Ear Pressure: Why Your Ear Feels Plugged

Why ears feel pressure

The middle ear is an air-filled space behind the eardrum. The eustachian tube opens briefly each time you swallow or yawn, letting air in so the pressure matches the outside. If the tube is swollen or blocked, air in the middle ear is slowly absorbed, the pressure drops, and the eardrum is pulled inward. That produces fullness, muffled hearing, popping or crackling, and sometimes discomfort.

Common causes of ear pressure

Eustachian tube dysfunction

Eustachian tube dysfunction (ETD) is the most common cause. Colds, allergies, sinusitis, reflux, smoking and enlarged adenoids in children inflame the lining of the tube. Symptoms are fullness, popping, muffled hearing and sometimes mild ear pain or dizziness. Most cases settle within 1 to 2 weeks as the cold clears.

A less common variant, patulous eustachian tube, is the opposite problem: the tube stays open, so you hear your own voice and breathing loudly. It is linked to weight loss and pregnancy and often improves when lying down.

Colds, allergies and sinus congestion

Swelling in the nose and throat blocks the eustachian tube opening. Allergic rhinitis causes recurring pressure during pollen season or around pets and dust.

Flying, diving and driving in mountains

Rapid changes in outside pressure, especially during descent in a plane, can cause ear barotrauma. The ear feels blocked and painful, and severe cases cause bleeding behind the eardrum or eardrum perforation. Scuba diving can also damage the inner ear. See barotrauma.

Fluid behind the eardrum

Otitis media with effusion (glue ear) is fluid trapped in the middle ear without active infection. It is very common in young children after colds and causes muffled hearing. In adults, persistent fluid in one ear needs the back of the nose examined to rule out a growth blocking the tube.

Middle ear infection

Acute otitis media causes pressure that builds to pain, with fever and, in children, ear pulling and irritability. The eardrum can burst and leak pus, after which pain often eases.

Earwax

Earwax buildup blocks the ear canal and causes fullness and muffled hearing, often after using cotton swabs, earbuds or hearing aids. Water in the ear after swimming or showering can make the wax swell and block suddenly.

TMJ disorders

Problems with the jaw joint, which sits right in front of the ear canal, can cause ear fullness, aching and clicking, with jaw pain on chewing and morning stiffness from teeth grinding.

Less common but important causes

• Sudden sensorineural hearing loss: sudden hearing loss in one ear, often first noticed as fullness. It is easily mistaken for a blocked ear and needs urgent treatment, usually with steroids.
• Ménière's disease: attacks of spinning vertigo lasting 20 minutes to several hours, with fullness, roaring tinnitus and fluctuating hearing loss in one ear.
• Acoustic neuroma: a benign growth on the hearing nerve causing slowly progressive one-sided hearing loss, tinnitus and fullness.
• Nasopharyngeal tumors: rarely, persistent one-sided fluid in an adult.
• Superior canal dehiscence: hearing your own eye movements or heartbeat, and dizziness with loud sounds.

Ear pressure in one ear vs both ears

How doctors find the cause

A doctor will look in the ear with an otoscope to check for wax, fluid, a retracted or bulging eardrum and infection. They may:

• perform tuning fork tests (Weber and Rinne) to tell a blockage (conductive loss) from nerve hearing loss
• order a hearing test (audiogram) and tympanometry, which measures how the eardrum moves
• look into the back of the nose with a small camera for persistent one-sided fluid
• order an MRI for one-sided nerve hearing loss or tinnitus

How to relieve ear pressure

Equalize the pressure

• Swallow, yawn or chew gum. These open the eustachian tube naturally.
• Valsalva maneuver: close your mouth, pinch your nostrils and blow gently as if blowing up a balloon until you feel a pop. Be gentle. Do not do this hard or if you have a cold with an ear infection.
• Toynbee maneuver: pinch your nose and swallow.
• Autoinflation devices: a balloon blown up through one nostril helps children and adults with persistent fluid.

Treat congestion

• Saline nasal rinses clear mucus.
• Steroid nasal sprays used daily for a few weeks reduce swelling, especially with allergies.
• Antihistamines help allergic congestion.
• Decongestant nasal sprays for no more than 3 days, or oral decongestants, may help short-term. Oral decongestants are unsuitable for people with high blood pressure, heart disease or glaucoma.

Flying tips

• avoid flying with a heavy cold if possible
• use a decongestant nasal spray about an hour before descent if you are prone to ear pain
• stay awake during descent and swallow or yawn often
• give babies a bottle, breastfeed or a pacifier during takeoff and landing
• filtered pressure-regulating earplugs can help

Earwax

Softening drops (olive oil or over-the-counter drops) for a few days often clear wax. Do not use cotton swabs, which push wax deeper. Persistent blockage can be removed by a clinician with suction or irrigation. Avoid ear candles, which do not work and can cause burns.

When medical treatment is needed

Persistent eustachian tube dysfunction may be treated with balloon dilation of the tube or ear tubes (grommets). Sudden sensorineural hearing loss is treated with steroids, ideally within 2 weeks.

Frequently asked questions

How do I get rid of pressure in my ear?

Swallow, yawn, chew gum or try a gentle Valsalva maneuver by pinching your nose and blowing gently. If congestion is the cause, saline rinses and a steroid nasal spray help. See a doctor if pressure lasts more than 2 to 3 weeks or comes with hearing loss.

Why does my ear feel plugged but there's no wax?

The most common reason is eustachian tube dysfunction from a cold, allergies or sinus congestion, which leaves the middle ear under low pressure. Fluid behind the eardrum, TMJ problems and Ménière's disease are other causes. Sudden one-sided plugging with hearing loss needs urgent assessment.

How long does ear pressure last after a cold?

Most ear pressure clears within 1 to 2 weeks after a cold, though some people have fullness for up to 4 to 6 weeks while fluid drains. If it lasts longer, see a doctor to check for persistent fluid.

Can sinus problems cause ear pressure?

Yes. Sinus infections and nasal congestion swell the lining around the eustachian tube opening, stopping it from equalizing pressure. Treating the sinus congestion with saline rinses and steroid sprays usually relieves the ears too.

Can high blood pressure cause ear pressure?

High blood pressure does not usually cause ear fullness. A pulsing sound in the ear (pulsatile tinnitus) can sometimes relate to blood vessels and should be checked. Ear pressure itself is far more often caused by eustachian tube problems, wax or fluid.