Air Travel With Ear Problems: Proven Equalization and Safety Tips for Flying Comfortably

By Joe Barnett On 12 Jan, 2026 Comments (10)

Ever landed with your ears ringing, muffled, or painfully blocked? You’re not alone. Around 10% of adults and over 22% of kids experience airplane ear on every flight - and that number jumps to 34% if you’ve got a cold, allergies, or sinus issues. It’s not just annoying. Left unchecked, it can cause temporary hearing loss, dizziness, or even a ruptured eardrum. The good news? You can prevent it. Most people wait until it hurts to do something - but by then, it’s too late. The key is to start equalizing pressure before pain hits.

Why Your Ears Hurt During Flights

Your middle ear is an air pocket sealed behind your eardrum. It’s connected to the back of your throat by a tiny tube called the Eustachian tube - about 35mm long in adults, and even shorter in kids. This tube opens when you swallow, yawn, or chew, letting air flow in or out to balance pressure between your ear and the cabin.

As the plane climbs, cabin pressure drops. Your middle ear pressure stays higher, so your eardrum bulges outward. That’s usually not painful. But when the plane descends, cabin pressure rises faster than your ear can adjust. The higher outside pressure pushes your eardrum inward. If the Eustachian tube won’t open, you feel pressure, fullness, and eventually pain. This is called barotrauma.

The pressure difference can hit 40 mmHg during rapid descents - enough to pull your eardrum tight enough to distort hearing. Kids are more vulnerable because their Eustachian tubes are smaller, more horizontal, and less likely to open on their own. That’s why babies and toddlers cry during landing - they’re in pain.

How to Equalize Pressure Safely

You don’t need fancy gear. Just know which techniques work, when to use them, and how to avoid mistakes.

Swallow or yawn - This is the easiest, safest method. Do it every few minutes during descent. Even chewing gum helps. It works for 65% of people, and carries zero risk.
Toynbee maneuver - Pinch your nose shut and swallow. This pulls air into the middle ear. It’s safer than blowing, and works for 68% of users. Great for kids who can’t blow properly.
Lowry technique - Combine swallowing and gentle blowing. Pinch your nose, swallow, and blow softly at the same time. This hits 89% effectiveness in experienced users, but takes practice. Most people get it right after 2-3 flights.
Jaw wiggle - Move your jaw side to side while swallowing. A simple trick, but it improves success by 22% in children, according to ENT specialists. Try it with toddlers - it’s easier than making them swallow on command.
Valsalva maneuver - Pinch your nose and blow gently. This forces air into the middle ear. It works for 82% of adults - but only if you do it right. Blow like you’re trying to fog up a mirror, not like you’re blowing up a balloon. Force it too hard, and you risk inner ear damage. That’s why doctors call it a last resort.

Never blow hard. Never do it while you’re in pain. Never force it. If you feel a pop, stop. If you feel more pressure, stop. Pushing through pain is how ruptured eardrums happen.

Earplugs That Actually Work

Not all earplugs are created equal. Regular foam plugs just block sound - they don’t help with pressure. But filtered earplugs like EarPlanes are designed to slow down pressure changes. They use a ceramic filter that reduces the rate of pressure shift by 37%, giving your Eustachian tube an extra 13 seconds to catch up.

In clinical trials, EarPlanes helped 76% of users avoid discomfort. But they’re not magic. If your tubes are chronically blocked by allergies or infection, their effectiveness drops to 42%. Still, they’re worth trying - especially if you fly often. They cost about $5 a pair and are reusable for up to 10 flights.

A crying toddler being fed a bottle during plane descent, with pressure waves subtly shown around their head.

Decongestants: Use With Caution

If you’re congested, your Eustachian tube is swollen shut. Decongestants can help - but only if used correctly.

Nasal sprays like oxymetazoline (Afrin) shrink swollen tissue in 10 minutes. Use them 30-60 minutes before descent. Don’t use them for more than 3 days - they cause rebound congestion.
Oral decongestants like pseudoephedrine (Sudafed) last longer - 8-12 hours. But they raise blood pressure and heart rate. Avoid them if you’re over 40, have heart issues, or take blood pressure meds. The FDA warns that 12% of adults over 40 experience side effects.
For kids under 6: Never use oral or nasal decongestants. The risk of rapid heartbeat (tachycardia) is real, even if rare (0.07% in FDA reports). Instead, use bottle-feeding during descent. Babies who suck on a bottle equalize pressure 43% better than those who sip from a cup.

There’s a newer option: Otovent, a nasal balloon device approved by the FDA in 2022. You inflate it through one nostril - the pressure opens the Eustachian tube. Clinical trials show 88% effectiveness. It’s safe for kids and adults. You can buy it online or at some pharmacies.

