Ear, Hearing and Balance Center

Ear Popping, Pain or Pressure? When to Be Concerned

October 11, 2023

When your ears pop on an airplane, it may be annoying but it’s actually a good sign.

“Ear popping is normal. The concern is when you can’t pop your ears,” says Daniel Killeen, MD, a University Hospitals ear specialist. “Ear popping occurs when the Eustachian tube opens and balances the pressure in your ear with the atmospheric pressure. Problems occur when the Eustachian tube does not open.”

What Causes Ear Symptoms

If you feel pain, ear fullness or muffled hearing, it could be a sign of a Eustachian tube blockage.

“It’s one of the more common complaints I get. Painful popping, ear fullness or muffled hearing is often caused by Eustachian tube dysfunction,” says Dr. Killeen. Symptoms of Eustachian tube dysfunction also may include ringing in the ears and dizziness or balance problems.

The Eustachian tube connects your ear to the back of the nose. It opens periodically, like when you swallow or yawn. That equalizes the pressure and prevents the build-up of fluid behind the ear drum.

Most often, the common cold, flu, allergies or sinus inflammation are causes of blockage of the Eustachian tube. “That can cause a number of issues for patients,” Dr Killeen says. “They might struggle with flying or diving in water. If fluid accumulates behind the ear drum, it can affect your hearing and lead to infections. This is very common in kids.”

When To See a Doctor

Eustachian tube dysfunction often resolves on its own, particularly if triggered by a cold or other virus.

You should see a doctor if these symptoms don’t go away:

Ear popping that causes pain or discomfort.
Feeling fullness or pressure in the ear.
Any sudden changes in hearing

“People can lose hearing in the inner ear suddenly, which may potentially be improved with timely steroid treatment,” Dr. Killeen says. “It could also be ear wax or fluid behind the ear drum, which is not time sensitive. If symptoms aren’t resolving, you should have your hearing evaluated.”

Sometimes people feel fluid in the ear and there is no fluid. Instead, it’s a sensation and an early symptom of hearing loss, says Dr. Killeen.

First-Line Treatment Options

If sinus inflammation is the problem, Dr. Killeen will recommend adults take allergy medications (nasal steroids) to reduce the swelling.
For patients who experience ear problems while flying or scuba diving, taking nasal decongestants beforehand often helps.
Topical nasal steroid therapy is recommended for persistent fluid behind the ear drum in adults.

Surgical Treatments

There are also simple surgical options for cases that don’t resolve with medication. Ear tubes are commonly recommended for children, who are prone to ear infections. Adults can also get tubes.

“Ear tubes are a simple solution that we sometime do for people with Eustachian tube problems. We basically make a little hole in the ear drum and put a tube in,” Dr. Killeen says. “Tubes last six months to 2 years. Most of the time, they fall out and the ear drum will close the opening.”

Another option for fluid behind the ear drum is balloon dilation. With the patient under sedation, a doctor inserts a balloon through the nose to open up the Eustachian tube.