However, the pressure within the ear must match the pressure outside the body. If the pressure either inside or outside the body becomes too high or too low, the ear will try to adapt to regain the balance.
What to do when ears do not pop
From altitude changes to ear infections, there are many reasons why pressure may build up in the ears. Sometimes, the pressure is easy to relieve, but on occasion, it takes a little longer.
Pressure in the ears develops when air and fluid block one of the major ear tubes, causing what is medically known as ear barotrauma.
The most common places for pressure to develop in the ear are the middle ear and the eustachian tube, which runs from the top of the throat to near the eardrum.
Children and babies are more susceptible to pressure-related blockages in the ears, as they have narrower Eustachian tubes than adults.
In this article, we discuss why people feel pressure in their ears, ways to relieve pressure when the ears do not pop, and tips to prevent it in the future.
The ears rely on pressure to function. It is because of pressure waves , which increase and decrease slightly, that people are able to hear.
However, the pressure within the ear must match the pressure outside the body. If the pressure either inside or outside the body becomes too high or too low, the ear will try to adapt to regain the balance.
This creates the feeling of the ears needing to pop.
Many factors can cause pressure to build up in the ears. Outside the body, air pressure may change with altitude changes, while depth changes alter hydrostatic pressure in water.
Activities in which altitude and hydrostatic pressure can change include :
- flying on an airplane
- scuba diving
- commercial diving
- hyperbaric oxygen treatment
Internal causes, such as congestion, can induce a buildup of air or fluid in the eustachian tube in the ear. This buildup creates a feeling of pressure in the ears.
The blockage to the eustachian tube may come from:
- earwax
- water
- fluid and mucus from a sinus infection
- seasonal allergies, such as hay fever
When pressure builds up in the ears, it can cause pain and discomfort, but it can also affect the person’s hearing and cause dizziness.
To relieve pressure, people can first try to pop the ears by opening the eustachian tube. They can do this by:
- yawning
- chewing gum
- screaming
- swallowing
- wiggling the jaw
- exhaling gently against a closed airway in the Valsalva maneuver
If possible, sucking on hard candy, such as a lollipop, can be a nice, gentle way of keeping the ear tubes open. For a baby, sucking on a bottle or pacifier can have the same effect.
People can try to prepare before an activity that is likely to increase the pressure in the ears. For instance, it may help to begin wiggling the jaw just before a plane takes off so that the ears have longer to adjust to the outside pressure.
Treatments for pressure in the ears can be either preventive, such as for a person about to take a flight, or curative, for those who have blocked ears that they cannot pop.
A doctor may prescribe preventive treatments if a person has preexisting ear problems.
For people without severe problems, a pharmacy will sell over-the-counter (OTC) nasal sprays and decongestants that can release pressure in the ears. One example is oral pseudoephedrine .
OTC options are suitable for scuba divers to take before a descent or air travelers to take before a flight. However, a person should not use them too frequently as their extended use can result in complications.
For instance, decongestant nasal sprays may stop offering relief and instead increase congestion if a person overuses them.
To relieve pressure after it has built up in the ears, a doctor can dilate the eustachian tube. To do this, they may use a eustachian tube balloon dilation or a pressure equalization tube, which releases fluid and pressure from the eardrum to the ear canal.
If these treatments do not work, a doctor may perform a surgical incision in the eardrum to release fluid and pressure. Surgery may also be necessary if a person ruptures their eardrum.
Scientists are still conducting research, but a device known as an Ear Popper , which delivers a stream of air through the nasal cavity to clear the area, may soon be available.
It is important to be cautious when relieving pressure in the ears, as an excessive pressure change in the ear may cause a burst or ruptured eardrum, also called a perforated tympanic membrane.
If the eardrum ruptures, it can cause other complications, including :
- hearing loss
- ear infection
- vertigo
- chronic pain
- injury to the external ear
The best way to prevent a pressure buildup in the ears depends on the cause. If a person knows that they are about to participate in an activity with an increase or decrease in external pressure, they can prepare by treating the problem before it begins.