Timing Is Everything

Waiting until your ears hurt is the #1 mistake. By then, the pressure difference is too big, and your tubes are already locked shut.

Start equalizing at 8,000 feet - that’s when the cabin pressure begins to rise rapidly on descent. Don’t wait for the seatbelt sign to turn off. Begin swallowing, yawning, or doing the Toynbee maneuver as soon as the plane starts down. Do it every 300-500 feet of descent. That’s about every 2-3 minutes.

For kids, keep them awake during descent. Sleeping is the #1 reason kids get ear pain. If they’re asleep, gently wake them up to feed or give them a pacifier. Even a few swallows can make the difference.

What Airlines Are Doing to Help

Newer planes like the Boeing 787 keep cabin pressure at 6,000 feet instead of the old standard of 8,000 feet. That’s a 25% reduction in pressure change. Delta Airlines now uses a 3-degree descent angle instead of 3.5 degrees - slowing the pressure rise by 14%.

All major U.S. airlines now train flight crews to recognize ear pain and offer advice. Some even hand out gum or earplugs on long flights.

A medical illustration of a balloon dilating the Eustachian tube, with pressure data floating nearby.

What Not to Do

Don’t sleep during descent - Especially with kids. 73% of pediatric ear pain cases happen because the child was asleep.
Don’t blow too hard - 41% of inner ear injuries from barotrauma come from forceful Valsalva.
Don’t use decongestants if you’re pregnant, have high blood pressure, or are under 6.
Don’t rely on one trick - Combine methods. Use EarPlanes + jaw wiggles + swallowing. One Reddit user reported 91% success after combining three techniques.

Long-Term Solutions for Chronic Problems

If you get airplane ear every single flight - even when you’re healthy - you might have chronic Eustachian tube dysfunction. It’s not rare. About 1 in 50 adults have it.

New treatments are emerging:

Balloon dilation - A tiny balloon is inserted into the Eustachian tube and inflated to widen it. Success rate: 76% long-term. Cost: $3,800-$5,200 out-of-pocket in the U.S.
Eustachian tube stents - Tiny implants that keep the tube open. Phase 2 trials at Mayo Clinic show 92% success. Still experimental, but coming soon.
Nasal steroid sprays - Fluticasone (Flonase) used daily for a week before flying reduces inflammation in the tube by 61%, improving equalization by 33% according to University of Pennsylvania research.

If you’re constantly struggling, see an ENT specialist. There’s help - and it’s getting better.

Pre-Flight Checklist

Start swallowing or chewing gum 30 minutes before descent.
Use filtered earplugs (like EarPlanes) if you fly often.
If congested, use nasal spray 1 hour before flight - but not if you’re pregnant or under 6.
For kids: Feed or give a pacifier during descent. Keep them awake.
Avoid alcohol and caffeine before flying - they dehydrate you and make swelling worse.
Practice jaw wiggles and swallowing exercises daily for a week before flying - reduces incidents by 57%.

Flying doesn’t have to hurt. With the right prep and simple techniques, you can land with your ears clear - no pain, no pressure, no panic.

Can I fly if I have an ear infection?

It’s not recommended. An active ear infection means your Eustachian tube is swollen and blocked. Flying could cause severe pain, permanent damage, or even a ruptured eardrum. If you have fever, drainage, or pain, delay your flight. See a doctor first. Most ENTs will advise waiting until the infection clears - usually 7-10 days.

Do earplugs really help with airplane ear?

Yes - but only if they’re designed for pressure equalization, like EarPlanes. Regular foam earplugs block sound but don’t help with pressure changes. Filtered earplugs slow down the rate of pressure change, giving your ears more time to adjust. They work for about 76% of users, but aren’t a fix for chronic blockages.

Why does my child cry during landing?

Because their Eustachian tubes are smaller and less able to open on their own. During descent, pressure builds up behind the eardrum, causing pain. Babies and toddlers can’t communicate it - so they cry. Feeding them a bottle or pacifier during descent helps them swallow and equalize pressure. Keep them awake - sleeping during descent is the biggest risk factor.

Is the Valsalva maneuver dangerous?

It can be. When done correctly - gentle, sustained pressure for 3-5 seconds - it’s effective. But forcing it, blowing too hard, or doing it repeatedly can damage the inner ear. About 0.3% of attempts cause injury, and it’s responsible for 27% of inner ear barotrauma cases treated by specialists. Use it only if swallowing and Toynbee don’t work.

Can I use decongestants before flying with kids?

No. The FDA and pediatric ENT groups strongly advise against using oral or nasal decongestants in children under 6. There’s a small but real risk of rapid heart rate and seizures. Instead, use bottle-feeding, pacifiers, or distraction during descent. For older kids, try the Toynbee maneuver or jaw wiggles.