated symptoms can be a sign of chronic or severe ear barotrauma such as –

  • Severe ear pain,
  • Bleeding from the ear,
  • Fever.

Recovery

Every other person has experienced a specific type of ear barotrauma. Most of the patients have a temporary hearing loss. It is recommended to avoid traveling at high altitudes while recovering as the pressure changes as altitude differs.

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Some of the patient’s experiencing ear fullness get relief from pressure in the ear without any kind of treatment. In case, the patient has ear barotrauma because of respiratory infection or allergies then it is prevented only when the masked cause is resolved.


Prevention

Individuals who experience an allergy attack or have an upper respiratory infection should avoid altitude changes. To decrease fullness in the ear you can take decongestants or antihistamines before going for scuba diving or for flying.

Capsules and pills take time to start working so, take them before not less than 30 minutes before takeoff.

Here are some steps listed below to decrease or prevent ear fullness –

  • Try to exhale through your nose when altitude changes.
  • When experiencing symptoms you can yawn, swallow, chew or drink for relief, take sips of water.
  • Do not wear earplugs while flying or diving.
  • Slow your speed while driving or descent slowly while scuba diving.
  • Use maneuver techniques while ascent and descent.
  • Reconsider travel planes in case of sinus infection, cold, and cough.
  • Take allergy medication.
  • Use an over-the-counter decongestant nasal spray.

Here is what you can use to prevent the pain and possible hearing loss from flying with a cold.

Mostly, every drug store carries a special earplug. They are pressure-relieving earplugs made from semiconductor baffles with a little ceramic infix the center.

The plug moves terribly slowly with a pressure amendment, giving your sinuses and eardrums time to regulate. Place them in before the plane doors shut and also the pressurization begins.

You’ll take the plugs out once at scoop altitude, however, place them at once more important before the plane starts.

You’ll still feel some sinus pain/pressure, however, it won’t be nearly as dangerous, and also the ceramic plug can keep your eardrums away from a blast. Earplugs are small and are available in a very little plastic box.

We hope you like the article and you find some relief from ear pressure. If your problems still persist and then consult a hearing professional for medical consultation, to find one call 1800-121-4408 (Toll-Free) today, Visit HearingSol Clinic in Delhi NCR.

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