How to relieve sinus pressure in your ears

In this article:

• Ways to relieve sinus pressure
• Typical duration
• Prevention
• The bottom line

In this article

• Ways to relieve sinus pressure
• Typical duration
• Prevention
• The bottom line

Anyone who has ever woken up with a stuffy or runny nose has gone through the same thought process before getting up and reaching for a tissue: First, they hope it’s just the common cold or allergies. And second, they hope it’s not a sinus infection. Why? Unlike colds, which are caused by a virus and can be pesky but work themselves out in a day or two, sinus infections are bacterial and often stick around for ten days or more and come with symptoms like nasal congestion, postnasal drip, facial pain, a sore throat, and in some cases, pain and pressure in the ear canals that can lead to tinnitus, and temporary hearing loss.

Ear or sinus pressure typically occurs when the eustachian tube, the pathway connecting the sinuses to the ears, becomes inflamed or irritated, preventing it from functioning properly (a condition known as eustachian tube dysfunction, or ETD). “This feels like the ears are plugged, a popping or cracking sensation, muffled sounds and/or ringing in your ears,” explains otolaryngologist and sinus surgeon Boris Karanfilov, MD, founder of Ohio Sinus Institute in Dublin, Ohio. “Sometimes these symptoms also present with pain.”

A sinus infection can also cause fluid to be trapped behind the eardrum, causing a blockage where bacteria and viruses grow, potentially leading to an inner ear infection (otitis media). The good news: There are simple strategies that can relieve sinus pressure in the ears, including decongestants, antihistamines, nasal irrigation, pain medications, and steroids, physically unclogging your ears, and minimally invasive in-office procedures with a specialist. Read on to discover how to relieve sinus congestion in your ears, plus how long it can last and how to prevent it.

7 ways to relieve sinus pressure in the ears

If sinus pressure is causing ETD and leading to discomfort and pressure in the ears, there are ways to relieve it. Here are seven expert-recommended strategies to combat sinus issues.

1. Over-the-counter decongestants

“Decongestants such as Sudafed (pseudoephedrine) or other various nasal sprays work to decrease inflammation in the eustachian tube, thus allowing the eustachian tube to function properly,” explains Dr. Karanfilov. “They work by decreasing ear pressure fluctuations in the middle ear.” In addition to Sudafed, nasal decongestant sprays like Afrin (oxymetazoline) and NeoSynephrine (phenylephrine nasal) may also be helpful to help fluid buildup drain from clogged ears.

2. Allergy medications

Allergy medicines, such as oral antihistamines (Zyrtec, Claritin, or Allegra) and nasal sprays (Flonase), can help relieve sinus pressure caused by allergies. Though these medications target allergies, they can also alleviate congestion from sinusitis. These medications often take a few days to work.

3. Nasal irrigation

“Nasal irrigation is helpful in keeping the inflammation of the sinuses and the region of the opening of the eustachian tube under control,” says Kashif Mazhar, MD, an otolaryngologist and founder and CEO of ExcelENT Medical. “Hence it is recommended as a treatment modality for patients with chronic sinusitis and for patients with ETD.”

Also known as sinus rinsing, nasal irrigation is the practice of flushing your nasal cavity with a saline solution, using either a neti pot, squeeze bottle, or other sinus rinse kit to pour or push the solution into one nostril and let it flow out the other. “Nasal irrigations are effective in reducing irritants such as allergens, viruses, or bacteria that can lead to eustachian tube swelling,” adds Dr. Karanfilov. “Limiting these irritants provides the best environment for the eustachian tube to function normally.” The sinus rinse helps push allergens and nasal mucus out of the sinus passages to alleviate the cause of congestion.

4. Over-the-counter pain medications

The pain medications you have in your medicine cabinet can be helpful when dealing with ear congestion caused by sinus pressure in the ears. “Pain medicine, especially non-steroidal anti-inflammatories (NSAIDs) like ibuprofen or Advil, will help with ear pain and pressure because they have an anti-inflammatory property as well,” says Dr. Mazhar.

Using an NSAID helps reduce the inflammation near the eustachian tube, normalizing the pressure in the middle ear and eliminating pain. Acetaminophen can also help relieve earaches and sinus pain.

