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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, for blocked, painful or muffled ears after flying or diving; the doctor tells you when your ear needs examining.
- What it is: stress on the eardrum when the pressure in the middle ear cannot keep up with the pressure outside, as a plane climbs or descends.
- Self-care: swallow, yawn or chew, and gently blow with your nostrils pinched and your mouth closed to even out the pressure.
- Usual course: most airplane ear settles with self-care within a few hours; see a doctor if it lasts more than 2 to 3 days or hearing stays muffled.
- Emergency: after a dive, call 112 for numbness, weakness, or problems with breathing, consciousness, vision, hearing or speech.
Do not book a video appointment if, after a dive, you have numbness, tingling, muscle weakness, difficulty moving, or problems with breathing, consciousness, vision, hearing or speech. These can be signs of decompression illness, and they need emergency care: call 112.
Can an online doctor treat ear barotrauma?
Yes, for most cases. Ear barotrauma is diagnosed mainly from what happened and how your ears feel, and both work by video. The doctor checks for the signs of a torn eardrum or inner ear damage, advises on clearing your ears and on decongestants, and tells you when you need an ear examination or a hearing test in person.
How an online consultation helps with ear barotrauma
- Warning signs checked first: Severe pain, worsening hearing loss, ringing, spinning and bleeding from the ear point to damage that needs an examination.
- Your ears cleared safely: How to even out the pressure gently, and whether a decongestant suits you, with your heart and blood pressure in mind.
- Eardrum and hearing checked: Fluid from the ear, sudden hearing loss or symptoms that last more than a few days mean the ear needs examining.
- Ready for the next flight or dive: When it is safe to fly or dive again, and how to protect your ears next time.
What the doctor checks in an online ear barotrauma consultation
The consultation follows a fixed order, and the warning signs come first. The doctor asks about:
- Warning signs: severe pain, bleeding or fluid from the ear, spinning, worsening hearing loss or ringing, and after a dive, numbness or weakness.
- What happened: a flight or a dive, and whether you had a cold, a blocked nose or an ear infection at the time.
- Your ears now: fullness, muffled hearing or pain, and whether one ear or both are affected.
- Your health: heart disease, high blood pressure, pregnancy and the medicines you take, before suggesting a decongestant.
- Your plans: when your next flight or dive is.
Before the call, note whether the symptoms started on the way up or the way down, and whether they are getting better.
What is ear barotrauma?
Ear barotrauma, often called airplane ear, is stress on the eardrum when the pressure in the middle ear and the pressure outside are out of balance. A narrow passage, the Eustachian tube, links the middle ear to the back of the nose and normally evens out the pressure. When the pressure changes quickly, as a plane climbs after take-off or descends to land, the tube often cannot react fast enough.
Flying is the usual cause, especially the descent to land, when the cabin pressure rises. Divers meet larger pressure changes, and middle ear barotrauma is the most common medical problem in diving. Any fast change in pressure can do it: driving on mountain roads, a fast lift in a tall building, diving to the bottom of a pool, or a hyperbaric oxygen chamber.
What makes it more likely
- a cold or a sinus infection
- hay fever
- a middle ear infection
- sleeping while the plane climbs or descends, when you cannot keep evening out the pressure
Ear barotrauma symptoms
It can affect one ear or both. The usual symptoms are:
- discomfort or pain in the ear
- a feeling of fullness or stuffiness in the ear
- muffled hearing or some hearing loss
- mild dizziness
Severe symptoms
- severe pain
- increasing pressure in the ear
- worse hearing loss
- ringing in the ear, called tinnitus
- a spinning feeling, called vertigo
- bleeding from the ear, or a nosebleed
Severe symptoms need a doctor. Rarely, barotrauma can tear the eardrum, or cause hearing loss, ringing or dizziness that does not go away. It can also leave fluid behind the eardrum, or lead to an ear infection.
How to clear your ears
These steps help during the flight and afterwards:
- Swallow and yawn: sucking a sweet or chewing gum makes swallowing easier.
- Use the Valsalva manoeuvre: take a breath, pinch your nostrils closed, keep your mouth shut and breathe out gently, as if blowing your nose, until you feel your ears pop. Repeat every few minutes during the descent, and stop if it hurts.
- Stay awake during the descent, so you can keep evening out the pressure.
- A decongestant tablet, taken about 30 minutes to an hour before the flight, or a decongestant nasal spray can help. Ask a pharmacist or a doctor first if you have heart disease, a heart rhythm problem or high blood pressure, or are pregnant.
- Filtered earplugs help some people, but you still need to swallow and yawn.
Decongestant nasal sprays are for short-term use: used for more than 3 to 4 days, they can make a blocked nose worse.
Most airplane ear settles with these steps. See a doctor if discomfort, fullness or muffled hearing lasts more than a few days.
How long does ear barotrauma last?
