Ear Pain During Travel

Why does it happen?
What are the symptoms?
How is it treated?
What happens if I do not do anything?

Why does it happen?

You can get ear pain during air travel when the air pressure inside your ear is different from the pressure outside your ear. Usually, a tiny tube called the Eustachian tube keeps the pressure the same. The Eustachian tube connects the inside of your ear with the back of the nose. (It opens and closes when you swallow your yawn)

When you fly, the air pressure around you changes quickly, especially during take-off and landing. Air pressure is the highest near the ground and lessens as you increase altitude. Changes in altitude put pressure on your eardrum.

If your Eustachian tube is blocked for some reason, it can be especially difficult to get enough air into your ear from your nose, especially if you have a cold. It is also more likely in children because their Eustachian tubes are shorter and narrower than in adults.

What are the symptoms?

Generally people experience pain during take-off and landing. The pain usually subside shortly after landing. People can also experience a feeling of blockage or dizziness. Occasionally they also experience tinnitus (ringing in the ears). Rarely the eardrum may perforate causing blood to weep out of the ear canal.

How is it treated?

If your ears are blocked because you have a cold or an infection, it may be better not to fly. If you cannot avoid flying, there are ways to reduce your chances of getting ear pain during the flight.

Medications

Decongestants are medications that reduce swelling the nose and facilitate temporary opening of the Eustachian tubes. They can be taken either orally or topically. Oral decongestants are present in most cold and flu tablets. The most effective tablets are those that contain pseudoephedrine. A sustained release form may be best so that the benefit lasts from before takeoff to landing.

Topical decongestants that contain oxymetazoline (Drixine, Otrivin) are also effective. They should be taken 20 minutes before take-off or landing. Note that these should never be used regularly for more than 3 days as they can cause long-term damage to the nose.

Generally decongestants of any type are not particularly effective in helping children.

Things you can do yourself

Yawning and swallowing or blowing hard while holding your nose may help to reduce the pressure in your ears. If you try these treatments, you should feel your ears ‘pop’. Chewing gum or sucking on a lollie may also be helpful.

What happens if I do not do anything?

You will probably find that the pain in your ears during the flight goes away shortly after you land. It is very unlikely that the pressure will cause a perforation, or a hole in your ear drum. A perforation is a very rare occurrence and even when it does occur, the hole generally heals itself in the majority of people. It is important to keep water out of the ear while a hole in the drum is healing. You can read more about that here.