Have you ever had that uncomfortable feeling when your ears can’t pop?
You swallow and yawn repeatedly, but your hearing still feels muffled. It’s a common problem, and most people have it at one time or another. But if your ears feel clogged more often than not, then there may be an underlying reason. Eustachian tube dysfunction (ETD) is a common reason why people may have pressure build-up in their ears. ETD can affect up to 90% of children before they start school, and it affects 1% of adults. It’s often related to allergies or upper respiratory infections. Besides ETD, there are other causes of clogged ears that can cause discomfort and ear fullness. So why are your ears clogged, and what can you do about it?
There are several reasons your ears may feel clogged. Many are related to problems with the eustachian tube. The eustachian tube is the connection between the middle ear and the back of the nose and throat. The middle ear is the part of the ear between the brain and the eardrum. This tube is open when you yawn, sneeze, and swallow. And it’s what stops pressure from building up inside the middle ear. But when the tube is swollen or narrowed, it can’t do its job as well.
Anything that causes the eustachian tube to narrow can cause clogged ears. Examples include allergies, head colds, and pregnancy. Some people are more likely to get problems with their eustachian tubes than others. For example, children have shorter eustachian tubes than adults. And a shorter tube is more likely to get blocked or infected. People who smoke are more likely to get a build-up of mucus in the eustachian tubes. Your ears might feel full for reasons that have nothing to do with your eustachian tubes. Earwax build-up is just one example of another common cause of plugged ears. In most cases, clogged ears get better within a few days. Sometimes they may last longer — especially if the cause is allergies or infection. If your symptoms aren’t settling, a healthcare provider can check for the common causes of plugged ears and recommend treatment (more on this below).
Anything that irritates, inflames, or narrows the eustachian tube can cause problems with the eustachian tube. Most commonly, inflammation causes swelling of the eustachian tube lining, which narrows it. Growths can also narrow the eustachian tube, or it may have an abnormal shape. But these are less common. Colds, allergies, and infections can all make the tubes swell. Hormones can also cause swelling, like during pregnancy or with some hormonal medications. Situations like diving and air travel can make underlying ETD worse. And then there are causes that have nothing to do with the eustachian tube at all. Earwax, swimmer’s ear, or true hearing loss can all make ears feel plugged.
Here Are 10 Of The Most Common Reasons For Clogged Ears.
- Sinus infections and other upper respiratory tract infections
Anything that causes swelling of the lining of the upper airways can also cause swelling and narrowing of the eustachian tubes. Various types of upper respiratory infections, including common respiratory viruses and COVID-19 (more below), can cause nasal and sinus inflammation.
Like many other respiratory viruses, the COVID-19 virus can cause nasal and sinus congestion and inflammation, leading to ETD. So people with COVID-19 may also experience ear pressure, fullness, muffled sounds, and ear pain.
- Allergic rhinitis (seasonal and environmental allergies)
Seasonal allergies (and allergies to other irritants) are another common cause of nasal and sinus congestion. People with nasal allergies have long-lasting swelling of the upper airways and are more likely to have ETD.
- Pregnancy and other hormonal states
High levels of estrogen hormone can cause swelling of the eustachian tube. This is common in pregnancy, with some contraceptive pills, and as a side effect of some hormone-blocking prostate cancer treatments.
- Fluid in the ear
Anything that leads to fluid build-up in the middle ear can make your ears feel plugged. The most common cause of this is middle ear infection, like acute otitis media. But fluid in the ear can also build up after the infection has passed. ETD usually causes otitis media. That’s one of the reasons it’s more common in young children.
- High altitude
Altitude changes, like with air travel or scuba diving, can cause plugged ears. This is especially true in people with underlying eustachian tube problems. It happens because pressure changes too quickly for the ear to be able to equalize.
- Swimmer’s ear
Swimmer’s ear (otitis externa) is an infection that causes inflammation and swelling of the ear canal. This can often cause a sensation of pain and fullness in the ear. Like its name suggests, swimmer’s ear most often occurs in the setting of swimming, playing water sports, or spending time in water-based play areas.
Some earwax is normal and healthy. But when it becomes impacted, it can cause muffled hearing and ear fullness. Wax impaction affects up to 5% of healthy adults and more than half of older adults in nursing homes. Checking for earwax is always a good idea if you have ear symptoms. Your provider can easily do this in the office, and treatment is also easy. Although it’s tempting, using Q-Tips to clean out your ears can cause damage to the eardrum or ear canal. They can also push earwax farther into the ear.
- Temporomandibular joint disorders (TMD)
Temporomandibular joint disorders (TMD) involve the muscles and joints of the jaw. Often the cause is teeth-grinding. Although pain or clicking of the jaw are the most common symptoms, people with TMD can also feel ear fullness and pain.
- Hearing loss
Ear fullness or a sensation of “stuffiness” can be a symptom of true hearing loss (also called “sensorineural hearing loss”). The cause of this type of hearing loss is damage to the inner parts of the ear or the auditory nerve. It usually comes on gradually with age, but it can also happen in younger people. Causes of sudden hearing loss include: Some viral infections, Exposure to sudden, loud noises, Head injuries, Autoimmune inner ear disease, Meniere’s disease
If you have sudden or new hearing loss, you should talk to your healthcare provider.
What to do if your ears won’t pop and you feel constant pressure
Typically, clogged ears will ease up within a few days. If you have a head cold, COVID-19, or allergies, symptoms may last a little longer. But if clogged ears continue beyond a few weeks, it may be time to see a healthcare professional about your treatment options. For newly clogged ears, try chewing gum, yawning, and swallowing. If you have nasal or sinus congestion, an over-the-counter decongestant or steroid nasal spray may help (more on that below).
You should see a healthcare professional sooner if you have any of the following symptoms:
- Ear pain
- Ear discharge
- Hearing loss
- Problems with balance or vertigo
Treatment for clogged ears
There are several different ways to treat clogged ears. Treatment depends on the cause. Often symptoms settle on their own over time. If you’re prone to blocked ears when you fly, it may help to take some of these treatments before you travel to avoid or minimize symptoms.
If you’ve tried home remedies and things aren’t getting better, you have some options. The first step is to see your healthcare provider. Depending on the cause of your clogged ears, you and your healthcare provider might consider the following treatments:
- Decongestants, like pseudoephedrine (Sudafed), cause blood vessels in the nose and the eustachian tubes to narrow. This helps to reduce swelling and congestion. Decongestants work quickly and last for up to 6 hours.
- Nasal steroid sprays, like fluticasone (Flonase) or Nasonex (mometasone), can help if your clogged ears are due to allergies and nasal congestion. They work by reducing inflammation of the lining of the nose. You often need to use nasal sprays for about 2 weeks before they really begin to work.
- Antihistamines, like Claritin (loratadine), Zyrtec (cetirizine), or Allegra (fexofenadine), can help if you have congestion that allergies cause.
- Oral steroid pills, like prednisone or methylprednisolone, can be a step-up treatment for persistent swelling when other options have failed.
- Antibiotics may be necessary if you have a sinus infection or an ear infection.
- Allergy shots might help with seasonal allergies or other irritants. But allergy shots can take a long time to show improvements.
- Ear drops to remove earwax can be helpful if earwax is the cause of your symptoms. Carbamide peroxide (Debrox) or hydrogen peroxide drops break up and soften the impacted earwax. In some cases, your provider may need to flush out or remove excess earwax.
In some severe cases, there are surgical procedures that can help with ETD:
- Balloon catheter dilation: inflation of a balloon to open up the eustachian tube
- Myringotomy: a surgical incision in the eardrum
- Tympanostomy: a surgical placement of ear tubes