Mild airplane ear usually settles with swallowing, yawning and gentle equalising, and hearing loss from barotrauma is almost always temporary. How long it lasts depends on the damage:
Swipe sideways to compare →
| What you have | Usual course | When to see a doctor |
|---|---|---|
| Blocked, full or muffled ears after landing | Usually settles with self-care | If it has not eased after a few hours of self-care, get advice; if it lasts more than a few days, see a doctor |
| Pain with fluid or infection behind the eardrum | Settles with treatment | If there is fever, discharge or severe pain |
| A torn eardrum | Usually heals on its own within 2 months | If it is not improving after a few weeks |
| Hearing loss, ringing or dizziness that does not settle | Rarely permanent | Promptly, for an ear examination and a hearing test |
Flying and diving with blocked ears
With a cold, a sinus infection, a blocked nose or an ear infection, consider postponing a flight, or use a decongestant to ease the symptoms if it suits you. If you have hay fever, keep taking your usual allergy medicines when you travel. Ideally, wait until blocked ears have settled before you fly again, because flying with a blocked Eustachian tube makes barotrauma more likely.
After diving, leave the recommended interval before you fly, to lower the risk of decompression sickness. Ear pain, blocked ears or hearing changes after a dive that do not settle need an ear check before you dive again.
It is safe to fly with a perforated eardrum, but after surgery to repair one, do not fly until you are told it is safe.
Ear barotrauma or something else?
Other ear problems can feel similar. These patterns help tell them apart:
Swipe sideways to compare →
| Condition | What points to it | Read more |
|---|---|---|
| Ear barotrauma | Blocked, painful or muffled ears that started during a flight or a dive | This page |
| Ear infection | Earache with a high temperature, often during or after a cold | Ear infection |
| Swimmer’s ear | An itchy, painful ear canal after swimming, worse when the ear is touched | Swimmer’s ear |
| Perforated eardrum | Sudden hearing loss, ringing, earache, or fluid, blood or pus from the ear | Needs an ear examination |
| Tinnitus | Ringing or buzzing that continues after the pressure has settled | Tinnitus |
Which ear barotrauma treatment might the doctor recommend?
Treatment depends on how severe the symptoms are and whether the eardrum may be damaged. This is the framework the doctors use, in line with NHS and travel medicine guidance.
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Blocked or muffled ears after a flight | Swallowing, yawning, gentle equalising, and a decongestant if it suits you | Yes | Not usually needed |
| Symptoms lasting more than a few days | A review, and an ear examination if needed | Partly | For the examination |
| Severe pain, ringing, spinning or bleeding from the ear | An assessment for eardrum or inner ear damage | Partly | For an ear examination and a hearing test |
| Sudden hearing loss, or fluid or pus from the ear | An urgent assessment, and antibiotics if infection is likely | Partly | Urgently, in person |
| Numbness, weakness or breathing problems after a dive | Emergency treatment | No | Call 112 now |
Ears still blocked after your flight? A doctor can tell you in one consultation what to do.
See available times →Treatment options for ear barotrauma
What you can do yourself
- Keep swallowing, yawning and equalising gently.
- Take paracetamol or ibuprofen for the pain.
- Use a decongestant if a pharmacist or a doctor says it suits you.
- If fluid is leaking from the ear, keep it dry and do not put anything into it.
Prescription treatment
A prescription is never issued without a consultation. Most ear barotrauma settles with self-care. The doctor may suggest a steroid nasal spray to help the Eustachian tube open. If there is an ear infection, or the eardrum has torn and infection is a risk, the doctor can prescribe antibiotics. If the doctor prescribes, use the prescription at a pharmacy near you.
Surgery is rarely needed. If other treatment fails, an ear specialist can make a tiny cut in the eardrum to release trapped fluid, and people who fly often and keep getting barotrauma may be offered ear tubes, which are not suitable for divers.
What does not help
Forcing air into the ears hard, or blowing your nose forcefully, can do more harm than good. Cotton buds and ear drops in an ear that may have a torn eardrum are best avoided unless a doctor recommends them.
Special situations
A cold before a flight
A blocked nose makes barotrauma more likely. Consider postponing the flight, use a decongestant if it suits you, and keep swallowing and yawning on the way down. The nasal congestion page covers what clears a blocked nose.
Divers
Ear pain or blocked ears after a dive that do not settle need an ear check before you dive again. Numbness, weakness, or problems with breathing, seeing, hearing or speaking after a dive can mean decompression illness: call 112.
A perforated eardrum
A perforated eardrum usually heals on its own within 2 months. Keep the ear dry, do not swim until it has healed, and see a doctor if it has not started to improve after a few weeks.
Holidays
Travel sickness and jet lag are covered on their own pages, and other holiday health problems on the travel illnesses page.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When ear barotrauma is treated online, and when you need in-person care
Treated online: blocked, painful or muffled ears after flying or diving, advice on clearing the ears and on decongestants, and planning the next flight.
