Ear pain on a plane happens when the air pressure inside your middle ear falls out of sync with the rapidly changing cabin pressure during climb and descent. The fix is keeping a narrow tube in your ear open so air can flow through and equalize the pressure on both sides of your eardrum. Most people can prevent the pain entirely with a few well-timed techniques.
Why Your Ears Hurt During Flights
A small passage called the eustachian tube connects each middle ear to the back of your throat. Its job is to keep air pressure equal on both sides of your eardrum. On the ground, it handles this easily. But when a plane climbs or descends, cabin pressure changes faster than the tube can adjust. The resulting mismatch pushes your eardrum inward or outward, causing that familiar stuffed, painful feeling.
Descent is usually worse than ascent. When the plane climbs, a slight positive pressure builds in your middle ear and typically escapes on its own through the eustachian tube. When the plane drops altitude, however, the cabin pressure rises and your eardrum gets pushed inward. Your eustachian tube has to actively open to let air back in, and if it can’t keep up, the pain builds. Cabin altitude changes during descent tend to be steady but persistent, often lasting 15 to 20 minutes as the plane works its way down to the runway.
Simple Techniques That Work
Every method below works the same way: it forces or coaxes the eustachian tube open so air can pass through.
- Swallowing or yawning. Both pull the eustachian tube open briefly. Sipping water throughout descent is an easy way to keep swallowing regularly.
- Chewing gum. The constant jaw movement triggers frequent swallowing, which is why it’s the most common in-flight remedy.
- Valsalva maneuver. Pinch your nostrils shut, close your mouth, and gently blow through your nose. You should feel a soft pop as air pushes into the middle ear. Don’t blow hard, as too much force can cause damage.
- Toynbee maneuver. Pinch your nostrils shut and swallow at the same time. The swallowing motion opens the tube while the closed nose compresses air against it. This is a gentler alternative to the Valsalva and works well for people who find blowing uncomfortable.
The key is starting early. Begin swallowing, chewing, or equalizing as soon as you feel the plane start its descent, not after the pain has already set in. Once your eardrum is pulled inward and the tissue swells, opening the tube gets much harder. If you’re not sure when descent begins, listen for the captain’s announcement or watch for the seatbelt sign to come on during the second half of the flight.
Using Decongestants Before You Fly
If you’re congested or you know from experience that your ears always hurt on planes, a decongestant taken before the flight can shrink the tissue around your eustachian tube and make it easier to equalize. There are two main options.
An oral decongestant containing pseudoephedrine (sold as Sudafed) should be taken before departure. Be aware it can make you feel jittery or anxious, so a lower dose is a reasonable starting point. A nasal spray containing oxymetazoline (sold as Afrin) works faster and more directly. Spray it about 30 minutes before takeoff, and again before landing on longer flights. Don’t use nasal spray decongestants for more than three consecutive days, as they can cause rebound congestion.
The CDC notes that people with existing eustachian tube problems should consider a nasal decongestant spray before air travel to reduce the risk of barotrauma.
Flying With a Cold or Sinus Infection
A cold, sinus infection, or allergies inflame the tissue around the eustachian tube, making it much harder to equalize. Air pressure changes during ascent and descent can then cause genuine barotrauma: fluid buildup in the middle ear, severe pain, or in rare cases a ruptured eardrum.
If you have to fly while congested, take a decongestant before the flight and equalize aggressively during descent. If you’ve ever had significant ear pain on a previous flight or have been diagnosed with eustachian tube dysfunction, treating the congestion before you board is especially important. People with chronic equalization problems lasting three months or longer may be candidates for a procedure called balloon dilation, which physically widens the eustachian tube opening.
Helping Babies and Young Children
Babies can’t chew gum or perform a Valsalva maneuver, so their main equalization tool is swallowing. Offer a bottle, pacifier, or breastfeed during takeoff and landing. If you bottle-feed, keep the baby sitting upright while drinking.
One important detail: try to keep your child awake during takeoff and landing. During sleep, we swallow far less often, so the eustachian tube stays closed for longer stretches. A sleeping baby whose ears can’t equalize will often wake up screaming, and by that point the pressure difference is already significant and harder to resolve. Timing a feeding to coincide with descent is the most reliable strategy.
Do Pressure-Regulating Earplugs Help?
Several brands sell filtered earplugs marketed specifically for flying. These claim to slow the rate of pressure change reaching your eardrum, giving your eustachian tube more time to catch up. The research on them is mixed.
One clinical study found that participants reported meaningfully less discomfort in the ear wearing the filtered plug compared to a placebo plug. But another study using the same type of earplug found no measurable benefit beyond noise reduction and concluded it couldn’t recommend them for preventing barotrauma. Both studies agreed the plugs don’t actually improve eustachian tube function.
At roughly $10 a pair, they’re low-risk to try. But they shouldn’t be your only strategy. Active equalization techniques and decongestants have a stronger track record.
Putting It All Together
The most reliable approach layers several methods. If you’re prone to ear pain, take an oral decongestant or use a nasal spray before the flight. Have gum or water ready. Start swallowing frequently as soon as the plane begins its descent. If swallowing alone isn’t enough, try the Valsalva or Toynbee maneuver every 30 seconds or so until you feel the pressure release. Stay awake for both takeoff and landing.
Most ear pain resolves within minutes of landing as the pressure fully equalizes. If pain persists for more than a few hours, or if you notice muffled hearing or fluid draining from your ear, that suggests the pressure difference may have caused fluid buildup or minor tissue damage worth having evaluated.