Ear Barotrauma

If you’ve ever felt a clogged-up, pressure-filled sensation in your ears, you’ve likely experienced barotrauma. Some describe the feeling as though their ears are underwater, with discomfort and muffled sounds also common symptoms.

Unlike a build-up of ear wax, the feeling of barotrauma can’t be fixed by cleaning your ears. But if you’re a frequent flyer, scuba diver or hiker, knowing the causes, prevention methods, diagnosis and treatments for this common condition is important.

From the signs and symptoms of barotrauma to the implications of leaving it untreated, here’s everything you need to know.

What is barotrauma?

Barotrauma is an ear condition where discomfort is caused due to pressure changes. Typically, this happens when the Eustachian tube becomes blocked or partially blocked, creating a vacuum that pulls the eardrum inward, restricting its ability to equalise pressure. It is most commonly experienced during plane flights or scuba diving due to frequent air and water pressure changes.

Symptoms of Barotrauma

Ear barotrauma symptoms can range in severity depending on the level of injury caused. Symptoms can include:

  • A feeling of pressure or fullness in the ear
  • Ear pain
  • Muffled sounds or sudden loss of hearing
  • Vertigo or nausea
  • Bleeding (rare).

Initially, the negative pressure of barotrauma can cause a feeling of fullness or dullness, like your ears are stuffed with pressure. This can progress to discomfort and (if the pressure does not return to normal) severe pain.

Many cases of barotrauma begin as middle ear barotrauma, but if left untreated or in cases where major trauma occurs, symptoms of inner ear barotrauma can be more intense.

Patients experiencing barotrauma also report hearing muffled sounds and varying degrees of hearing loss. It’s important to note the hearing loss associated with ear barotrauma is most often temporary, but seeking help for hearing loss is still incredibly important. In some cases, vertigo, nausea and bleeding can accompany other symptoms.

Barotrauma Causes

The most common causes of ear barotrauma include:

  • Airplane takeoffs and landings
  • Scuba diving
  • Hiking
  • Driving through mountains.

This is because each of these scenarios relates to changes in altitude and a dramatic drop and rise in air or water pressure. Experiencing barotrauma when flying is also known as airplane ear, which you may feel during takeoff and landing. For some, the sensation can feel like a ‘pop’ in the ears or a feeling of fullness.

A similar sensation can also be felt when moving through mountains, on foot or by car. However, changes in air pressure are typically more rapid and noticeable when flying or scuba diving.

Middle ear barotrauma is the most common scuba diving-related medical disorder, affecting more than 40% of divers at some point.

Diagnosing Barotrauma

If barotrauma is suspected, healthcare professionals are likely to perform an otoscopy — where they look inside the ear with a particular type of instrument — to determine any damage. This can sometimes be accompanied by hearing and balance tests.

If you’re experiencing any ear barotrauma symptoms, it’s essential to seek medical attention for proper evaluation so necessary treatment can be provided. If left untreated, ear barotrauma could lead to eardrum pain and fluid leakage. In severe cases, it can lead to bleeding or a ruptured eardrum, resulting in long-term hearing loss.

Barotrauma Treatment

The options for ear barotrauma treatment vary depending on the severity of the condition.

In mild cases, home remedies and self-care options include:

  • Yawning
  • Chewing gum
  • Breathing exercises.

The above can encourage the Eustachian tube to open and release the pressure. A common home remedy for blocked ears (particularly during or after flying) is the Valsalva manoeuvre. This technique involves taking a deep breath in, holding it and pinching your nose as you gently try to blow out of it simultaneously. This sends pressure to your ears to encourage a pressure release.

Over-the-counter medication options can include:

  • Antihistamines
  • Decongestants
  • Antibiotics (if infection occurs)
  • Nasal steroids.

In more severe cases, ear barotrauma treatment can include surgery. This often involves a specialist making a small incision in the eardrum to equalise the pressure and drain the fluid. Or, if a ruptured eardrum from barotrauma does not heal, it may also need to be repaired surgically.

Preventing Barotrauma

There are several prevention methods that can help a person significantly reduce their risk of experiencing barotrauma.

Prevention methods when flying include:

  • Chewing gum during take-off and landing helps activate the muscles that open and close the Eustachian tubes. If you don’t like gum, try yawning or swallowing.
  • Decongestants can work as a preventative if taken before flights.
  • The Valsalva manoeuvre or other breathing and swallowing techniques.
  • Prevention methods when diving include:
  • Equalising pressure early and often – The best method is to hold your nose and blow gently while tilting your head from side to side.
  • Practising equalising on land before entering the water – If you’re having difficulty that day, don’t dive.
  • Keeping ears clean and dry post-dive – If suspected barotrauma occurs, keep ears clean and dry to prevent infection.

You should also avoid the above activities when you’re already suffering from congestion or a cold, as your ability to equalise the pressure in your ears and sinus will already be compromised.


For the most part, barotrauma isn’t all bad news. In most cases, it is preventable and treatable. However, its symptoms and warning signs should never be ignored as they can lead to more serious infections and long-term implications.

If you’re a frequent flyer or scuba diver, take particular care with your ears when subjecting them to changing pressures, and if you suspect you may be experiencing barotrauma, seek help from a health professional.

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