Ear Barotrauma: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats ear barotrauma?
Ear barotrauma, ear pain and pressure damage caused by sudden air or water pressure changes, is usually treated by an ENT (ear, nose and throat doctor). Mild cases often improve with simple care. Contact your provider if you have severe ear pain, fever, or drainage or bleeding from the ear. An ENT specialist can help if the ears will not open.
What is ear barotrauma?
Ear barotrauma causes discomfort in the ear. It happens when the air pressure inside the ear and outside the eardrum is different. The problem may include damage to the ear.
The eustachian tube is the tube that connects the middle ear to the back of the nose and upper throat. Swallowing or yawning opens it. Air can then flow into or out of the middle ear. This helps keep the pressure equal on both sides of the eardrum.
Symptoms
Common symptoms include:
- Dizziness.
- Ear discomfort or pain in one or both ears.
- Slight hearing loss.
- A feeling of fullness or stuffiness in the ears.
A severe problem, or one that lasts a long time, can cause other symptoms. These include a feeling of pressure in the ears, as if you were underwater. They also include moderate to severe hearing loss and a nosebleed.
Hearing loss from barotrauma is almost always temporary. Complications can include an ear infection, blood in the eardrum, fluid in the middle ear, a ruptured eardrum, and vertigo, a spinning feeling.
Causes and who gets it
Barotrauma happens when the eustachian tube is blocked. Then the air pressure in the middle ear is different from the pressure outside the eardrum.
It often happens with altitude changes. Flying, scuba diving, and driving in the mountains are common examples.
A stuffy nose from allergies, colds, or an upper respiratory infection makes barotrauma more likely. A blockage can also be present before birth, or come from swelling in the throat.
Babies and children are especially prone to ear blockage because their eustachian tubes are narrower than in adults.
How doctors diagnose it
A health care provider looks in the ear. The eardrum may show a slight outward bulge or an inward pull. In severe cases, there may be blood or bruising behind the eardrum.
Severe barotrauma can make the eardrum look like it does with an ear infection.
Treatment
Simple steps can open the eustachian tube and ease the pressure:
- Chew gum or suck on candy.
- Yawn or swallow.
- Breathe in, then gently breathe out while you hold your nostrils closed and keep your mouth shut.
Blow gently, not forcefully. A pop means it worked. When flying, do not sleep as the plane prepares to land.
Some people need medicine to relieve a stuffy nose. Options include decongestants and steroids, taken by mouth or as a nose spray. Ask your doctor first if you are pregnant or have heart disease, high blood pressure, irregular heart rhythms, or thyroid disease. Using decongestant nose sprays for a long time can cause more congestion.
Antibiotics may be needed to prevent or treat an ear infection if barotrauma is severe.
Surgery is rarely needed. A doctor can make a small cut in the eardrum so pressure can equalize and fluid can drain. People who must change altitude often may need ear tubes. This is not an option for scuba diving.
Scuba divers should go down and come up slowly. Diving while congested is dangerous.
When to see a doctor
Try home care first. Contact your provider if the discomfort does not ease after a few hours.
Contact your provider if new symptoms develop, especially drainage or bleeding from the ear, fever, or severe ear pain.
If your ears will not open, or the ear pain does not go away, an ENT specialist (an ear, nose, and throat doctor) can help. They may place small ear tubes or make a small cut in the eardrum to release pressure or fluid.
Call 911 or go to the emergency room for trouble breathing, chest pain, fainting, a sudden change in mental state, or sudden hearing loss. Do not wait for sudden hearing loss to pass, because waiting can make treatment work less well.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. For ear barotrauma, such a doctor can look in the ear, explain simple relief steps, and follow how you are healing. They can refer you to an ENT if the problem does not ease.
Common questions
What causes ear barotrauma?
Ear barotrauma is caused by fast changes in air or water pressure, such as during airplane takeoff and landing, scuba diving, or driving through mountains. It happens when the ear cannot equalize pressure quickly enough, causing pain and pressure.
How quickly can I be seen for ear barotrauma?
How fast you can be seen depends on the office you choose, so call to ask about openings. Try home care first. Contact your provider if the discomfort does not ease after a few hours, or if you have drainage or bleeding from the ear, fever, or severe ear pain.
Can a direct primary care doctor manage ear barotrauma?
Yes, for mild cases a direct primary care doctor can check the ear, explain simple relief steps, and watch for improvement. Cases with severe ear pain, drainage or bleeding from the ear, or fever need care from a provider, and an ENT can help if the ears will not open.
Sources
- MedlinePlus - Ear barotrauma
- NIDCD - Sudden Sensorineural Hearing Loss (SSHL)
- American Academy of Otolaryngology-Head and Neck Surgery (ENT Health) - Ears and Altitude (Barotrauma)
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
