Eustachian tube dysfunction: pressure, popping and muffled ears
If your ears feel full, pop or crackle, especially after a cold or a flight, the small tube that balances the pressure behind your eardrum may not be opening properly. It usually settles on its own. Here is what helps, and when to get it checked.
A small tube with a big job.
Each ear has a Eustachian tube, a narrow channel that runs from the space behind your eardrum to the back of your nose. It opens briefly every time you swallow or yawn, letting air in so the pressure behind the eardrum matches the air around you, and letting mucus drain away.
When the tube is swollen or does not open properly, the pressure behind the eardrum drops and the eardrum is pulled slightly inwards. That causes the full, blocked feeling, the muffled hearing and the popping. If the tube stays blocked for long enough, fluid can collect behind the eardrum.
Most cases follow a cold, a sinus infection or hay fever, and clear as the swelling goes down.
Occasionally the tube stays open too much, so your own voice and breathing sound loud in your ear. It is worth mentioning if that sounds like you.
Signs of a blocked tube.
If the blocked feeling has not cleared, it is worth having your ears examined and your hearing tested. We can check for wax, look at the eardrum and measure any effect on your hearing.
What causes Eustachian tube problems.
Anything that causes swelling at the back of the nose can stop the tubes opening.
The most common cause. The lining of the nose and tubes swells and makes extra mucus.
Inflamed sinuses next to the tubes can keep them blocked for longer.
Allergic swelling can cause tube problems that come and go with the seasons.
Fast pressure changes, especially when descending, can overwhelm a tube that is already slightly swollen.
Smoke irritates the lining of the nose and the tubes, and slows the way they clear mucus.
Rarely, a growth at the back of the nose affects the tube. A one-sided blocked ear that does not settle in an adult should always be checked by a GP.
What helps.
Most Eustachian tube problems clear without treatment. These can help the tubes open in the meantime.
- Swallow, yawn or chew sugar-free gum, which all open the tubes briefly.
- Try gentle autoinflation: close your mouth, pinch your nose and breathe out gently until you feel your ears pop. Stop if it hurts. Pharmacies also sell nasal balloon devices that do the same job more gently.
- Use steam inhalation or a saline nasal rinse to help clear congestion.
- Ask a pharmacist about a decongestant spray for a few days, or an antihistamine if allergies are the cause.
- When flying, stay awake for the descent and keep swallowing.
If symptoms last more than a few weeks, keep returning, or affect one ear only, see your GP. A steroid nasal spray or a referral to ENT may be suggested.
Checking what is behind the blocked feeling.
We check for wax, which causes very similar symptoms, and look at the eardrum.
A full test shows whether your hearing is affected and by how much, with results explained the same day.
If wax is part of the problem, microsuction clears it with a free hearing check afterwards.
If there are signs of a problem that is not clearing, we write to your GP with our findings.
See a GP or pharmacist if
- Your ear is very painful, or you have a high temperature
- There is discharge from the ear
- Symptoms have lasted more than a few weeks, or affect only one ear
- Your hearing dropped suddenly
Sudden hearing loss is different from a blocked tube and needs medical care the same day. If you are unsure, contact NHS 111.
Frequently asked questions.
Most cases settle within a few days to a few weeks, usually as a cold or sinus infection clears. If it lasts longer than that, see your GP.
It can cause a temporary, mild hearing loss by stopping the eardrum moving freely, or by letting fluid collect behind it. Hearing usually returns to normal once the tube is working properly again.
Flying with blocked tubes can be painful and can occasionally damage the eardrum. A pharmacist can advise on a decongestant beforehand, and swallowing or chewing during the descent helps. If your symptoms are severe, ask your GP before you travel.
It is worth ruling out. Wax causes very similar fullness and muffled hearing. A quick look in your ears tells us which, and microsuction clears wax in the same visit.
It can. Pressure changes and fluid behind the eardrum can bring on ringing or a low hum, which usually settles as the tube recovers.
Not clearing? Let us take a look.
Ear examinations and hearing tests in our Birmingham clinic or at home.
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Written and clinically reviewed by our HCPC registered audiologists. Last reviewed: 15 October 2026. This page is general information, not a diagnosis. If you are worried about your hearing or your ears, book an appointment or speak to your GP.