Note: If you find that an OTC pain reliever is helping, try massaging around your ears as well. If that is effective at minimizing pain, the source may be a temporomandibular (TMJ) disorder rather than sinus pressure. “A lot of times, TMJ discomfort can mimic ETD problems,” says Dr. Karanfilov. “Using OTC pain relievers can sometimes help both conditions, and this is why it is important to see your ENT specialist, who can run a special test called a tympanogram that will check the pressure in the middle ear. This will help determine the source of the pain.”

5. Steroids

If the sinus pressure in your ears is particularly uncomfortable, prescription steroids can be an effective strategy. “Your ENT or your healthcare provider may prescribe you a short course of oral prednisone that will reduce the inflammation quickly and can reduce the ear pressure and ear pain,” Dr. Mazhar says.

While corticosteroids have been proven to be an effective short-term treatment for acute sinusitis and, therefore, will likely help with associated ETD and ear pain as well, they do come with a host of potential side effects, including suppressing the immune system. Patients on corticosteroids can also become moody, have an insatiable urge to eat, and experience insomnia. You may want to weigh these risks against the severity of your symptoms before choosing this treatment path.

6. Valsalva maneuvers

Have you ever tried to “pop” your ears by holding your nose and forcing air out your closed nostrils? Then you’ve performed a Valsalva maneuver, which can equalize pressure in the middle ear and reduce pain and discomfort. If inflammation is forcing the eustachian tube closed, the Valsalva maneuver can push air through it to open it up and normalize the pressure again, says Dr. Karanfilov.

To try it: Sit or lie down. Take a large breath in, then, while pinching your nose closed and shutting your mouth, push that breath out against your nose and mouth for 15 to 20 seconds. Open your nose and mouth and breathe out. This is not harmful to the eardrum.

7. Eustachian tube balloon dilation

“There are some minimally invasive office-based surgical procedures like eustachian tube balloon dilation that have been shown to have the best and longest-acting beneficial effect,” explains Dr. Mazhar. In this procedure, which can be performed under local anesthesia, an endoscope with a tiny balloon is inserted into the nose until it reaches the eustachian tube at the back. The balloon is then inflated to open the eustachian tube, similar to the way a stent opens an artery. “This is covered by Medicare and some, but not all, commercial insurance companies,” adds Dr. Karanfilov, who helped develop the technology.

It has also been shown to be highly effective. In one study published in The Journal of International Advanced Otology, people with chronic ETD for whom nasal steroid sprays and Valsalva maneuvers weren’t working underwent the procedure. Of those who had eustachian tube balloon dilation, 69% experienced an immediate improvement in their ETD, and the improvement persisted six months after the procedure.

How long does ear pressure from sinusitis last?

“Ear pressure is not a typical symptom of sinus infection, but we see it in conjunction with eustachian tube dysfunction and chronic sinusitis or sinus infection,” explains Dr. Mazhar. “During an episode of sinus infection or an exacerbation of chronic sinusitis, the ETD can become worse. And this can lead to ear pressure and ear pain.”

That said, it’s not uncommon for these two issues to coincide, especially in people with chronic sinus infections. “Multiple studies have shown that about 60 to 70% of patients with chronic sinusitis will also have eustachian tube dysfunction and symptoms of ear pressure and ear pain,” Dr. Mazhar says. When these two issues are happening concurrently, the ear pressure and pain will likely last as long as the symptoms of the sinus infection do, which is typically 7 to 10 days in acute cases or 12 weeks or more in chronic cases.

How to prevent sinusitis and ear pressure

While sinus infections do not always cause ear pressure and pain, the presence of the virus can lead to inflammation in the area of the nose, sinuses, and ears, increasing the likelihood of ETD occurring at the same time. If you are taking steps to avoid catching a sinus infection, such as those below, you are less likely to develop ETD as well:

• Wash hands frequently
• Avoid close contact with people who have colds or upper respiratory infections
• Get recommended vaccines, such as the flu vaccine and COVID-19 vaccine
• Use a humidifier at home to avoid dry air
• Do not smoke or vape

The bottom line

Though it is not always present, ear pressure and pain can sometimes be a symptom of eustachian tube dysfunction that happens concurrently with sinusitis. If you’re having these symptoms, medications like decongestants, NSAIDs, and steroids can help, as can home remedies like nasal irrigation or popping your ears, or a minimally invasive procedure known as eustachian tube balloon dilation. If none of the home remedies are working and your symptoms persist for weeks, seek medical treatment from a healthcare provider, such as a sinus specialist, who can run tests to determine the cause and advise on the best course of treatment.