Common ear problems while scuba diving

How to deal with ear pain while diving?

diver wtih ear trouble Most divers really only start to appreciate how much of a hassle their ears can be once they start to have ear problems. From being a minor inconvenience to a major hassle, ear problems have ruined many a holiday. Understanding your ears and what are the most common problems you can have with them is key to avoiding them. By developing a few good habits, you are almost guaranteed to consign ear issue to history.

3 types of ear problems

inner ear diver Almost every common ear problem with diving will fall into one of three broad categories. Problems will either be related to the outer ear, which is not just the area on the side of your head, but also your ear canal and includes everything up to your eardrum (Tympanic Membrane). The second category of problems are related to the inner ear, and they include everything on the other side of your eardrum, including your middle ear, round window and oval window. The last category of ear-related problems concern your Eustachian tubes and your sinuses. The Eustachian tube supplies air to your inner ear and allows you to equalize. When they develop problems, equalization becomes difficult if not impossible.

Outer ear problems

The outer ear is particularly prone to two major types of issues: infections and wax build, both will result in pain when diving and difficulty equalizing. Wax build-up creates a plug in your ear, making it impossible to equalize properly. The only solution is to irrigate your ears with warm water! While there are some home kits you can buy to do this, it is not recommended, you should seek medical assistance with the procedure.

There are various types of infections that can affect the outer ear, most can be solved with a simple course of ear drops, that will treat the infection and reduce the inflammation. To be able to determine which drops to use, you will need to seek advice from a doctor. If you find that you are prone to outer ear infections, you will need to regularly rinse your ears out with clean, fresh water after every dive.

Inner ear problems

Inner ear problems fall into two distinct categories: infections and barotraumas. Infections can be caused by several things, and the only way you will be able to deal with them is by seeing a doctor and taking some medicine. A healthy strategy to avoid infections is to make sure that when you dive your ears are in great shape and you are not “pushing” them in any way.

Barotraumas are an injury to the inner ear caused by pressure. The main reason they happen is because you were not careful enough when descending and either equalized too hard, or failed to equalize sufficiently. The only way to avoid them is to make sure your sinuses and ears are in a good shape and unblocked, and to equalize regularly and gently when descending. Remember to be gentle with your ears to avoid barotraumas.

Eustachian tubes and sinuses

ear pain while diving The Eustachian tubes are key to proper equalization. Most problems with them are due to congestion and inflammation. To avoid problems caused by inflamed or congested Eustachian tubes, make sure to only dive when you are completely healthy. The most common issue divers have is trying to dive slightly congested, or just after a cold, where the mucus build-up will interfere with proper equalization and could even cause more problems as you try to force your body to do something difficult. It is not recommended that you use decongestants or sprays to clear your tubes to go diving.

The Eustachian tube is the main guilty party when it comes to reverse blocks affecting the ears or sinuses. A reverse block is similar to a squeeze but occurs on ascent. As you go up and the pressure is reduced, normally the air in your ears and sinuses would just escape automatically and equalize with the water pressure. However occasionally mucus will block the Eustachian tube or sinuses, making it impossible for the air to escape. This leads to a pressure imbalance causing pain. The only solution to dealing with a reverse block is to re-descend until the pain stops. Then recommence your ascent as slowly as possible to give the trapped air a chance to work its way out.


If you love diving then keeping your ears in good shape should be one of your top priorities, since if they are damaged you will not be able to dive. It is much better to suffer one or two days on the shore letting your ears recover from any ailment, than to force yourself to dive and potentially risk losing he ability to dive ever again!

Which is the best equalization technique?

Basically, there isn’t one. The most commonly used techniques are the Valsalva and the Frenzel, which are ancient techniques. There are multiple other techniques that have been developed over the years. Most of the more modern techniques were developed by dive bomber pilots during the second world war. The best technique for equalization is the one that works for you, small differences in our anatomy can make one technique more difficult or even impossible, search around and practice the various techniques until you find the perfect one for you.

I keep getting outer ear infections, how do I protect myself?

Persistent ear infection can be a real hassle, if you search online you will find many a recipe to treat your ears after a dive. These can be somewhat strange, and can involve everything from pouring olive oil in your ear, to other weird and wonderful mixtures. By far the safest and one of the best and least controversial method, is to just use some clean fresh water to rinse your ears out with after every dive. Using water is the simplest, most hygienic and readily available way to rinse out your ears after diving!

What about decongestants, I hear many divers take them?

While a lot of divers will swear that they use one or the other types of decongestants, it is generally absolutely not recommended without proper medical clearance. Decongestants and nasal sprays, can cause you significant problems in the water. This is because as the spray takes effect at the beginning of the dive you can equalize easily, however near the end of the dive after an hour or so, when the effects of the spray have worn off problems can develop. Blockage can in return lead to reverse blocks in your sinuses or ears or possibly even both.

Can I still dive if I perforated my eardrum?

No you cannot dive, do not even consider diving until you have had a full check-up from your doctor, or even better a physician who specializes in diving medicine. Going diving with a perforated eardrum can lead to some very nasty consequences, including infection which can lead to the perforation becoming permanent and could ultimately damage your hearing.