Why Your Ears Hurt on a plane and The Simple Tricks to Stop it
Your bags are packed, your passport is ready, and you’re dreaming of sunshine and relaxation. The last thing you want is for that uncomfortable, blocked-up ear feeling to ruin the start of your well-deserved break. That feeling, often called “airplane ear,” is incredibly common. But why does it happen?
Inside your ear, behind the eardrum, is a small, air-filled cavity (the middle ear). To ensure a continuous supply of air, it is connected to the back of your nose by a tiny channel called the Eustachian tube. Its job is to act like a pressure-valve, constantly letting tiny puffs of air in and out to match the pressure of the world around you.
During a flight, the cabin air pressure changes very quickly, especially during take-off and landing. Your Eustachian tubes can struggle to keep up, creating a pressure difference that pushes or pulls on your eardrum, leading to that familiar pain and stuffiness.
The good news? A little preparation can make all the difference.
Here are several well-established autoinflation exercises that can be performed at home. It is advisable to consult a healthcare professional before starting these exercises, especially if you have an ear infection, a perforated eardrum, nasal allergies, or have recently had ear surgery. If in doubt, ask for advice.
Before You Fly: The Week Leading Up
If you often struggle with your ears, being proactive is key.
- Manage Colds and Allergies: If you have a cold, sinus infection, or are suffering from hay fever, your Eustachian tubes are likely already swollen and struggling. This makes them much less effective during a flight. If possible, speak to your pharmacist or GP about using a decongestant or antihistamine to help clear your passages before you travel.
- Try a Saline Nasal Spray: Using a simple saline spray (available from any chemist) for a few days before you fly can help to moisturise your nasal passages and clear mucus, giving your Eustachian tubes the best possible chance to work properly. Ask your audiologist, pharmacist or ENT Consultant for advice about nasal rinses.
On the Day: Your In-Flight Toolkit
The most crucial times are during ascent (the first 20-30 minutes) and descent (the final 20-30 minutes). Stay awake during these periods so you can be proactive.
- The 3 ‘S’s – Swallow, Sip, and Suck
These are the easiest and most effective things you can do. The muscle that opens your Eustachian tube is the same one you use to swallow.
- Swallow: Make a conscious effort to swallow regularly.
- Sip: Drink plenty of water. Taking small sips forces you to swallow.
- Suck: Sucking on a boiled sweet or chewing gum stimulates saliva production, which makes you swallow more often.
- Yawn (Even if You’re Not Tired!)
A big, wide yawn is a powerful way to activate the muscle and open the tube. Don’t be afraid to fake a few big yawns as the plane begins its descent. You’ll often feel a satisfying ‘pop’ or click.
- More Specific Autoinflation Techniques
If the simple manoeuvres are not enough, you can try the following more targeted exercises. Remember to perform them gently; forceful blowing can potentially damage the ear.
Important: Do not perform these techniques if you have an active cold or sinus infection, as it can risk forcing mucus into the middle ear. Never blow hard.
a) The Valsalva Manoeuvre
This is one of the most common and straightforward methods for equalising ear pressure.
- How to Perform:
- Take a deep breath.
- Pinch your nostrils closed with your fingers.
- Close your mouth.
- Gently try to exhale or “blow” through your pinched nose. You should not let any air escape.
- A “pop” or “click” in the ears indicates that the manoeuvre was successful.
- Frequency: Perform as needed, typically a few times a day, or when experiencing pressure changes.
b) The Toynbee Manoeuvre
This technique combines swallowing with a pinched nose.
- How to Perform:
- Pinch your nostrils closed.
- Take a small sip of water or simply swallow the saliva in your mouth.
- You may feel a “pop” as the Eustachian tubes open.
- Frequency: This can be repeated several times a day as needed.
c) The Lowry Technique
This method is a combination of the Valsalva and Toynbee manoeuvres.
- How to Perform:
- Pinch your nostrils closed.
- Simultaneously blow gently through your nose (as in the Valsalva manoeuvre) and swallow (as in the Toynbee manoeuvre).
- This coordinated action can be very effective at opening the Eustachian tubes.
- Frequency: Perform as needed, but with gentle pressure.
d) The Frenzel Manoeuvre
This technique is often used by scuba divers and requires a bit more practice to master, but is very effective and gentle.
- How to Perform:
- Pinch your nostrils closed.
- Close the back of your throat, as if you were about to lift a heavy weight. You can achieve this by making the “k” sound without vocalising.
- With the back of your throat closed, use your tongue as a piston to push air upwards towards the back of your nose.
- This creates pressure in the nasal cavity and helps to open the Eustachian tubes.
- Frequency: Can be performed as needed once mastered.
- The Otovent® Treatment Device
The Otovent® is a medical device specifically designed for autoinflation. It consists of a nosepiece and a special balloon. It is particularly useful for children with glue ear but can be used by adults as well.
- How to Use:
- Connect the balloon to the nosepiece.
- Hold the nosepiece firmly against one nostril, and use your other hand to close the other nostril.
- Take a deep breath in through your mouth.
- Close your mouth and inflate the balloon with your nose until it is about the size of a grapefruit.
- You may feel a change in your ear as the pressure equalises.
- Repeat on the other side.
- Frequency: Follow the manufacturer’s instructions, which typically recommend using the device two to three times daily.
Important Safety Precautions
While these exercises are generally safe, it is crucial to follow these guidelines:
- Be Gentle: Never blow with excessive force, as this can cause a significant increase in pressure and potentially damage your eardrums.
- Stop if You Feel Pain: If any of these exercises cause sharp or severe pain, stop immediately.
- Stop if There’s a Nosebleed: Some of us have a naturally thin nasal membrane, which can rupture with excessive pressure. Stop the above exercises immediately if there is a nosebleed.
- Avoid When Sick: Do not perform these exercises if you have an active cold, sinus infection, or throat infection, as this could force infected mucus into the middle ear and cause a more severe infection.
- Consult a Doctor: It is always best to consult with a doctor or audiologist before starting these exercises, especially if you have a history of ear problems or if your symptoms are severe or persistent. They can diagnose the underlying cause of your Eustachian tube dysfunction and recommend the most appropriate course of action.
By incorporating these gentle and effective exercises into your routine, you can help maintain healthy Eustachian tube function and find relief from the discomfort of blocked ears.
References & Further Reading
- ENT UK – Eustachian Tube Dysfunction. Expert information from the professional body for UK ENT specialists, explaining the underlying issues and conservative treatments like autoinflation. https://www.entuk.org/patients/conditions/eustachian-tube-dysfunction
- National Institute for Health and Care Excellence (NICE) – Otitis media with effusion: Otovent. This page provides an overview of the evidence for the Otovent® device as a method of autoinflation. https://www.nice.org.uk/advice/mib35/chapter/The-technology
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