Why Do My Ears Hurt When Flying/Scuba Diving?

Most people who have spent time on an airplane in the past will recall feelings of changing pressure in the ears as the plane gained or lost altitude. People who dive underwater or go climbing at high altitudes may also have experience with this sensation.

The medical term for this is ear barotrauma, a condition that causes ear discomfort due to pressure changes. Ear barotrauma occurs when the eustachian tube, which connects the middle of the ear to the throat and nose, is blocked. Occasional ear barotrauma is common, particularly when altitude changes are at play, but frequent cases may lead to complications.

Symptoms of barotrauma develop because pressure inside the ear is different than pressure outside the ear. Here are the situations that might cause this:

Airplane ear: During the descent or ascent of an airplane
While scuba diving (the first 14 feet is often the biggest risk)
While hiking or driving through mountains

Any issue that may block the eustachian tubes can put you at risk for barotrauma, however. Colds, allergies and active infections may make it more likely, and infants and young children can be at risk due to smaller eustachian tubes that become blocked more easily.

Symptoms and Complications

Symptoms of ear barotrauma in mild or moderate cases may include:

Uncomfortable pressure inside the ear or general ear discomfort
Slight hearing loss or trouble hearing
Stuffiness or fullness in the ear

If barotrauma is allowed to progress long enough without treatment, or if the case is severe, additional symptoms may include:

•Intensifying of symptoms listed above
Ear pain
Nosebleed
Moderate to severe hearing loss or difficulty
Eardrum injury

Ear barotrauma is usually temporary, and will generally clear up fairly quickly. However, complications may arise in certain severe or chronic cases, including:

Ear infection
Ruptured eardrum
Hearing loss
Recurring pain
Chronic dizziness and feelings of unbalance (vertigo)
Bleeding from ears and nose

If you have ear pain or decreased hearing, contact your doctor for treatment.

Diagnosis and Treatment

A medical exam might be required to rule out an ear infection and confirm ear barotrauma. This could include air squeezed into the ear, or a close look with an otoscope. If there are no significant findings in the physical exam, your reporting of symptoms and the situation that caused them will give clues for diagnosis.

Ear barotrauma can often be managed without medical assistance. Here are a few self-care methods to relieve pressure:

Yawn
Chew gum
Practice breathing exercises
Take antihistamines or decongestants

In severe cases, you may be prescribed an antibiotic or steroid to help with infection or inflammation. In other severe or chronic cases, surgery might be necessary. The most common type here is ear tubes, which are most commonly used in children and can help prevent infections from barotrauma.

Another surgical operation involves a tiny slit in the eardrum to allow pressure to equalize while removing fluid present. This may or may not be a permanent solution.

Prevention and Lessening Techniques

Steps you can take to lessen or prevent ear barotrauma include:

Take antihistamines or decongestants before scuba diving or flying on a plane
Descend slowly while diving
Swallow, yawn and chew gum if you feel barotrauma symptoms coming on
Exhale through your nose during an ascent in altitude
Avoid wearing earplugs while diving or flying

To learn more about ear barotrauma or to lower your risk, speak to your doctor about your options.

Our specialists have received extensive training and completed a variety of procedures, offering the best ENT care for our patients. Our team also has access to a variety of specialties to ensure that patients receive coordinated care.

Sources:

“Ear Barotrauma.” Healthline. http://www.healthline.com/health/ear-barotrauma#overview1

“Barotrauma.” American Hearing Research Foundation. http://american-hearing.org/disorders/barotrauma/