For example, a person can reduce the chances of blocked ears while scuba diving by keeping the pressure inside the ears in line with the pressure of the outside environment.
Divers do this by continually equalizing, which involves pinching the nose and gently blowing out. They do this throughout the dive but with particular attention during descent. Scuba divers also follow a golden rule of never holding their breath while underwater, as this can cause pulmonary barotrauma .
Another example is in hyperbaric chambers , where people undergo a form of oxygen therapy. Here, doctors minimize the chances of pressure building up in the ears by controlling the compression rate and consistency of the pressure within the chamber.
As we discussed above, a person can reduce the buildup of pressure during a flight by sucking on candy, wiggling the jaw, or using other similar methods to keep the eustachian tube open.
Regularly inhaling tobacco smoke increases the risk of severely blocked ears. A person may be able to lower the pressure in their ears by refraining from smoking.
The ears rely on a fine balance of pressure to function effectively. If the balance between the pressure within the ear and that outside the body changes, the ears will adapt to match the external pressure. This creates the sensation of ears feeling as though they need to pop.
Before an activity that may put pressure on the ears, such as flying, people can try popping the ears before the pressure becomes too great.
If the ears will not pop, it is important not to force them. While pressure in the ears can be highly uncomfortable, it is generally not dangerous, and a rapid change of pressure in the ear can put the eardrum at risk.
It sometimes takes a few days for the pressure to balance out, but a person will then notice a “pop” as the eustachian tube clears.
Last medically reviewed on August 12, 2020
- Ear, Nose, and Throat
- Pain / Anesthetics
How we reviewed this article:
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- Chapter 2: Basics of sound, the ear, and hearing. (2004). Hearing loss: Determining eligibility for social security benefits.
https://www.ncbi.nlm.nih.gov/books/NBK207834/ - Ears and altitude (barotrauma). (2018).
https://www.enthealth.org/conditions/ears-and-altitude-barotrauma/ - Ears and altitude. (n.d.).
http://www.entsc.com/ears-and-altitude/ - How to pop your ears. (n.d.).
https://med.uth.edu/orl/online-ear-disease-photo-book/appendix/how-to-pop-your-ears/ - Mallen, J. R., & Roberts, D. S. (2019). SCUBA medicine for otolaryngologists: Part I. Diving into SCUBA physiology and injury prevention.
https://onlinelibrary.wiley.com/doi/full/10.1002/lary.27867 - ONeill, O. J., et al. (2020). Ear barotrauma.
https://www.ncbi.nlm.nih.gov/books/NBK499851/ - Tseng, W.-S., et al. (2018). Analysis of factors related to failure in the pressure test: A six-year experience in Taiwan [Abstract].
https://pubmed.ncbi.nlm.nih.gov/29571230/
Eustachian Tube Dysfunction
The Eustachian tube is an opening that connects the middle ear with the nasal-sinus cavity. This tube helps to:
- Balance pressure in the middle ear (commonly felt as your ears popping)
- Drain fluid from the middle ear
- Protect the ear from both hearing sounds your body causes and nasal drainage
This tube contains a valve that opens and closes. Inadequate opening of this tube can cause a buildup of fluid in the ears, which can lead to a feeling of pain and pressure in the ear. A tube that is too open can also cause a persistent feeling of pressure as well as hearing unusual sounds such as your own breathing or your own voice too loudly. Eustachian tube disorders are common and one of the leading causes of ear infections (otitis media).
Common Eustachian tube disorders include:
- Patulous Eustachian tube dysfunction
- Obstructive Eustachian tube dysfunction
- Baro-challenge-induced Eustachian tube dysfunction (obstructive Eustachian tube dysfunction when on airplanes or when SCUBA diving)
Eustachian Tube Dysfunction | FAQ
Patulous Eustachian Tube Dysfunction
Patulous Eustachian tube dysfunction is a disorder of the valve of the Eustachian tube that causes it to remain open. When this valve remains open, sound can travel from the nasal-sinus cavity to the ears, allowing you to hear your own voice or your own breathing too loudly, or even the sound of blood pumping. Patulous Eustachian tube dysfunction can also alternate with obstructive Eustachian tube dysfunction.
