Whether you’re on a cross-country flight or in bed fighting off a bad cold, a feeling of fullness in your ears can make an already uncomfortable situation worse.
Here’s what’s happening and how to pop your ears the right way.
When you have a viral infection or allergies or experience changes in altitude, your ears might feel full, and you might not be able to hear as well as usual. What’s happening? Your Eustachian tubes, which link your middle ear to the back of your nose and throat, are filling with excess fluid, says David M. Kaylie, M.D., FACS, professor and vice chairman for clinical operations in the Department of Head and Neck Surgery & Communication Sciences at Duke University Medical Center.
Like your sinuses, your middle ear makes mucus-y fluid to flush out debris. Muscles in your palate and throat open the Eustachian tubes to drain them.
“Every time you chew or yawn or swallow, those muscles pull up the Eustachian tube and let the fluid drain out,” says Dr. Kaylie. “You do that thousands of times a day, and you don't even notice it, but every time you do that, that little tiny bit of fluid that's in your ear drains to the back of your nose, and you swallow it, and you don't even feel it. And also, the air gets in to equalize pressure.”
However, if you have a cold or allergies, the lining of your nose gets inflamed and congested. “If your nose is congested, the Eustachian tube will be congested also, so then it doesn't open well and drain well,” says Dr. Kaylie. The fluid that usually drains out builds up instead, giving you that feeling of pressure.
What if your ears are clogged for seemingly no reason?
If your ears feel clogged often, not just during acute situations, it might be a different story. While Eustachian tube dysfunction can become a chronic problem, it’s not common in adults.
“People who have this kind of chronic ear fullness without having allergies or a cold or anything like that, it's probably not Eustachian tube [dysfunction]; it's probably something else,” says Dr. Kaylie.
It could be your jaw. One common cause of ear pressure is temporomandibular joint dysfunction, which causes pain and inflammation in the joints connecting your jawbone and your skull.
Your temporomandibular joints sit directly in front of your ears on each side, just millimeters from your ears. These help your jaw hinge open and closed.
“Since [the jaw] has to swing evenly in two places, if there's any misalignment of the way it's opening, it can put tension and pressure in one of the joints,” says Dr. Kaylie. “This can cause inflammation and cause you to have discomfort in that joint.” One of the first symptoms will be a stuffed-up, full feeling in your ears that won’t be relieved by popping. Although the problem is in your jaw, the sensation feels like it’s in your ear. You might even have ear pain, but your hearing won’t be affected, says Dr. Kaylie.
You might have a migraine. Sometimes migraines can cause symptoms of ear fullness that people assume is related to their Eustachian tubes, says Bryan Ward, M.D, Associate Professor of Otolaryngology - Head and Neck Surgery at Johns Hopkins University. “But honestly, the most common cause of ear fullness I probably see in my clinic has to do with jaw clenching,” he says. Stress from the COVID-9 pandemic has made this phenomenon even more common in the past few years.
You might have a disruption in your inner ear. Another potential cause of ear fullness is superior canal dehiscence, “something that is actually more common than we ever thought; we’re seeing it more and more,” says Dr. Kaylie. First identified in the early 2000s, superior canal dehiscence is caused by pressure around the brain that physically erodes a tiny bone in your ear responsible for detecting head motion and helping you maintain your balance.
This disruption in your inner ear gives you a sensation of ear fullness despite completely normal Eustachian tube function. In superior canal dehiscence, you can hear your voice very loudly in your ear when you speak or chew. Patients with this condition often say they can hear their own footsteps, and “sometimes they even say they hear their eyes move,” says Dr. Kaylie. “When they move their eyes, they hear kind of a squishing noise in their ear.”
In addition, loud noises can make someone with superior canal dehiscence feel dizzy. “If somebody claps or yells near their ear, it'll give them like a brief vertigo,” says Dr. Kaylie.
Your Eustachian tubes might not be functioning right. Another less common cause of ear fullness is Patulous Eustachian Tube. In this condition, the Eustachian tubes stay open instead of opening and closing like they’re supposed to.