In-person care: an ear that needs examining, sudden hearing loss, fluid or blood from the ear, and any sign of decompression illness after a dive.
When to get in-person care
Call 112 or go to an emergency department now for:
- numbness, tingling or muscle weakness after a dive
- difficulty moving or passing urine after a dive
- problems with breathing, consciousness, vision, hearing or speech after a dive
Get medical advice the same day for:
- sudden hearing loss in one or both ears
- severe ear pain, or bleeding from the ear
- a spinning feeling or ringing in the ear after a flight or a dive
- hearing loss with earache or discharge
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your ears: say whether it started on a flight or a dive, which ear is affected, and whether your hearing has changed.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s ear barotrauma? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Ear infection can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about ear barotrauma
How do I unblock airplane ear at home after a flight?
For airplane ear, swallow, yawn or chew gum, and blow gently as if blowing your nose while pinching your nostrils closed, with your mouth shut. A decongestant can help if it suits you. See a doctor if your ears are still blocked after a few days.
How long does airplane ear last?
Mild airplane ear usually settles with swallowing, yawning and gentle equalising. Get advice if it has not eased after a few hours of self-care, and see a doctor if discomfort, fullness or muffled hearing lasts more than a few days, or if you have severe symptoms.
What is the most common cause of ear barotrauma?
Flying is the most common cause of ear barotrauma, especially the descent to land, when cabin pressure rises faster than a blocked or narrow Eustachian tube can let air into the middle ear. Diving is the other common cause, and a cold, sinus infection or hay fever makes both more likely.
Can ear barotrauma be permanent?
Rarely. Most cases settle with self-care, and hearing loss from barotrauma is almost always temporary. Rare complications are hearing loss that cannot be restored, ringing in the ears that does not stop, and ongoing dizziness, so severe or lasting symptoms need an ear check.
Can I fly with ear barotrauma?
Ideally wait until your ears have settled, because flying again with a blocked Eustachian tube, a cold or an ear infection makes barotrauma more likely. If you have to fly, use the Valsalva manoeuvre during the descent, and a decongestant if it suits you.
Can I fly if barotrauma has perforated my eardrum?
Yes, it is safe to fly with a perforated eardrum, and ear barotrauma is actually less likely, because the hole lets the pressure equalise through the eardrum itself; the ear may feel odd, and you should keep water out of it. After surgery to repair a perforation, do not fly until the surgeon says the graft has healed, usually several weeks.
Is ear barotrauma serious?
Usually not. Rarely, ear barotrauma can tear the eardrum or cause hearing loss or ringing that does not go away, so severe pain, bleeding, spinning or worsening hearing need a doctor.
Why do my ears hurt when the plane lands?
As the plane descends, the cabin pressure rises quickly. If the Eustachian tube cannot open fast enough to let air into the middle ear, the difference in pressure stresses the eardrum and causes the pain of ear barotrauma.
Can I fly with a cold?
You can, but a cold or a blocked nose makes ear barotrauma more likely. Consider postponing the flight, or use a decongestant if it suits you, and keep swallowing and yawning during the descent.
How can I prevent ear barotrauma when flying?
Stay awake for the descent and start equalising early: swallow, yawn, chew gum or suck a sweet from the moment the plane begins to come down, and use the pinched-nose gentle blow if the ears start to feel full. A decongestant tablet or nasal spray about an hour before landing helps if you have a cold or hay fever, filtered earplugs that slow the pressure change help some people, and with a heavy cold consider postponing. Divers prevent ear barotrauma by equalising every metre down.
Can diving cause ear barotrauma?
Yes. Middle ear barotrauma is the most common medical problem in diving. Ear pain, blocked ears or hearing changes after a dive that do not settle need an ear check, and numbness, weakness or breathing problems after a dive need 112.
Do decongestants help with airplane ear?
They can. For airplane ear, a decongestant tablet taken about 30 minutes to an hour before the flight, or a decongestant nasal spray, may help. Ask first if you have heart disease, a heart rhythm problem or high blood pressure, or are pregnant.
Can an online doctor treat ear barotrauma?
Yes, for most cases. A doctor can assess ear barotrauma from your symptoms by video, advise on clearing your ears and on decongestants, and tell you when your ear needs examining in person. Signs of decompression illness after a dive need 112.
- Airplane ear, Mayo Clinic, updated 15 April 2025.
- Ear barotrauma, MedlinePlus, US National Library of Medicine, reviewed 29 April 2026.
- Barotrauma of the ear, Patient.info, 2022.
- Air travel, CDC Yellow Book, Centers for Disease Control and Prevention (US), updated 23 April 2025.
- Perforated eardrum, NHS, National Health Service (UK), reviewed 19 April 2023.
- Middle ear barotrauma in diving, DAN Europe, 2025.
- Should I call DAN or EMS first?, Alert Diver, DAN Europe, published 23 May 2025.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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