Why do we experience pain in our ears during changes in altitude?
- Pain in the ear at high altitude is a pressure pain. Normally, the pressure inside the ear, and in the ambient environment is equal.
- The ear is closed to the external environment at the eardrum, but connected with the pharynx (and the oral cavity) via the eustachian tube. It is through this tube only that the pressure can be equalised. This happens routinely while swallowing and yawning as the tube opens up in these actions and the air in the ear and in the mouth gets connected at the same pressure (Which is also the pressure outside).
- At high altitudes, the pressure outside is less than the inside of the ear, due to these pressure differences, the tube fails to open, the pressure difference results in painful ear.
- When flight takes off and the plane begins its ascent, the air pressure inside the inner ear quickly surpasses that of the pressure outside. The tympanic membrane or eardrum swells outward. Picture a loaf of bread rising while baking, and you get the idea.Conversely, if air pressure inside the inner ear rapidly becomes less than the air pressure outside, the tympanic membrane will be sucked inward, almost like a vacuum effect. What has happened is that the Eustachian tube has flattened and needs a bit of help from you to continue to do its job of bringing air into the inner ear. Whether ascending or descending, the stretching of the eardrum can cause pain.