Ear pain during flights is caused by a pressure imbalance between the air inside your middle ear and the rapidly changing cabin pressure, and it’s almost entirely preventable. The key is keeping your eustachian tubes open so air can flow freely in and out of the middle ear. A few simple techniques before and during your flight can make the difference between a painful descent and a comfortable one.
Why Your Ears Hurt on Planes
Your middle ear is a small, air-filled space sealed off from the outside by your eardrum. Normally, the air pressure on both sides of that eardrum stays equal thanks to the eustachian tube, a narrow passage connecting your middle ear to the back of your throat. Every time you swallow or yawn, this tube briefly opens, letting air move in or out to balance the pressure.
During a flight, cabin pressure drops on ascent and rises again on descent, sometimes faster than your eustachian tubes can adjust. If the tube is slow to open, or swollen from a cold or allergies, the pressure difference pushes your eardrum inward or outward, stretching it. That stretch is what you feel as pain, fullness, or muffled hearing. Descent tends to be worse than ascent because the rising pressure pushes the eustachian tube closed rather than open, making it harder for your body to equalize on its own.
Swallowing, Yawning, and Chewing
The simplest prevention method is anything that makes you swallow more often. Swallowing activates a small muscle that pulls the eustachian tube open, allowing air to pass through and equalize the pressure. Chewing gum, sucking on hard candy, or sipping water all work. Start before the plane begins its descent (the pilot usually announces this 20 to 30 minutes before landing) and keep going until you’re on the ground. Yawning has the same effect, so if you can trigger a yawn, do it.
The American Academy of Otolaryngology specifically recommends these techniques just before takeoff and throughout descent, the two phases when pressure changes most rapidly.
The Valsalva and Toynbee Maneuvers
If swallowing alone isn’t enough, two simple pressure-equalization techniques can force your eustachian tubes open.
Valsalva maneuver: Pinch your nostrils shut, close your mouth, and blow gently as if you’re trying to exhale through your nose. You should feel a soft pop or click as the tube opens and pressure equalizes. Don’t blow hard. Gentle, steady pressure is all it takes, and too much force can cause damage.
Toynbee maneuver: Pinch your nostrils shut and swallow at the same time. This combines the mechanical tug of swallowing with the sealed airway to push air into the middle ear. Some people find this gentler and easier to repeat than the Valsalva.
Both work well, and you can alternate between them during descent. The key is frequency. Don’t wait until your ears are already in pain. Start equalizing early and repeat every 30 seconds or so during the pressure change.
Decongestants and Nasal Sprays
If you’re flying with any nasal congestion, whether from a cold, allergies, or chronic sinus issues, the swollen tissue around your eustachian tubes makes equalization much harder. Over-the-counter decongestants and nasal sprays can shrink that swelling and keep the tubes functional.
An oral decongestant like pseudoephedrine (Sudafed) taken before your flight gives the medication time to reduce swelling system-wide. Mount Sinai recommends a low dose of 30 mg, since higher doses can cause jitteriness and anxiety. A topical nasal spray like oxymetazoline (Afrin) works faster and more directly on the nasal passages. Use it before takeoff, and again before descent on longer flights. If you have allergies, take your regular allergy medication at the beginning of the flight rather than waiting.
One caution: people with high blood pressure, heart disease, irregular heart rhythms, or thyroid conditions should check with a doctor before using pseudoephedrine, as it can affect cardiovascular function.
Staying Awake During Descent
This one catches people off guard. Falling asleep during descent is one of the most common causes of landing with painful, clogged ears. When you’re asleep, you swallow far less often, so your eustachian tubes stay closed while cabin pressure climbs steadily. You can wake up with significant pressure trapped in your middle ear, pain, and hearing that sounds like you’re underwater.
Set an alarm or ask a travel companion to wake you about 30 minutes before landing. This gives you time to start swallowing, chewing gum, or using equalization maneuvers while the pressure is still changing gradually.
Preventing Ear Pain in Babies and Children
Young children and infants are especially prone to ear pain during flights because their eustachian tubes are narrower and more horizontal than an adult’s, making them slower to equalize. Babies can’t perform the Valsalva maneuver or chew gum, so you need to encourage swallowing through other means.
For infants, nursing or bottle-feeding during takeoff and descent is the most effective approach. The sucking and swallowing motion keeps the eustachian tubes cycling open. A pacifier works too, though not quite as well since it produces less swallowing. For toddlers and older children, a sippy cup, lollipop, or snack that requires chewing can serve the same purpose.
Just like adults, children should not sleep during descent. Kids swallow more often when awake, so keeping them alert during the last 20 to 30 minutes of the flight gives their ears the best chance of adjusting comfortably.
What to Do If Your Ears Stay Blocked After Landing
Mild fullness or muffled hearing after a flight is common and usually resolves within a few minutes to a few hours as your eustachian tubes catch up. Try the Valsalva or Toynbee maneuver on the ground, or chew gum and swallow repeatedly. A warm washcloth held over the ear can also help by relaxing the tissue around the tube.
If your ears still feel blocked after a few days, or if you need a decongestant or anti-inflammatory to manage the congestion, that’s a sign the barotrauma was more significant. Very rarely, the pressure difference is severe enough to rupture the eardrum. Signs of this include sudden sharp pain followed by relief, fluid or blood draining from the ear, and noticeable hearing loss. A ruptured eardrum typically heals on its own within weeks, but it needs medical evaluation to rule out infection or other complications.
Flying With a Cold or Sinus Infection
The worst ear pain on flights happens when people fly with significant nasal or sinus congestion. Swollen eustachian tubes simply can’t open, no matter how much you swallow or blow. If you’re dealing with a bad cold or active sinus infection, decongestants become essential rather than optional. Use both an oral decongestant and a topical nasal spray to give yourself the best chance of keeping the tubes clear.
If your congestion is severe enough that you can’t pop your ears at all on the ground, flying carries a real risk of barotrauma. In those cases, rescheduling the flight by even a day or two, if possible, can save you from days of ear pain or a potential eardrum injury afterward.