‘Cabin crew, be seated for take-off’.
And you’re ready to go.
The noise of the engine. Feeling the plane lift from the ground. Soaring through the clouds watching the houses become tiny dots below.
Taking off in a plane is an exciting experience. But amongst the excitement, there's a niggling problem. One that is potentially harmful to your hearing. It’s real, it’s painful and it has a name: airplane ear.
You know the one. That painful pressure, resulting in ear popping and muffled hearing.
And it doesn’t discriminate. No matter how much you paid for your seat or how much leg room you have, ear discomfort is sure to have crept up on most fliers at some point.
For the majority, the discomfort is nothing more than an annoyance. But in some cases, it can become more serious, leading to severe pain, hearing loss and permanent hearing conditions. When you get caught up in the fast-paced chaos of travel, it’s easy to neglect your ears. But protecting them is vital.
In this blog post we’re going to look at what causes plane ear, the symptoms to watch for and the treatment available to you.
First up, what exactly is airplane ear and what are its causes?
Airplane ear: The cause.
Why do ears pop on a plane?
And more importantly, why do my ears hurt on a plane?
They’re commonly asked questions and the simple answer is: it’s all down to pressure.
The pressure, pain and popping that occurs is related to fluctuation in ear pressure and how fast it happens.
Your middle ear is an air-filled space formed by bone and the eardrum. It is connected to the back of the nose by a tunnel called the eustachian tube. The outside air that passes through the eustachian tube keeps the pressure equal to that of the outside world.
If a pressure difference occurs, that’s when airplane ear pain rears its head and problems can arise.
When you’re on land and going about your usual daily life, the air pressure inside the inner ear and the air pressure outside are essentially the same (or at least not different enough to cause issues).
But in the air, it’s a different story. The pressure balance isn’t equal, and the change is so rapid that the pressure inside the inner ear doesn’t have enough time to equalize. In this case, the tympanic membrane in your ear will swell outwards – a bit like a loaf of bread rising during baking – and this is called airplane ear. Or in more medical terms, ear barotrauma.
Imagine if you were taking a slow hike to the top of the highest mountain. The slow speed at which you were going would allow time for the pressure to equalize along the way. But during take-off or landing, that’s not how it works. And your ears are blindsided by the change and can’t keep up.
During this time, the eardrum is stretched and not able to vibrate, which can cause pain, popping, or muffled hearing.
What are the symptoms of airplane ear?
The more common symptoms can include:
° A ‘stuffiness’ in your ears
° Muffled hearing
° Ear popping
° Ear pain
Sometimes you may feel a “pop”, which is a sign that your eustachian tubes are open. But if they stay closed your middle ear can fill with liquid to try and balance the pressure inside. If closed, they won’t be able to drain, which is when more serious symptoms can occur.
These symptoms can include:
° Extreme ear pain
° Vertigo (dizziness)
° Tinnitus (a permanent ringing sound in your ear)
° A burst eardrum (you may notice fluid or blood leaking from your ear)
° Hearing loss
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Are some people more at risk?
Unfortunately, most fliers are at risk of airplane ear. It’s the way the human body works.
However, if when you board you have an existing issue with your eustachian tube, and it’s not opening as it should, you may be more at risk.
° Signs of an existing issue include:
° Stuffy sinuses
° A cold or other infection
° The shape and size of your ear canal (children)
° Tobacco smoke or other irritants
° Hormonal changes such as pregnancy
° Environmental factors such as exposure to loud explosions in the military for example, or scuba diving without the safe gear
Tips to help prevent airplane ear
The good thing to remember is that if you take the right approach to self-care, airplane ear is entirely preventable.
By following some handy advice, you can make sure that you don’t cause any permanent damage and ensure that you have a comfortable flight.
Here’s how to prevent your ears from popping on a plane:
Invest in earplugs
Are earplugs safe on a plane? Do earplugs help with airplane pressure? These are common questions that are asked surrounding earplugs for flying.
