Q: Sometimes my ears hurt during flights. Why does this happen, and what can I do about it?
When you fly thousands of feet above ground, the changes in cabin pressure can be downright unpleasant — causing potential issues like abdominal bloating, headaches and yes, earaches.
“Airplane ear” is an umbrella term for a variety of symptoms caused by rapid changes in altitude and air pressure, said Dr. David Gudis, an otolaryngologist at NewYork-Presbyterian/Columbia. For some people, it’s no more than a clogged feeling that temporarily muffles hearing. For others, the condition may cause intense pain and even damage the ear drum.
“The good news is that it generally resolves on its own,” Dr. Gudis said. “It can just be very uncomfortable until it does.” This can take anywhere from seconds to days, he added.
Why does air travel hurt your ears?
In the space behind your eardrum, or the middle ear, is a structure called the Eustachian tube, which connects the middle ear to the back of the nose and throat. The Eustachian tube is responsible for keeping the air pressure between the middle ear and the environment the same.
Keeping air pressure balanced is “something we don’t normally have to think about,” said Dr. Esther X. Vivas, a professor of otolaryngology at the Emory University School of Medicine in Atlanta. We can usually do it by yawing or swallowing, which contracts muscles that open the Eustachian tube, experts said.
But when the air pressure changes quickly during a flight, it can be hard for the Eustachian tube to “keep up,” Dr. Gudis said. This can make us feel that we need to yawn or “pop our ears” to force the tube open so air can pass through, said Dr. Gregory Levitin, an otolaryngologist at the Mount Sinai Health System in New York City.
If air can’t pass through the Eustachian tube, the air pressure inside your ears won’t be the same as the air pressure around you, Dr. Levitin said. You can think of it as “your ear not being able to breathe very well,” Dr. Vivas said.
The unequal pressure can stretch the ear drum and cause pain, experts said. It can also stifle hearing by preventing the ear drum from properly responding to sound waves.
Why are some people more prone to airplane ear?
There are several explanations, experts said, but the most common culprit is having upper respiratory congestion before you fly.
The middle ear and Eustachian tube have a mucous lining that traps and protects against harmful bacteria. But when you’re congested from something like a cold, allergies or a sinus infection, the lining may swell, which can clog the tube, said Dr. Howard W. Francis, a professor of otolaryngology at the Duke University School of Medicine.
Flying with an ear infection can also increase your chances of experiencing rare yet severe and painful symptoms of airplane ear such as a ruptured ear drum, Dr. Francis said. If you have an ear infection and you’re scheduled to fly, consider changing your travel plans if possible, Dr. Francis said.
Airplane ear usually goes away once air can pass through the Eustachian tube — which can happen within seconds, minutes, hours or a few days of when your symptoms start, experts said.
The quickest way to deal with it is to “pop your ears,” Dr. Vivas said. Try forcing yourself to yawn, or chew gum or sip water to get yourself to swallow.
If that doesn’t work, Dr. Gudis said, try the Valsalva maneuver, a breathing technique that involves closing your mouth and pinching your nose while gently exhaling.
Any symptoms that last for weeks, are extremely uncomfortable or that happen every time you fly should prompt a visit to an ear, nose and throat doctor, Dr. Gudis said.
How can you prevent airplane ear?
If you’re feeling congested but need to catch a flight, use a nasal decongestant spray within 30 to 60 minutes before takeoff, Dr. Levitin said.
Trying the Valsalva maneuver as a plane ascends or descends can help prevent symptoms altogether, Dr. Francis added.
Those who fly frequently or who often experience airplane ear may want to ask their doctor about pressure equalization tubes — small, hollow tubes that are surgically inserted into the eardrum to facilitate airflow to the middle ear.
But in general, most people can prevent airplane ear with much simpler strategies, Dr. Gudis said. “It’s very rare that patients need an intervention for this kind of problem.”
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