Symptoms of Patulous Eustachian Tube Dysfunction
Symptoms of patulous Eustachian tube dysfunction include:
- A sense of fullness in the ears
- The ability to hear your own voice, breathing or bodily functions very loudly
Causes of Patulous Eustachian Tube Dysfunction
Causes of patulous Eustachian tube dysfunction include:
- Weight loss
- Chronic neuromuscular or immunological disease
- Chronic nasal allergy
- A history of acid reflux disease
- Stress and anxiety
Diagnosing Patulous Eustachian Tube Dysfunction
Your doctor may use a variety of techniques to diagnose patulous Eustachian tube dysfunction while viewing your ear drum (tympanic membrane). Your doctor may ask you to breathe deeply and swallow to see how the ear drum responds. Your doctor may also measure the pressure inside your ear using specialized tools.
Treatment for Patulous Eustachian Tube Dysfunction
Medical treatment for patulous Eustachian tube dysfunction includes:
- Limiting decongestants and caffeine
- Drinking more water
- Medicated nasal drops
Surgery for patulous Eustachian tube dysfunction includes:
- Implants
- Fillers
- Grafts or fat transfers
The surgical method will be determined by your doctor. In some cases, tympanostomy tubes (ear tubes) may make the condition worse. Implants, fillers, grafts and fat transfers act to fill out the tissue in the surrounding area so the Eustachian tube can close properly and return to normal function. Sometimes grafts are applied to the ear drum.
Eustachian Tube Dysfunction
Obstructive Eustachian Tube Dysfunction
Obstructive dysfunction occurs when the valve of the Eustachian tube does not open properly. This prevents pressure from balancing and fluids from draining out of the ear.
Symptoms of Obstructive Eustachian Tube Dysfunction
Symptoms of obstructive Eustachian tube dysfunction include:
- Pressure and/or pain in the ears
- A sense of fullness in the ears
- Muffled hearing
Causes of Obstructive Eustachian Tube Dysfunction
Causes of obstructive Eustachian tube dysfunction include:
- Environmental allergies
- Sinusitis
- Acid reflux
- Neoplasms (abnormal growth of tissue)
- Impaired muscle coordination or muscular deficiency, for example, in patients with a cleft palate
Diagnosing Obstructive Eustachian Tube Dysfunction
Over time, negative pressure can build up in the ear, causing pain, ear fullness and muffled hearing. When this occurs, sometimes your doctor can see the ear drum (tympanic membrane) change shape due to this pressure and become concave. Negative pressure and structural changes in the ear can also be signs of obstructive Eustachian type dysfunction.
Obstructive eustachian tube dysfunction can be chronic, intermittent or short term. This is commonly felt during flights, when you have a cold or when SCUBA diving.
Baro-Challenge-Induced Eustachian Tube Dysfunction
When obstructive Eustachian tube dysfunction is only felt during airplane flights or SCUBA diving, this is known as baro-challenge-induced Eustachian tube dysfunction.
Treatment for Obstructive Eustachian Tube Dysfunction
Following evaluation and diagnosis, your doctor will determine the best course of treatment. This may include medication or surgery, and a doctor may recommend avoiding triggers. Surgical treatments include:
- Tympanostomy tubes (ear tubes)
- Balloon dilation of the eustachian tube
- Adenoidectomy (removal of adenoids in the back of the nose)
- Potassium titanyl phosphate (KTP) laser to reduce inflamed tissue
Common Misconceptions About Eustachian Tube Dysfunction
A common course of treatment for Eustachian tube dysfunction is the use of decongestants or antihistamines. In some cases, this treatment may make the condition worse. If decongestants or antihistamines do not provide relief, contact your doctor. You may need to see an ear, nose and throat specialist for treatment.
Johns Hopkins Eustachian Tube Health Center
The Johns Hopkins Eustachian Tube Health Center provides comprehensive evaluation, diagnosis and management of Eustachian tube dysfunction that include medical, multidisciplinary and surgical approaches.
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