Ear pain during a flight happens when the air pressure inside your middle ear falls out of sync with the rapidly changing cabin pressure around you. The good news: a few simple techniques, timed correctly, can prevent it almost entirely. The key is keeping your Eustachian tubes, the tiny passages connecting your middle ear to the back of your throat, open and flexible during ascent and especially descent.
Why Your Ears Hurt on a Plane
Your middle ear is a small air-filled space sealed off by your eardrum on one side. On the other side, a narrow tube (the Eustachian tube) runs down to the back of your nose and upper throat. Under normal conditions, this tube opens briefly every time you swallow or yawn, letting air flow in or out so the pressure on both sides of your eardrum stays equal.
During a flight, cabin pressure drops as the plane climbs and rises again as it descends. If your Eustachian tubes can’t open fast enough to match these changes, the pressure difference pushes your eardrum inward or outward, stretching it painfully. Descent is usually worse than ascent because the increasing pressure outside your ear compresses the tube shut, making it harder to equalize. On a long flight, the plane may be descending for an hour or more before landing, which means the pressure shift isn’t a brief moment you can simply endure.
Equalization Techniques That Work
The most reliable way to prevent ear pain is to actively push air through your Eustachian tubes before they lock shut. Three techniques cover nearly every situation:
- Valsalva maneuver: Pinch your nostrils closed and gently blow through your nose. You should feel a soft pop or click as air pushes up into your middle ear. Don’t blow hard, and don’t hold the pressure for more than about five seconds. Forcing it can raise fluid pressure in your inner ear and potentially damage delicate membranes.
- Toynbee maneuver: Pinch your nostrils closed and swallow. Swallowing pulls the Eustachian tubes open while your tongue compresses air against them. This is gentler than the Valsalva and works well if you find blowing uncomfortable.
- Frenzel maneuver: Pinch your nostrils, close the back of your throat as if you’re about to lift something heavy, then make a “K” sound. This pushes the back of your tongue upward, compressing air toward the tube openings without the risks of hard blowing.
The safest methods are the ones that use throat and tongue muscles to open the tubes rather than raw air pressure. If one technique doesn’t work for you, try another. Start equalizing early, before you feel any pressure at all, and repeat every few seconds during descent. Once a significant pressure difference builds up, the tubes can lock closed, and no amount of gentle blowing will open them.
Swallowing, Yawning, and Chewing
You don’t always need a formal maneuver. Swallowing and yawning both activate the muscles that pull the Eustachian tubes open, which is why sipping water, chewing gum, or sucking on hard candy during descent helps so many people. The goal is continuous, repeated swallowing throughout the pressure change, not a single gulp when pain starts. Keep a water bottle handy and take small sips every 30 seconds or so once the captain announces the initial descent.
Nasal Decongestant Sprays
If you’re congested from a cold, allergies, or sinus issues, your Eustachian tubes are already partially swollen shut, and standard equalization techniques may not be enough. A decongestant nasal spray containing oxymetazoline (sold as Afrin, among other brands) or phenylephrine (Neo-Synephrine) shrinks the swollen tissue at the back of your nose where the Eustachian tubes open. Spray into each nostril about 30 minutes before the plane begins its descent. If it’s a short flight, using the spray before boarding covers both takeoff and landing.
These sprays are meant for occasional use. Using them for more than three consecutive days can cause rebound congestion, making the problem worse on a return flight.
Stay Awake During Descent
One of the most overlooked causes of severe ear pain is sleeping through the descent. When you’re asleep, you’re not swallowing frequently enough to keep up with the changing pressure, and you can’t perform any equalization maneuvers. If you tend to nap on flights, set an alarm for about an hour before your scheduled landing time. That buffer accounts for the gradual descent phase on longer flights.
Preventing Ear Pain in Babies and Young Children
Infants and toddlers can’t equalize on command, which is why they so often cry during landing. The strategy is to trigger swallowing for them. During descent, give an infant a bottle or pacifier to suck on. Older toddlers can sip from a sippy cup or eat a snack. The repeated swallowing action opens their Eustachian tubes the same way it does for adults.
Make sure your child is awake as the plane begins to descend. On a long flight, this can mean waking them up well before landing. About 20 minutes before descent, a children’s nasal decongestant spray (children’s oxymetazoline) can help if the child is congested. Timing matters here because the spray needs a few minutes to take effect before the pressure changes begin.
Pressure-Regulating Earplugs
Filtered earplugs designed for flying (often sold as “EarPlanes” or similar brands) contain a small filter that slows the rate at which air pressure changes reach your eardrum. They don’t block the pressure change entirely; they just give your Eustachian tubes more time to equalize naturally. These work best for people who experience mild to moderate discomfort and want a passive solution. They’re not a substitute for active equalization if you have significant congestion or a history of severe ear barotrauma.
When Flying Could Be Risky
Most ear pain on flights is temporary and harmless, but certain situations raise the stakes. If you’ve had recent ear surgery, flying can cause pain, bleeding, or complications at the surgical site. A severe ear infection or a ruptured eardrum also changes the equation. In these cases, the pressure difference can worsen damage or push infected material into spaces where it doesn’t belong. If you’re dealing with any of these conditions, talk to an ENT specialist before booking a flight.
Heavy nasal or sinus congestion from a bad cold is a more common concern. You can still fly, but you’ll want to use a decongestant spray and equalize aggressively. If your Eustachian tubes are so swollen that nothing seems to open them on the ground (you can test by pinching your nose and swallowing), the descent could be genuinely painful, and postponing travel is worth considering.