How to pop your ears safely
If you have acute ear fullness, like when you’re sick or dealing with seasonal allergies or traveling by air, try chewing gum or yawning. Either can make your ears pop and equalize the pressure.
If that doesn’t work? “The safest way to pop your ears is to perform a maneuver called a modified Valsalva maneuver, which is basically what divers do when they're trying to pop their ears,” says Dr. Ward.
This is a modified method of clearing the inner ear as first described in 1704 by Antonio Valsalva, a researcher who studied ear anatomy. To do it, first plug your nose and close your mouth.
“Hold your nose and blow against your closed nostrils to generate a little bit of pressure in the back of the nose, and then swallow hard against that pressure,” says Dr. Ward. “It's that combination of a little bit of positive pressure along with that swallow that allows the Eustachian tube to open up and for you to put some air up to the space behind your eardrum.”
It's possible to do this without swallowing, but if you do it that way, you could deliver so much pressure that you could actually damage your ears, says Dr. Ward. In general, the key to doing this safely is to be gentle.
“You shouldn't be delivering a lot of pressure, but just enough to kind of give a boost to the swallow so that you can open your Eustachian tubes,” he says.
If you aren’t experiencing relief? “Try to avoid doing excessive jaw manipulation to clear your ears,” says Dr. Ward. He often sees that when people have trouble clearing fluid from their ears, they end up moving their jaw in strange positions to try to improve their symptoms.
“What ends up happening is that then they stress those muscles around the jaw, and they eventually replace the one cause of ear fullness with another one,” he says. “And there's this cruel cycle that they get into where they just keep doing more and more jaw manipulations to try to make their ear feel better, but in fact, it's only stressing those jaw muscles more and making the symptoms last longer.”
One more thing: The occasional, gentle ear pop is probably OK, but frequent popping might not be the best idea.
Researchers at the University of California San Francisco reported that frequent ear popping might have contributed to one woman’s retinopathy, a disease of small blood vessels in the eye. The Valsalva maneuver might increase eye pressure in a way that can rupture superficial retinal blood vessels, the researchers suggest.
Other ways to clear your ears
Popping your ears isn’t your only option. If you have allergies, antihistamines or nasal sprays can help you reduce ear fullness so you don’t feel the need to pop in the first place. (See the best allergy medications here.)
And if you always have ear trouble on planes, try using Afrin nasal spray when you board and again half an hour before landing, suggests Dr. Kaylie. Afrin is a powerful decongestant that can open your Eustachian tubes. When used appropriately, just in these settings, it is effective and safe.
“The thing about Afrin though, is if you use it regularly for more than three days, it can cause what's called rebound congestion, and people actually get really hooked on Afrin nasal spray, because if they don't use it, their nose is so congested,” says Dr. Kaylie. “So, I recommend if they're going to use it, just use it for the flight. Don't use it on a regular basis.”
Pseudoephedrine, commonly available as Sudafed, another powerful decongestant, can also help, but check with your doctor first. Sudafed can raise your heart rate and cause problems, especially in people with high blood pressure.
When to see a doctor
If you can’t pinpoint the cause of acute ear fullness and you have hearing loss and pain, see a healthcare provider to rule out the possibility of an ear infection. But be cautious: “If your primary care doctor is prescribing antibiotics multiple times, and it's just not getting better, you really want to think: maybe this isn't an ear infection,” says Dr. Kaylie. An otolaryngologist (ear, nose, and throat doctor) can help.
And if your ear problems are chronic, you need to see a doctor.
“Particularly if you have ear fullness and vertigo, or ear fullness with migraines, those are all things that need to be evaluated,” says Dr. Kaylie.
In these cases, popping your ears won’t provide the relief you need, and your doctor can recommend more targeted treatments instead.
There is a wide range of treatments available for temporomandibular joint dysfunction, from nonsurgical methods like corrective dental appliances and physical therapy to surgery for the most severe cases.
Superior canal dehiscence and Patulous Eustachian Tube can be treated with surgery.
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