What to do when your ears block up on a flight

The plane starts its descent. You are nodding along to your headphones, or halfway through an episode, when suddenly your ears feel like someone has pressed two fingers over them. Everything goes muffled and far away, the cabin announcement sounding like it is coming up from underwater. Then a dull pressure, sometimes a little stab of pain, builds inside your ear. You swallow once, listening hard, and it just sits there, stubborn.

If you have lived through exactly that moment, congratulations, you are completely normal. Blocked ears on a flight are something almost every flyer meets at least once, and most of the time it is harmless. But it is genuinely uncomfortable, especially when you do not know why it happens, let alone what to do to make it stop.

Why do your ears block up?

Inside your ear there is a small pocket of air sitting behind the eardrum, called the middle ear. Connecting that pocket to the back of your throat is a tiny tube, the Eustachian tube. Normally this tube stays shut and only flicks open a little each time you swallow or yawn, just enough to keep the pressure equal on both sides of the eardrum.

When the plane climbs or drops, the pressure in the cabin changes fairly fast. The trouble is that the tiny tube often cannot open quickly enough to keep up. So the pressure on each side of the eardrum no longer matches, the eardrum gets pulled tight toward one side, and you feel that blocked, muffled, sometimes painful sensation. Landing is usually worse than take-off, so if it hits hardest as you approach the runway, that is normal.

Put simply, your ear is not broken. The tiny valve linking it to your throat just has not opened in time to even the pressure out.

So what can you do about it?

The good news is that most of the fixes are very simple, and they all aim at the same thing: getting that little tube to open so air can pass through and balance the pressure. Work through a few of these.

• Swallow and yawn. This is the easiest one, because every swallow or yawn nudges the tube open a fraction. Just keep swallowing on purpose while the plane is climbing or coming down.
• Chew gum or suck on a sweet. Chewing and sucking make you swallow more often without even thinking about it. It is also why a lot of airlines hand out sweets before take-off.
• Sip some water. Sipping, especially something fizzy, keeps you swallowing steadily, and it helps with the dry throat you get in that parched cabin air too.
• Try a gentle Valsalva. Pinch your nose shut, close your mouth, then blow out very softly, as if you were trying to sneak a quiet nose-blow. You should hear a small pop and feel your ears clear. Never blow hard or strain, because overdoing it can hurt your ears. Gentle is plenty.
• Stay awake during the descent. A bit of a shame, but when you sleep you stop swallowing, the tube opens less often, and you can wake up with your ears badly blocked. If you are prone to it, ask a flight attendant to wake you before the plane starts coming down.
• Consider pressure-regulating earplugs. There are special earplugs that let the pressure around your eardrum change more slowly. If you are someone whose ears ache on every single flight, they are worth a try and easy on the wallet.

If you fly often, or you have a cold

When you are sniffly, congested, or fighting a cold, the Eustachian tube is already swollen and stuffy, so flying right then makes your ears block and ache more than usual. In that situation, some people take an oral decongestant or use a nasal spray before the flight to clear the sinuses a little.

That said, these are not right for everyone, and a lot depends on your own health. Before you take anything, it is worth a quick word with a pharmacist at the chemist or your doctor, especially if you are on other medication or have an existing condition. And do not lean on a nasal spray for days on end.

What about babies?

Babies cannot swallow on command, and their ears are more sensitive, so they tend to wail on take-off and landing. The simplest trick is to feed them, give a bottle, or offer a pacifier at exactly those two moments. The sucking and swallowing helps their ears balance the pressure on their own, and usually they settle quickly.

When should you actually see a doctor?

In the vast majority of cases, your ears clear within a few minutes to a few hours after landing, and everything goes back to normal. But keep an eye out and get it checked if any of this applies:

• Your ear is still painful or muffled for hours, even days, long after you have landed.
• You have severe blockage, dizziness, ringing in the ear, or you suspect there is fluid draining from it.
• You flew with a heavy cold or an ear infection, and the discomfort just drags on and refuses to ease.

To be clear, this piece is general information to help you understand what is happening to your ears, not a substitute for medical advice. If you have to fly with a heavy cold or an ear infection, or the pain and blocked feeling keep dragging on, go and see a doctor for peace of mind.

Otherwise, keep it gentle. Chew a sweet, swallow a few times, yawn nice and wide if you need to, and let your body do the rest. In a few minutes the world around you will turn crisp and clear again, and the trip is still right there, waiting up ahead.