Dear Alice,

When I fly, I get earaches. How can I avoid this on an upcoming flight?

Dear Reader,

What you're experiencing is called barotrauma, or a sudden change in ear pressure that results from a difference in the air pressure in your middle ear chamber from the air pressure of the environment. In addition to flying, pressure changes can also occur during scuba diving, driving in the mountains, and explosions. Symptoms of barotrauma include:

  • Temporarily impaired hearing
  • Rnging in the ears
  • Dizziness
  • Pain in the inner ear (earaches)

The pressure in the airplane cabin changes during take-off and landing. This is because cabins are not pressurized to preserve the air pressure that existed on the ground. When the air pressure changes in the surrounding environment, the Eustachian tube, which connects the middle ear to the back of your nasal cavity, will allow air to leave or enter the middle ear to even out the pressure difference. But if your Eustachian tube is blocked due to congestion or some other problem, barotrauma results.

The following tips can come in handy during take-off and landing:

  • Swallowing
  • Yawning
  • Chewing gum
  • Sucking on hard candy
  • Exhaling while holding your nostrils shut and closing your mouth

All of these might help open up the Eustachian tube and allow air to flow in or out. If you must fly with a cold, you can also try to take a decongestant an hour before take-off. If it is a long flight, you might want to take another dose an hour before landing.

If symptoms of barotrauma, such as impaired hearing or earaches, persist after a few hours of landing, it is important that you see your health care provider. Treatment may involve the above-mentioned exercises and/or decongestants to help open the Eustachian tube. For severe barotrauma, antibiotics may be necessary to avoid an ear infection; only very rarely is a surgical opening of the eardrum required.

While your earaches during flying are annoying, they probably aren't an indication of severe barotrauma if they go away within a few hours of landing. So the next time you travel, try the yawning or breathing tips mentioned above for a more comfortable flight.


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