The answer is yes. And we don’t mean the usual cheap, throwaway yellow earplugs. We’re talking about earplugs that are specially designed to safeguard your ears and give them the maximum protection when flying.
They work to slowly equalize the pressure against your eardrum, protecting the delicate parts of the ear and easing pain and discomfort.
The Experience Plus earplugs reduce noise by up to 23dB. They work to equalize the pressure in your ear and the new tech means that they won’t block or muffle sound. You’ll still be able to hear everything you need to on board. They’re also ultra-comfortable and fit snugly in your ears, so you won’t have to worry about them falling out.
Swallowing or yawning
The main way to prevent airplane ear is to open the eustachian tube as much as possible. When you swallow or yawn, the clicking or popping sound that you hear is a tiny bubble of air that has moved from the back of the nose to the middle ear, via the eustachian tube. Making sure that the eustachian tube is working overtime and open more frequently will give it a greater chance of accommodating the air pressure.
Chewing gum or sucking on candy
Both of these actions will stimulate the frequent swallowing that’s needed to help equalize the air pressure.
Try the Valsalva maneuver
This handy tip is often used by frequent fliers. Take a big mouthful of air, close your mouth, and then pinch your nose. Then, gently force air out of your mouth until your ears pop. It’s a great way to open up the eustachian tubes.
IMPORTANT NOTE: if you’re sick with a cold or allergies are raging, the Valsalva maneuver is not the one for you, as it could cause a severe ear infection.
Medical treatment for airplane ear
Most cases of airplane ear are mild, only last a few minutes and can be treated with tips and self-care.
If it lasts longer, you may need medical treatment for an infection or another underlying problem.
Treatment may include:
° Oral decongestants or nasal spray to open the eustachian tube are often a great airplane ear remedy
° Antihistamines may be prescribed if allergies are a contributing factor
° Pain medications or eardrops may be suggested to relieve any pain.
° Eardrops are only recommended if the eardrum isn’t ruptured
° Antibiotics for a ruptured eardrum
° A hearing exam for any hearing loss present
° In rare and extreme cases, surgery may be necessary to repair the eardrum
Other expert tips to avoid ear pain when flying
To keep ear pain at bay, there are other little hints you can take on board with you.
° Stay awake during ascent and descent. If you’re asleep you’re unlikely to be taking any preventative measures to protect your ears, such as yawning or chewing on gum
° Drink lots of fluids in-flight to stay hydrated
° Use nasal spray one hour prior to landing
If your ears are still blocked after a flight, plagued by stuffiness, and muffled hearing is still a thing, you can try the Valsalva maneuver. A warm compress applied to the ear or steaming will also help. The aim is to gently ease the pressure as slowly as possible.
Airplane ear and children
Children can often suffer from airplane ear more severely.
This is down to a child’s eustachian tubes being smaller and narrower than an adult’s. The change in air pressure in the ear can often have painful consequences.
There are some things you can do to ease the pressure.
° Encourage swallowing by giving them their bottle or pacifier.
° Children older than four can try sucking on a lollipop or drinking through a straw to ease the pressure
Make sure you avoid decongestants – they aren’t recommended for young children
You should speak to your pharmacist about the possibility of pain-relieving eardrops, especially if they’ve struggled on a flight previously
Airplane ear is common and it’s painful.
But it’s important to remember that it’s also preventable.
Here’s a quick recap:
° Airplane ear is caused by an imbalance in pressure between the middle ear and pressure outside the ear. The rapid and intense change in pressure can cause the eustachian tube to become blocked, which causes airplane ear.
° Some conditions can put you more at risk, namely those that affect how the eustachian tube is opening, such as colds, allergies, and having a smaller tube (like children), or outside irritants such as tobacco.
° Earplugs can be used to alleviate the pressure and ease the pain. So can special techniques such as the Valsalva maneuver, yawning frequently and sucking on hard candy.
° In the rare event that medical intervention is needed, there are treatments available such as antibiotics, hearing exams, or even surgery for extreme damage.
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