Pressure in the ears

Some people notice it whilst driving or hiking in the mountains, others during take-off or landing in a plane. Still others experience it when they have a cold or during a particularly stressful period in their lives: they suddenly feel pressure in their ears.

All of a sudden, it feels like “cotton wool in your ear”. Perhaps your hearing isn’t as good as it used to be, or perhaps you even have earache as well as the pressure.

In this article, you’ll find out what causes ear pressure, what triggers it and, above all, what you can do about it.

What is ear pressure and how does it occur?

Our ear is a complex organ consisting of many individual parts, from the outer ear to the ear canal, right through to the sensitive hair cells and the eardrum, a thin membrane at the end of the ear canal. Behind the eardrum lies the middle ear, to which the Eustachian tube is connected; this connects the ear to the nasopharynx.

The Eustachian tube is responsible for ventilating the ear and regulating pressure within it. If the Eustachian tube is blocked, for example due to a cold, earwax or the need to equalise pressure at different altitudes, an imbalance arises between the external pressure and the pressure in the middle ear. The eardrum bulges inwards or outwards. This manifests as a feeling of pressure in the ears or pressure in one ear.

Causes: Why do you experience pressure in your ears?

The reasons for pressure in the ears can vary greatly and may be of both physical and psychological nature. We would like to outline some of these causes below.

• Pressure in the ear due to a cold: Among the most common causes of pressure in the ears are colds, a runny nose and flu. The pressure in the ears occurs when the ‘Eustachian tube’ (ear trumpet) in the ear becomes blocked. This is caused by increased mucus production during a cold.
  

• Pressure in the ears due to infections: Various infectious diseases can also cause a feeling of pressure in the ears or in one ear. Sinusitis, in which the mucous membranes of the sinuses become inflamed, is a particularly common cause. Here too, a blocked Eustachian tube can be the trigger for ear pressure.
  
  
• Ear pressure caused by stress: Prolonged psychological stress often leads to physical symptoms. One such symptom can be ear pressure. It is important to monitor these symptoms closely, as they may indicate impending sudden hearing loss, the onset of tinnitus or other ear conditions.
  

• Ear pressure during flights: The reason why people often feel pressure in their ears whilst flying or after a flight is the change in air pressure. This pressure is often particularly noticeable during take-off or landing. Incidentally, the situation is similar when diving. Here too, pressure differences arise, for example when descending and surfacing.
  
  
• Pressure in the ears due to ear conditions: Pressure in the ear is one of the symptoms of various ear conditions. These range from middle ear infection or an ear canal infection, through sudden hearing loss, to Meniere’s disease. Depending on the condition and its stage, the pressure in the ear can vary in intensity. If the pressure does not subside or is accompanied by earache, you should therefore always consult an ENT specialist.
  

• Ear pressure due to water in the ear: Water in the ear is often harmless and drains out on its own. In some cases, however, it can become trapped in the ear, for example due to an excess of earwax. In this case, ear pain and ‘muffled’ hearing are often
  accompanied by pressure in the ear.
  

• Pressure in the ear due to earwax: A common, but usually harmless, cause of pressure in the ear is earwax. If there is too much earwax, a plug can form, leading to a blockage in the ear, which in turn causes the sensation of pressure.
  
  
• Pressure in the ear due to dental and jaw problems: Pressure in the ears is not always directly related to the ears themselves. Tension in the temporomandibular joint can also be a cause of ear pressure. Furthermore, dental problems can lead to earache, as the jaw and ears are closely connected.

Relieving pressure in the ears: How pressure equalisation works

The sensation of pressure in the ears can be very uncomfortable. However, there are a few simple tips or methods you can use to equalise pressure, which in turn relieves the pressure in the ears.

These include:

• Swallowing: Eating or drinking can work wonders for pressure in the ears. Chewing and swallowing usually leads to pressure equalisation. If you don’t have any food to hand, simply swallowing saliva is often enough.
  

• Chewing (chewing gum): Chewing gum has proven particularly effective for equalising pressure in the ears. Even as a preventative measure - for example, before a plane takes off or lands - chewing gum continuously can help reduce pressure in the ears.
  

• Yawning: As with swallowing, yawning also tenses the muscles in the palate. The muscle that keeps the Eustachian tube closed relaxes in the process and opens it. If you cannot yawn on command, you can simply mimic the action. The movement - opening the mouth and moving the lower jaw - is usually sufficient to equalise pressure.
  

• Valsalva manoeuvre: In the so-called Valsalva manoeuvre, pressure equalisation is controlled via breathing. Those affected breathe out gently whilst keeping their mouth and nose closed. To do this, press your lips together and briefly pinch your nose shut with your fingers.
  

Pressure in the ears won’t go away: better to see a doctor

Pressure in the ears is often harmless and disappears quickly, but it can also be a sign of a serious illness. For this reason, you should see an ENT specialist if

• the pressure does not go away on its own after a short time
• you experience ear pressure very frequently and repeatedly
• you notice other symptoms, such as earache, dizziness, fever, headache or nausea
• you notice hearing loss or reduced hearing in addition to the pressure in your ear
• you feel as though your ear is blocked and the blockage does not clear up on its own
• You feel unwell in connection with the ear pressure

What does an ENT specialist do for ear pressure?

The ENT doctor will first diagnose the ear pressure, which means they will identify the cause and, if necessary, identify any underlying condition.

Based on this diagnosis, the doctor will determine the treatment, for example medication, professional earwax removal or nasal irrigation, or, if necessary, an operation to dilate the Eustachian tube so that the blockage can clear.