Ear pain is a common complaint among scuba divers and some call it the ear squeeze. As a diver, when going deeper under the water, the pressure from the outer environment will increase and as a result, your middle ear, that part behind your eardrum, will get squeezed by the increasing pressure that the water from outside puts on you. The middle part of the ear is usually made of the eardrum (tympanic membrane) and bone and the space between the two is air-filled.
There is a tunnel, known as the Eustachian tube, which connects this part of the ear to the backside of the nose. Any outside air that goes through the tube equalizes the pressure between the middle ear and the outside world. Ear squeeze or pain will arise when the Eustachian tube malfunctions and a pressure difference arises.
Scuba diving ear pain
Ear can pain occur while decending during scuba diving, after the diver drops deep under water. The squeezing ear pain occurs near the ear surface where relative pressure changes are greater. Every foot below the water surface will increase the pressure on the ears. On average, for every 33 feet under the water, the atmospheric pressure will increase by around 1 atmosphere, which is comparable to 1-atmosphere pressure for every person standing at the sea level.
Normally, the Eustachian tube opens and allows the pressure behind the diver’s eardrum to equalize with the pressure of the seawater inside the ear canal. However, if the Eustachian tube fails to do that, the water will push the eardrum inwards with every increase of pressure of the seawater inside the ear canal.
The pressure stretches and inflames the eardrum and causes pain. If the diver ignores the pain and decides to drop deeper, the pressure increases further and can cause bursting of the eardrum. That will allow the cold seawater to enter the middle ear. The result is vomiting, nausea, confusion and dizziness.
Rapid descents and ascents in commercial air flight or while driving a car might also cause equalization problems of pressure inside the ear, but not similar to that expected in diving. The problem is likely to cause an ear pop but it is unlikely to cause an ear squeeze.
The types of problems
Almost each of the most common ear problems associated with diving will fall in one of the three categories. The problems can either affect the outer ear, the ear canal and the tympanic membrane (anything to the eardrum).
The second category of the pain is associated with the inner ear and it includes anything on the diver’s eardrum such as the middle ear, the oval window and round window.
The third category of scuba diver ear related problems related to the Eustachian tube and the sinuses. The purpose of the Eustachian tube is to supply air to the inner ear and to facilitate equalization of the body. If a problem occurs in the area, the equalization might become difficult.
The outer ear problems
The diver’s outer ear might suffer two primary issues, wax build up and infections, both result in severe pain when diving in addition to difficulty equalizing. Because wax build-up makes a plug in the ear it makes it hard to equalize properly. The best cure is to irrigate the ears with some warm water. You can buy home kits to treat the problem or seek professional medical help.
Various infections affect the outer ear but most of them are treatable with simple eardrops, which treat infections and reduce inflammation. To identify the best eardrops for your problem, you will need the help of a medical professional. If you are more prone to the outer ear infections, you will have to rinse the outer ear regularly with some clean water after each dive.
The inner ear problems
The inner ear problems exist in two different types, barotraumas and infections. Infections result from various things and to solve them in a better way, you will need to consult a doctor and potentially take some medication.
Barotraumas are another form of inner ear injuries that result from pressure. They primarily occur if the diver is not careful when descending or equalizes very hard or fails to equalize sufficiently. To avoid them, you will have to ensure that your ears and sinuses are in the right shape and unblocked and to equalize gently and regularly when diving.
The sinuses and Eustachian tubes
The Eustachian tubes are the most important when it comes to proper equalization. The most common problems that affect them are inflammation and congestion. To avoid the problems associated with congested or inflamed Eustachian tubes, you will have to ensure that you are healthy before you start diving. Do not try to dive when you are partially congested or after a cold because the mucus build-up is likely to interfere with your proper equalization and will cause more problems as you force the body to do something hard. Use sprays or decongestants to clear up your tubes before you go diving, under the advice of a medical professional.
The Eustachian tubes are usually guilty in case of reverse blocks that affect the sinuses or ears. Reverse blocks are very similar to squeezes but they occur on ascent. As the diver goes up and the outside pressure starts reducing, the air in the sinuses and the ears starts escaping automatically and the inside pressure starts to equalize with the outside water pressure. However, mucus might block the sinuses and the Eustachian tube, therefore, making it hard for the air to escape. This can result in pain associated with pressure imbalance. The best solution is to re-descend until the sharp pain has ended. After that, recommence the ascent as slow as possible so that the air trapped inside can escape.
Mostly, ear pain associated with scuba diving goes away by itself, within one week, and without any long term effects. If the eardrum ruptures, it will heal itself in a longer period, seek medical adivce but a surgical repair might be necessary. If facial paralysis is present seek medical advice and it may be temporary. In the case of mild hearing loss seek medical advice.