What causes the pain?
Normally the air pressure in your middle ear is
the same as the air pressure outside your body. Your
Eustachian tube (which connects your middle ear to
the back of your nose) helps
to keep it this way.
When you swallow or yawn, the tube, which is
normally closed, opens
briefly. This lets a tiny bubble of air flow up the
tube and into your middle ear.
But this air
gradually gets absorbed by the tissues around your
middle ear. So you need to keep swallowing to let your
Eustachian tube open from time to time. This makes
the air pressure inside your ear the same as that
outside your ear.
Why is it worse when flying?
When you travel in an aeroplane, the air
pressure around you changes quickly, especially
during take-off and landing.
Air pressure is highest near the ground and
lessens as you get higher. But you may not be able
to swallow fast enough to keep the middle ear filled
This means that the air pressure inside your
middle ear and your outer ear is different, and your
eardrum gets pulled inwards towards your brain.
Your ear can feel blocked, and it can be very
painful. If your Eustachian tube is blocked for some
reason, it can be especially difficult to get enough
air into your ear.
You're more likely to get ear pain during a
Your nose or sinuses are blocked because of
an allergy or a cold. This often means your
Eustachian tube is blocked too
You're a child. Young children have shorter
and more horizontal (flatter) Eustachian tubes
than adults. This means the tube gets blocked
What treatments work?
If your ears are blocked because you've
got a cold or an infection, it may be better
not to fly. But you may not want to, or be
able to, cancel a holiday or business trip
just for this reason.
If you have to fly with a cold or
blocked ear, there are some simple things
you can do to reduce your chances of getting
earache during the flight.
Yawning, swallowing or blowing hard
while pinching your nose can help reduce
the pressure in your ears. You should
feel your ears 'pop'.
Taking a decongestant tablet or
syrup before take-off may stop you
getting pain in your ears if you're an
adult. You can buy decongestants that
contain a drug called pseudoephedrine
from a pharmacy. They come as tablets
and syrups. Brand names include Sudafed
There's no evidence that
decongestant tablets or syrup can help
young children avoid earache during a
Some people use a decongestant spray
before they fly, although the
effectiveness seems to be less than
tablets or syrup. Brand names include
Afrazine, Sudafed, Vicks Sinex, Otrivine
The earache caused by flying is
different to earache caused by an infection.
If you have an ear infection you should
consult your doctor before flying.