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Things to know about ear pressure

Discover more about common causes and how to relieve ear pressure.

About causes, treatment and prevention of pressure on the ears

Ear pressure can be a common occurrence in everyday situations and often has benign causes. However, prolonged ear pressure can indicate insufficient ear ventilation or underlying health issues. In this article, you will learn more about the common causes, treatments, and prevention methods for ear pressure. If you're also have experiencing problems with your hearing, take our free online hearing test for an initial and quick assessment.

What is ear pressure?

Most people are familiar with the unpleasant feeling of ear pressure, especially when driving in high altitudes or on board a plane. However, in some cases, ear pressure can persist for a longer period of time and become more intense. This can cause uncomfortable or even painful sensations, such as a plugged ear, muffled hearing, and even dizziness.

When should you see a doctor?

If ear pressure symptoms persist for an extended period and cannot be relieved by swallowing or yawning, it may indicate an imbalance in the ear's pressure or inflammation. In such cases, it is crucial to consult an ear, nose and throat (ENT) specialist for an examination.
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What are the causes of ear pressure?

When air pressure outside the ear differs from that of the middle ear, it can cause uncomfortable ear pressure. This pressure can be relieved quickly by yawning, swallowing, or chewing gum.

Persistent ear pressure can be a result of a disturbance in the ventilation of the Eustachian tube. The Eustachian tube is a narrow connection between the middle ear and the nasopharynx, which opens briefly and then closes again during swallowing to equalize pressure.

A tube ventilation disorder can be caused by various factors, such as enlarged adenoids in children or a narrowing of the cartilaginous or bony area of the Eustachian tube in adults. A cold can also cause the Eustachian tube to become swollen, leading to ear pressure. Long-term nasal obstruction due to a cold or a defective nasal septum can cause negative pressure in the middle ear and pressure on the ears. Additionally, sinusitis can manifest as ear pressure.

Other causes of ear pressure

Ear pressure can be caused by an obstruction, such as earwax build-up or a foreign object,  inflammation, a perforated eardrum, psychological stress and tension in the neck or temporomandibular joint (TMJ). People who grind their teeth at night may experience ear pressure, headaches, and jaw pain.

Ear pressure, along with tinnitus or sudden hearing loss, may indicate an underlying ear condition that requires medical attention.

Ear pressure in the tunnel

When traveling on express trains, many individuals may experience ear pressure, and in some cases, ear pain, particularly when entering a tunnel. This is due to the sudden and significant change in air pressure caused by the train's movement. As the train enters the tunnel, the air is compressed, leading to an increase in air pressure. However, the body may not have enough time to adjust to the change in pressure, resulting in a feeling of pressure in the ears.

Ear pressure when flying

Due to the rapid nature of pressure changes during flight, the body's automatic pressure equalization mechanism fails to function on an airplane. During takeoff in an airplane, the cabin pressure decreases as the plane gains altitude. This decrease in pressure can cause a build-up of pressure in the middle ear, leading to discomfort or even pain in the ears.

Upon landing, the external pressure rises again as the plane descends, which can cause a negative pressure in the middle ear if pressure equalization doesn't occur. This negative pressure can also result in discomfort or pain in the ears.

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What can I do against ear pressure?

Simple measures can often alleviate the sensation of ear pressure, and some of its causes can be avoided. However, if ear pressure is a result of an underlying condition or an ailment of the ear or auditory tube, treatment may require more complex interventions and should ideally be administered by a physician.

Pressure equalisation in acute ear pressure

In the event of sudden ear pressure in one or both ears, simple techniques can often alleviate the discomfort. Try swallowing several times, chewing (like gum), or yawning, as these movements usually open the auditory tube, thereby equalising any negative or positive pressure in the ear. If these techniques prove ineffective, perform the Valsalva manoeuvre by pinching the nose and mouth closed while exhaling slowly, forcing air into the Eustachian tube and equalizing the pressure in the middle ear.

For individuals who frequently experience ear pressure before flights or while traveling with a cold, using a nasal spray beforehand can be beneficial. The decongestant properties of the spray helps air circulate better in the nasopharynx and auditory tube, thus preventing ear pressure. In such cases, it is best to use the spray again before landing.

Treatment of permanent ear pressure

If ear pressure persists despite attempts to alleviate it through chewing or similar techniques, seek medical attention to identify and relieve its underlying cause. In the simplest case, it may be due to earwax build-up in the ear canal, which can be removed by a doctor through a simple ear irrigation procedure

When fluid accumulation in the middle ear causes pressure on the eardrum and prevents drainage, minor surgical intervention may be necessary for long-term relief. This typically involves puncturing the eardrum to allow fluid to escape through a small opening.

In cases where this problem occurs frequently, a tympanostomy tube can be inserted into the eardrum to facilitate ventilation of the middle ear and allow fluids to drain more effectively.

Treatment with medication

When fluid accumulates or pressure imbalances occur in the ear, it is often due to illnesses like the common cold that can cause inflammation of the mucous membranes or swelling in the ear, nose, and throat areas responsible for regulating air pressure - such as the auditory tube.

Allergic reactions can also lead to swelling and pressure in the ears, and treating the underlying condition with medication is recommended in such cases. Depending on the cause, decongestant nasal sprays, antibiotics, or antiallergic agents may be useful.

Physiotherapeutic measures for tension

Frequent ear pressure can be a result of tension in the muscles and incorrect strain on the vertebrae, which can affect the normal functioning of the ear and lead to pressure imbalances. In such cases, a doctor may recommend physiotherapy to address them. Physiotherapy is a treatment method that involves exercises, massages, and other techniques to improve the function of the affected muscles and joints, which can help relieve the ear pressure.

Valsalva manoeuvre

The Valsalva manoeuvre serves not only to balance ear pressure but also to remedy hiccups and alleviate tachycardia. It proves beneficial in situations involving sudden pressure changes, such as during descent while diving or in-flight aboard an airplane. In these instances, the pressure tends to close the Eustachian tubes, hindering the adjustment of pressure within the middle ear.The Valsalva manoeuvre serves not only to balance ear pressure but also to remedy hiccups and alleviate tachycardia. It proves beneficial in situations involving sudden pressure changes, such as during descent while diving or in-flight aboard an airplane. In these instances, the pressure tends to close the Eustachian tubes, hindering the adjustment of pressure within the middle ear.
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How do I prevent ear pressure?

Preventive measures vary depending on the cause of the ear pressure.

Clean your ears

Maintaining proper ear hygiene can prevent the formation of earwax plugs. It is important to avoid pushing earwax deeper into the ear canal when cleaning the ears. As a result, ear often advise against the use of cotton swabs.

Use hearing protection

Certain situations, such as flying, can trigger ear pressure. One way to prevent this is by using earplugs when travelling to alleviate ear pressure.

Nasal spray for colds

A person who frequently experiences ear pressure when they have a cold can prevent it by using a nasal spray to clear their auditory tube clear. However, it is important to note that most nasal sprays should not be used for an extended period and should be used with caution.

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