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 with air.
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 flight if:
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 more easily.
NHS Direct: Best Treatments Health Overview
Immunisations & vaccinations
Avoid a DVT on long journeys
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 and Galpseud,
There’s no evidence that decongestant tablets or syrup can help young children avoid earache during a flight.
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 and Otraspray.
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.
What causes the pain?