Airplanes and ear pain: Why it happens and what you can do
With all of the inequality in airplane travel these days, from vastly different fares, comfortable aisle seats vs uncomfortable middle seats and business class vs coach, one thing remains a great equalizer in air travel: ear discomfort. No matter where you are sitting in the plane or how much leg room you have, the ear pressure, pain and popping do not discriminate.
Ear difficulties during airplane travel are usually nothing but an annoyance, but what happens when it becomes more serious? Unfortunately the ear pain and pressure does, in rare cases, lead to severe pain and hearing loss, so it is best to take precautions, before, during and after a flight.
What actually happens
So what actually happens to ears when we fly? It really comes down to air pressure. Normally the air pressure inside the inner ear and the air pressure outside are essentially the same, or at least not different enough to cause any trouble. Even if you were to hike to the top of a tall mountain, the slow speed of your ascent would allow time for the pressure to equalize along the way. A problem only occurs when the change in altitude is so rapid that the pressure inside the inner ear and the air pressure outside don’t have time to equalize, as occurs in air travel.
When your flight takes off, and begins its ascent, the air pressure inside the inner ear quickly surpasses that of the pressure outside. The eardrum swells outward. Picture a loaf of bread baking, and you get the idea. Conversely if air pressure inside the inner ear rapidly becomes less than the air pressure outside, the tympanic membrane (the eardrum) will be sucked inward, almost like a vacuum effect. What has happened is that the Eustachian tube has flattened and needs a bit of extra help from you in order to continue to do its job of bringing air into the inner ear. Whether ascending or descending, that stretching not only causes the eardrum not to vibrate (thus the muffled sounds) but also causes the pain you feel.
Everyone who has flown in an airplane has felt the effects of a change in altitude on ears; a feeling of fullness and popping is commonplace. You need to equalize the pressure by introducing as much air as possible via the Eustachian tube and there are a number of ways to do that.
Let’s start with swallowing, the easiest way to equalize the pressure. When you swallow, that clicking or popping sound you may hear is actually a tiny bubble of air that has moved from the back of the nose into the middle ear, via the Eustachian tube. The Eustachian tube ensures that the air in the middle ear is constantly being re-supplied. That air is then absorbed into the membranes of the inner ear, and the cycle starts over again. This constant cycle of air ensures that the air pressure on both sides stays equal. When you fly, the trick is to ensure that the Eustachian tubes work overtime and open more frequently to accommodate the change in air pressure.
One of the most commonly used methods to open up the Eustachian tubes and allow more air into the inner ear is swallowing. Chewing gum or sucking on hard candy will help; for infants, whose Eustachian tubes are much narrower than an adult’s, the change in air pressure can be even more excruciating, so a bottle or pacifier is recommended to increase swallowing, especially upon descent. Older children might suck on a lollipop, drink through a straw or blow bubbles through a straw in order to relieve ear pain. If you are planning on flying with an infant or child, talk to his pediatrician about the possibility of pain relieving eardrops for use in flight.
There are other ways to unblock ears, of course. For healthy adults, most experts recommend the Valsalva maneuver. With a mouthful of air, close your mouth and pinch nose your nose shut; gently force air out until ears your ears pop. Note: if you are sick with a cold or allergies, the Valsalva maneuver is not recommended, as it could cause a severe ear infection. Instead, try a lesser known method called the Toynbee maneuver: close your mouth and nose and swallow several times until pressure equalizes.
Other tips from experts include:
- Avoid sleeping during ascent or descent
- Drink lots of fluids in-flight to stay hydrated
- EarPlanes: Specially designed ear plugs that have a filter to equalize pressure
- Nasal spray: Take only on as as-needed basis as overuse of nasal sprays can end up causing more congestion. Use 1 hour prior to descent
- Decongestant: Shrinks nasal membranes. Take one hour before descent, also post-flight until ears normalize
And remember, consider changing your travel plans if you have congestion, a cold or an allergy attack. The sickness can cause a blockage in the Eustachian tube, preventing the necessary equalization of pressure. A ruptured eardrum or severe infection can occur; in short it can be dangerous to your hearing and cause hearing loss or permanent damage. See a hearing healthcare professional if your hearing doesn’t return to normal within several days post-flight. If you don't have a regular hearing healthcare professional, check out our directory to locate one near you.