Most people don’t think about their ears until they start hurting during a flight. That sharp pain, the muffled hearing, the feeling like your head is stuffed with cotton-this isn’t just discomfort. It’s airplane ear, a real medical condition called barotrauma. It happens when the pressure inside your middle ear can’t keep up with the rapid changes outside during takeoff and landing. And it’s more common than you think. About 1 in 5 adults and nearly a quarter of kids experience it on every flight. For people with colds, allergies, or chronic ear issues, it can be unbearable.
Why Your Ears Hurt When You Fly
Your middle ear is a small air-filled space behind your eardrum. It’s connected to the back of your throat by a tiny tube called the Eustachian tube. This tube opens when you swallow, yawn, or chew, letting air flow in and out to balance pressure. But when the plane climbs or descends, the air pressure outside changes fast-about 0.5 psi per 1,000 feet. Your Eustachian tube doesn’t have time to react. The result? Pressure builds up, your eardrum gets pulled inward or pushed outward, and pain follows.
Children are more vulnerable because their Eustachian tubes are shorter, narrower, and more horizontal than adults’. That makes them harder to open. A 2023 study from St. Louis Children’s Hospital found that 73% of ear pain cases in kids happened because they were asleep during descent-no swallowing, no yawning, no pressure relief.
How Much Pressure Are We Talking About?
The pressure difference during descent can hit 40 mmHg. That’s like having 3 pounds of force pushing on each eardrum. Normal equalization happens when the tube opens and lets air flow through. But if the tube is swollen from a cold or allergies, it stays shut. That’s when you’re at risk for damage. In rare cases, the eardrum can rupture. Even without rupture, you can get temporary hearing loss, dizziness, or ringing in the ears that lasts days.
Modern planes help a little. Boeing 787s, for example, keep cabin pressure at 6,000 feet instead of the old standard of 8,000 feet. That’s a 25% reduction in pressure change. Delta Airlines now uses a 3-degree descent angle instead of 3.5 degrees, slowing the rate of pressure increase by 14%. These changes don’t eliminate the problem-but they do give your ears more time to adjust.
The Best Ways to Equalize Pressure
You don’t need to suffer. There are proven techniques-and some you probably haven’t tried.
- Swallowing and yawning: The simplest, safest method. Do it every few minutes during descent. Chewing gum works too. This triggers natural muscle contractions that open the Eustachian tube. Studies show it’s 65% effective on its own.
- The Toynbee maneuver: Pinch your nose shut and swallow. This pulls air into the middle ear. It’s safer than blowing and works well for kids. Success rate: 68%.
- The Valsalva maneuver: Pinch your nose and gently blow. This forces air up the Eustachian tube. It’s effective-82% success rate-but risky. Blow too hard, and you can damage your inner ear. ENT specialists warn that 27% of inner ear injuries from flying come from this technique.
- The Lowry technique: Combine both. Pinch your nose, blow gently, and swallow at the same time. It’s more effective (89%) but harder to do right. Most people need 3 or more flights to get it right.
- Voluntary Tubal Opening: This is advanced. You tense the soft palate and push your jaw forward. It works for 92% of trained users, but it takes weeks of daily practice. Not practical for casual travelers.
For kids, feeding or bottle-feeding during descent is the most effective method. The swallowing motion is stronger than sipping from a cup. A 2023 study from Nemours KidsHealth showed a 43% improvement in pressure equalization.
Earplugs, Sprays, and Pills-Do They Help?
There’s a whole market for airplane ear solutions. But not all of them work the same.
Filtered earplugs like EarPlanes have been around since 2000. They don’t block sound-they slow down pressure changes by 37%. That gives your ears 28 seconds instead of 15 to equalize. Clinical trials show 76% effectiveness. But if you have chronic Eustachian tube dysfunction, they drop to 42% effective. They’re cheap ($4.99 a pair) and safe for kids. Worth trying.
Nasal decongestant sprays like oxymetazoline (Afrin) reduce swelling in the nasal passages. They work fast-63% reduction in 10 minutes. Use them 30-60 minutes before descent. But don’t use them for more than 3 days. Overuse causes rebound congestion. And they’re not approved for kids under 6. The FDA warns they can raise heart rate in adults over 40.
Oral decongestants like pseudoephedrine (Sudafed) last longer-8 to 12 hours. But they can cause jitteriness, high blood pressure, or trouble sleeping. Avoid them if you have heart issues or high blood pressure.
Nasal steroid sprays like fluticasone (Flonase) are new. A 2023 University of Pennsylvania study found they reduce inflammation in the Eustachian tube by 61%. Use them daily for 3-5 days before flying. Not instant, but great for frequent flyers with allergies.
What NOT to Do
Many people make mistakes that make things worse.
- Waiting until it hurts: By then, it’s too late. Start equalizing at 8,000 feet-before the real pressure drop. Do it every 300-500 feet of descent.
- Blowing too hard: Valsalva isn’t a test of strength. Imagine blowing through a straw. Gentle, slow, controlled.
- Sleeping during descent: Especially for kids. Set an alarm. Wake them up 20 minutes before landing. Give them a snack or drink.
- Using decongestants for kids under 6: Rare but documented cases of rapid heartbeat have been reported. Stick to swallowing, yawning, or feeding.
What’s New in 2026?
Medical advances are making a difference. In 2022, the FDA approved the Otovent device-a nasal balloon you inflate with your nose. It pushes air up the Eustachian tube. Clinical trials showed 88% success. It’s now available over the counter.
Mayo Clinic is testing tiny stents that keep the Eustachian tube open. Phase 2 trials showed 92% success for chronic sufferers. This could be a game-changer for people who fly often or have lifelong ear issues.
And in development: smart earplugs from Bose. They have pressure sensors and give real-time feedback via a phone app. Are you equalizing correctly? The app tells you. Beta testing starts in 2026.
When to See a Doctor
If you have pain that lasts more than a few hours after landing, hearing that doesn’t return, dizziness, or fluid draining from your ear-see an ENT specialist. Chronic Eustachian tube dysfunction is treatable. Options include balloon dilation (a 15-minute office procedure with 76% long-term success) or stent placement. Costs range from $3,800 to $5,200 out-of-pocket in the U.S., but many insurance plans cover it if you’ve tried other methods first.
For frequent flyers-business travelers, pilots, flight attendants-pre-flight exercises make a huge difference. One 2022 study found that people who did daily swallowing exercises for a week before flying reduced their ear pain by 57%.
Quick Tips Before Your Next Flight
- Start equalizing 30 minutes before descent-don’t wait.
- Use filtered earplugs if you’re prone to ear pain.
- For kids: feed or give a bottle during descent.
- For adults with congestion: use a nasal spray 1 hour before landing.
- Never force the Valsalva maneuver. Gentle pressure only.
- Stay hydrated. Dry nasal passages make equalization harder.
Flying doesn’t have to hurt. With the right tools and timing, you can protect your ears and enjoy the ride.