When the pressure changes inside the middle ear—or the eustachian tube becomes blocked—your ear can feel congested, plugged, clogged, or "stuffy." Sounds can be muffled; you may hear a crackling or popping noise.
Ear congestion can happen for several reasons, including allergies, a cold virus, or altitude changes—such as those experienced in air travel. An earwax buildup can also make the ear feel congested.
Ear congestion is usually mild and goes away within a few days, but in some cases, symptoms can persist and need further treatment.
This article will discuss common causes of ear congestion, ways to relieve it, and next steps to take if it persists.
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How to Unclog Your Ears
Sinus-Related Ear Congestion
Sinus congestion can affect your ears as well as your nose. Congestion happens when the tissues and blood vessels become swollen with increased fluid.
Medical and environmental conditions can lead to sinus congestion:
- Allergies
- Colds
- Flu
- Deviated septum
- Dry air
- Hormonal changes
- Medications
- Nasal polyps
- Pregnancy
Treatment
Drinking plenty of water and blowing your nose gently are two simple remedies to try first. If this doesn't work, the following tips may also help:
- Flushing your nasal cavity with a saline solution can help remove excess mucus and debris from your nose and sinuses.
- Using a saline mist or nasal spray can provide moisture to your sinuses. Dry sinuses can be due to irritants such as pollen, dust, and bacteria.
- Using a humidifier or standing in a warm shower can help with sinus irritation or inflammation, a common cause of ear congestion. It may help to sleep with a humidifier in your room.
If non-medicinal measures aren't helping your congested ears, and you are 12 years old or over, a decongestant medication may work. Talk to a healthcare provider before using a long-acting decongestant nasal spray or oral decongestants.
Your healthcare provider may also suggest a nasal steroid spray, such as Nasonex (mometasone furoate monohydrate) or Flonase (fluticasone propionate).
In some cases, medications such as decongestants or antihistamines may make symptoms worse. Visit your healthcare provider if your ears are still congested after using these medications.
Water Buildup
Water can get trapped in your ear during bathing, showering, or swimming. This can create pressure on your ear and make your ears feel plugged up.
Treatment
If water is trapped in your ear after showering or swimming, try turning the side of your head down while gently pulling your earlobe in different directions.
Applying a warm washcloth or a heating pad set to low on the affected ear may provide relief. Make sure there is a cloth between your skin and the heat source to protect your skin.
Wax Buildup
Earwax (cerumen) is needed to protect your ears, but too much of it can cause congestion. Earwax can build up to the point where it blocks your ears.
Treatment
If you have a lot of earwax or it is impacted, you can try various remedies to clear your ears:
- Soften the wax with over-the-counter wax removal kits.
- Use hydrogen peroxide.
- Use mineral oil.
- Try ear irrigation.
A Warning About Earwax Removal
Be careful clearing your earwax by yourself. Don't insert anything into your ear, including cotton swabs (Q-tips), hair pins, pencil erasers, etc. This can push the wax down further and make the problem worse.
Objects can also break off into the ear canal. If your ears feel clogged by earwax, and you can't remove it without inserting anything into your ear, let a healthcare provider take a look. Special tools may be needed to safely remove the wax buildup.
Avoid using ear candles. These products claim to pull wax and debris out of the ear, but there is no evidence that they work, and they can cause serious injuries. The Food and Drug Administration (FDA) advises against their use.
Allergies
Allergies are your body's natural reaction to allergens—substances that cause your body to have an allergic reaction. If you have an allergy and are exposed to that specific allergen, your immune system responds and you may have a number of symptoms.
In addition to ear congestion, allergy symptoms include watery eyes, runny nose, sneezing, rash or hives, or a more serious, life-threatening reaction known as anaphylaxis.
Treatment
If your ear congestion is caused by allergies such as hay fever, antihistamine medications may help. Look for a long-acting product. Talk to your healthcare provider before starting antihistamines to ensure they are right for you.
Preventing exposure to irritants helps you keep your symptoms at bay. Adopting these habits can help reduce exposure:
- Keep windows closed when pollen levels are high, and use your air conditioning in your home and car.
- When outdoors, wear glasses or sunglasses to protect your eyes from pollen.
- Use "mite-proof" bedding covers to limit exposure to dust mites.
- Use a dehumidifier to help control mold.
- Wash your hands after petting any animal.
Altitude Changes
Usually the pressure inside your ear is the same as outside your ear. However, changes in altitude like when you're flying, driving in the mountains, or scuba diving, can cause the pressure inside your ear to be different from the pressure outside your ear (barotrauma).
Blockage of the eustachian tube can prevent the air from equalizing. The eustachian tube connects the middle ear to the back of the nose and throat. When the eustachian tubes open, you may feel or hear a "pop."
Treatment
You may be able to clear your eustachian tubes with some facial motions. These techniques can also be helpful when flying, especially during the 15 to 30 minutes of descent:
- Moving your mouth in up-and-down motions
- Yawning
- Swallowing while pinching your nose closed
- Chewing gum (after age 6 years)
- Sucking on candy
- Giving a pacifier or fluids to drink to babies or young children
If you're flying and experience severe ear pain, ask your flight attendant for a hot towel to place tightly on the opening of the ear.
If you fly often and commonly experience this problem, talk to your healthcare provider about using decongestant medication an hour before traveling.
Why Do My Ears Hurt?
Ear Infections
An ear infection can occur in the middle ear or external ear.
A middle ear infection (otitis media) is when the middle ear becomes infected or inflamed. Ear infections are fairly common. Often the cause of ear infection is a cold, sore throat, respiratory infection, or allergy. Children are most likely to develop an ear infection, but adults can get one too.
