When you catch a cold, the familiar symptoms of a stuffy nose and sore throat often come with a sensation of aural fullness or pressure. This feeling, commonly described as a plugged ear, is a direct result of the upper respiratory infection spreading to the delicate structures of the head. It causes muffled hearing and a sense of being underwater, which is a temporary side effect of the body’s immune response.
The Anatomical Reason
The sensation of a plugged ear during a cold is caused by a temporary malfunction of the Eustachian tube, a narrow passageway connecting the middle ear to the back of the throat and nasal cavity. This tube ventilates the middle ear, ensuring air pressure on both sides of the eardrum remains equal to the surrounding environment. It also allows fluid and mucus to drain from the middle ear space.
During a cold, the entire lining of the respiratory tract, including the tissue surrounding the Eustachian tube opening, becomes inflamed and swollen. Excess mucus production further exacerbates this issue. This combination of swelling and thick secretions effectively blocks the tube, preventing it from opening properly when you swallow or yawn.
When the tube remains sealed, the air trapped inside the middle ear is slowly absorbed, creating negative pressure. This pressure difference pulls the eardrum inward, limiting its ability to vibrate normally. This leads to the characteristic feeling of fullness, pressure, and muffled sound, a condition known as Eustachian tube dysfunction. The blockage is typically self-resolving, but the plugged feeling can last for several days or a week after the initial congestion subsides.
Immediate Relief Methods
Relief methods for a plugged ear include mechanical actions that force the tube open and chemical treatments that reduce underlying swelling. Simple mechanical methods often provide the fastest temporary relief by engaging the muscles attached to the Eustachian tube. Swallowing, yawning, and chewing gum can all activate the tensor veli palatini muscle, which is responsible for opening the tube.
A slightly more forceful technique is the modified Valsalva maneuver. To perform this, pinch your nostrils shut, close your mouth, and try to blow air out through your nose. The goal is to generate a small, controlled amount of pressure to force the tube open, often resulting in a noticeable “pop.” It is important to blow very gently to avoid damaging the eardrum or inner ear structures.
For chemical relief, over-the-counter decongestants, both oral and nasal sprays, shrink swollen blood vessels around the Eustachian tube opening. Oral decongestants like pseudoephedrine offer systemic relief, while nasal sprays like oxymetazoline provide localized action. Nasal sprays should not be used for more than three consecutive days to prevent rebound congestion, where the nasal lining swells more severely once the medication wears off.
Nasal irrigation using a saline rinse or neti pot is another useful approach, which flushes out thick mucus and moistens the nasal lining. By reducing congestion and inflammation in the nasopharynx, saline rinses indirectly help clear the Eustachian tube opening. The saline solution works to gently shrink the swollen tissues and remove the physical obstruction of mucus.
When to Seek Medical Attention
While the plugged sensation from a cold usually resolves on its own, certain symptoms can signal the blockage has progressed to a secondary complication, such as acute otitis media, or a middle ear infection. The most common warning sign is the onset of severe, throbbing ear pain that does not improve with over-the-counter pain relievers. This kind of pain suggests pressure buildup or bacterial growth behind the eardrum.
A high fever, especially one that develops after the initial cold symptoms have started to resolve, is another clear indication that an infection may be present. Fluid drainage from the ear canal, which can be yellow, brown, or pus-like, suggests a perforation of the eardrum, which requires immediate medical assessment. The appearance of dizziness or a loss of balance can also indicate that the inflammation is affecting the inner ear.
You should consult a healthcare provider if the feeling of fullness or muffled hearing persists for more than seven to ten days after all other cold symptoms have disappeared. Prolonged Eustachian tube dysfunction can lead to fluid remaining trapped in the middle ear, a condition called otitis media with effusion, which may require medical intervention.