Many people experience ear pain when they scuba dive or fly. Some feel that they cannot dive, even in a swimming pool, because they have trouble “clearing” their ears. This ear discomfort is due to pressure changes in the middle ear.
Eustachian Tube Function
The middle ear space operates normally when it is under standard atmospheric pressure, the same pressure in our environment. That pressure is regulated by the Eustachian tube, which ventilates the middle ear space and opens into the back of the nose. The act of breathing through the nose allows air into the middle ear space through the Eustachian tube. This tube opens and closes as needed to allow the correct pressure in the ears.
The Problem with Flying and Diving
Rapid decent while traveling on an airplane or while diving will prevent the Eustachian tubes from opening properly, causing pain from a buildup of negative pressure in the ears. This can lead to middle ear fluid, especially when one is also experiencing symptoms of a cold. In some cases, the pressure buildup can be so bad that it leads to a ruptured eardrum.
The act of swallowing and chewing will help open the Eustachian tube, as it is attached to the muscles on the roof of the mouth. That’s why chewing and swallowing come naturally to us when we feel ear pain or pressure upon airplane landing.
Treatment Options
Although rare, some people do have chronic Eustachian tube problems and no amount of medicine or surgical procedures will give them relief. However, most people will benefit from the following simple treatment options.
For Flying
- If you can avoid it, do not fly when you are sick.
- Take Sudafed before flying.
- Use nasal Afrin spray before flying, and also prior to landing if you are on a long flight. (A note of caution: Use Afrin for a very limited amount of time, as it can be chronically addictive.)
- “EarPlanes,” available at many drugstores, are plugs that can be worn while flying, and specifically landing, to help equalize pressure.
- Drink enough fluids, as the mucous membranes can get sticky when not well hydrated and make ear congestion worse.
- Chew gum while landing.
For Diving
- If you have pain when attempting to dive, do not go down further.
- Try to descend very slowly.
- Taking Sudafed before a dive is very helpful for some people. Make sure the dose is low, 30 mg, as Sudafed can make you a bit jittery and anxious—not a feeling you want when you are under water and trying to relax.
If these techniques do not help, consult your local ENT (ear, nose, and throat doctor).
To find an excellent doctor who is right for you, please call our Physician Referral Service at 866.804.1007.