Swimmer's ear is the common name for an external ear infection (otitis externa). Swimmers are often affected because when water gets trapped in the ear, fungi or bacteria can grow and cause infection.
Treatment
You may not need treatment for an ear infection. Some go away on their own. If symptoms aren't getting better, contact a healthcare provider.
Medical treatment for middle ear infection may include:
- Antibiotic medication by mouth or ear drops
- Medication for pain and fever
Treatment for an external ear infection may involve:
- Antibiotic ear drops
- Corticosteroid ear drops (for swelling)
- Pain medication
- Keeping the ear dry
Ménière's Disease
Ménière's disease is a disorder of the inner ear. Symptoms of Ménière's disease include severe dizziness (vertigo), ringing in the ears (tinnitus), hearing loss, and a feeling of fullness or congestion in the ear. Ménière's disease most often affects only one ear and occurs in adults aged 40 to 60 years.
The symptoms are caused by a buildup of fluid in the inner ear compartments collectively known as the labyrinth. The labyrinth is responsible not only for hearing, but also your sense of balance.
Treatment
An ear, nose, and throat (ENT) specialist can help make a diagnosis. Sometimes Ménière's disease gets better on its own. Other times medication, lifestyle change, or other treatments may be needed.
Prescription medications include:
- Meclizine
- Diazepam
- Glycopyrrolate
- Lorazepam
Alternative treatments may include:
- Limiting dietary salt and taking diuretics (water pills)
- Avoiding caffeine, chocolate, and alcohol
- Not smoking
- Learning cognitive therapy techniques
- Pressure pulse treatment (air pressure pulses)
- Surgery
Additional Causes
Ears can become congested for other reasons as well:
- Acoustic neuroma is a noncancerous tumor of the ear. Its most common symptom is hearing loss in one ear.
- Cholesteatoma is an abnormal skin growth or skin cyst in the middle ear. It can eventually lead to infection, drainage, and hearing loss.
- Serous otitis media (otitis media with effusion) is a collection of fluid behind the eardrum. It is commonly called "glue ear" because the fluid is often thick or sticky.
- Temporomandibular joint (TMJ) disorders involve the joint located in front of your ears connecting your lower jaw to your skull. They can cause fullness in your ear, along with other symptoms.
- Rebound congestion (rhinitis medicamentosa) is nasal congestion that gets worse due to the overuse of nasal decongestants. It's a common condition you can prevent by following the instructions on the product label.
Rarely, a blocked eustachian tube can indicate a more serious problem, such as:
- Nasal polyps
- Cleft palate
- Skull base tumor
- Neoplasms (abnormal growth of tissue)
- Impaired muscle coordination or muscular deficiency
Severe Ear Congestion and Complications
Complications can also occur from long-term eustachian tube dysfunction, including:
- Glue ear (a buildup of fluid in the middle ear that can last months and cause temporary hearing loss)
- Retraction of the eardrum (when the eardrum is pulled inward toward the middle of the ear)
- Chronic middle ear infection
- Hearing loss
- Ruptured eardrum
If less invasive strategies have been ineffective, your healthcare provider may suggest medical procedures, such as:
- Tympanostomy tubes: Tiny hollow tubes are inserted into the eardrum to allow fluid to drain and equalize pressure.
- Myringotomy: A small incision is made in the eardrum, through which fluid in the middle ear is suctioned out.
- Balloon dilation of the eustachian tube: A balloon catheter is inserted through the nose into the Eustachian tube, then filled with saline. After about two minutes of sustained pressure, the balloon is emptied and removed.
- Adenoidectomy: This is surgical removal of the adenoid located in the back of the nose.
- Potassium titanyl phosphate (KTP) laser: A laser is used to reduce inflamed tissue.
Recovery Time May Vary
While ear congestion typically clears up within a few days, recovery time may take longer depending on the circ*mstances and the cause of the clogged ear.
For example, glue ear can take up to three months to clear.
When to See a Healthcare Provider
Symptoms from ear congestion typically clear up within a few days, sometimes within minutes. Many times, however, ear congestion can last days or weeks.
Contact a healthcare provider if you or your child experiences:
- Ear congestion that lasts longer than 48 hours
- A foreign object in the ear
- Earache or pain
- New symptoms, such as itching
- Fever of 102.2 degrees F (39 degrees C) or higher
- Worsening symptoms
- Symptoms of a middle ear infection that last for more than two to three days
- Hearing loss
Seek urgent medical attention if you or your child:
- Develops sudden, complete hearing loss
- Has severe pain
- Feels dizzy
- Has redness, swelling, or pain around or behind the ear
- Has pus or blood draining from your ear (that is new or increasing)
If an ear infection is present, an antibiotic may be given to clear up the infection, but the fluid in the ear may take six to twelve weeks to go away.
Summary
Ear congestion is usually a result of blocked eustachian tubes. Common causes of blocked eustachian tubes include illnesses (such as colds) that cause nasal or sinus congestion, environmental allergies, pressure changes (such as in an airplane), ear infections, and anatomical abnormalities. A buildup of earwax can also cause the ear to feel full.
Ear congestion can often be treated at home with strategies such as swallowing, yawning, chewing gum, nasal flushing, applying heat, washing the ears, and using a humidifier. In some cases, medications such as decongestants or antihistamines may be helpful. If noninvasive measures don't relieve ear congestion, surgery may be needed.
Ear congestion usually clears up within a few days. See your healthcare provider if your ears are still congested after a few days, or you have new or worsening symptoms (such as pain, fever, or discharge).
