Ear Pressure During Hyperbaric Oxygen Therapy: Why It Happens and How to Clear Your Ears
Lisa St. John, M.S.
Lisa is our Clinic Director and Founder. She earned her Master's degree from Harvard University, completed a Fellowship at Stanford University, and has spent the last 30 years working in the healthcare field.
Ear pressure is the most common side effect of hyperbaric oxygen therapy (HBOT), and it's usually easy to manage. As the chamber pressurizes, the air behind your eardrum needs to equalize, just as it does on an airplane. Swallowing, yawning or a gentle "Valsalva" can clear it, and your technician can pause the pressure at any time.
If Your Ears Feel Full, You're Not Alone
You settle into the chamber, the pressure starts to build, and your ears feel stuffed, like a plane coming in to land. Many first-time patients notice it within the first few minutes.
That feeling is normal. It's also the reason new patients ask us about their ears more than almost anything else. The good news is that equalizing is a skill, and most people pick it up quickly.
Why It Happens
Behind each eardrum is a small air-filled space called the middle ear. A narrow passage, the Eustachian tube, connects it to the back of your throat. When pressure around you rises, your eardrum gets pushed inward unless air can flow through that tube to balance it.
For some people the tube opens easily. For others it opens slowly, especially with:
A cold, allergies or sinus congestion
Recent ear surgery or past ear problems
Natural differences in anatomy
When the pressure can't equalize, you feel fullness, popping or pain. If the imbalance is ignored or forced, it can irritate or injure the eardrum. This is called middle ear barotrauma.
How to Clear Your Ears: 5 Simple Techniques
Start early, while the chamber is first pressurizing, and don't wait for pain.
Swallow. Sip water or swallow often. Every swallow helps open the tube.
Yawn or move your jaw. Open wide and wiggle your jaw side to side.
Valsalva maneuver. Gently pinch your nose and blow softly, as if inflating a balloon. Gently is the key word. Hard blowing can hurt your ears.
Toynbee maneuver. Pinch your nose and swallow at the same time.
Tell your technician. If one ear won't clear, say so. They can slow the pressure, hold it, or ease it back up a little until you equalize.
Your care team will walk you through these before your first session, and you'll be able to talk to them through the intercom the whole time.
What Not to Do
Don't push through ear pain. Mild pressure is normal. Sharp pain isn't. Signal your technician right away.
Don't blow hard. Forcing a Valsalva can cause more harm than good.
Don't come in congested without telling us. A cold or sinus infection makes equalizing harder, so we may recommend rescheduling.
Don't self-treat with decongestants. Check with your healthcare provider first.
What If It Keeps Happening?
If you have trouble equalizing in several sessions, tell your care team. Options may include adjusting how quickly we pressurize, an exam by an ear, nose and throat (ENT) specialist, or, in some cases, small ear tubes (tympanostomy tubes) that make pressure changes easier. Most patients never need them.
Contact your healthcare provider if you notice ear pain that lingers after a session, drainage or blood from the ear, muffled hearing that doesn't improve, ringing, or dizziness.
Safety and Expert Care
Ear comfort is part of how we think about patient safety. At Bay Area Hyperbarics, our team screens your ears before treatment, coaches you through equalizing and monitors you throughout each session.
Consult a healthcare provider before starting any new treatment. This article is for educational purposes and does not replace medical advice from your care team.
Frequently Asked Questions
Is ear pain normal during HBOT? Pressure and fullness are normal. Sharp pain isn't, and it's a signal to ask your technician to pause the pressure.
Why do my ears hurt in a hyperbaric chamber? Pressure rises faster than the air in your middle ear can equalize. Techniques like swallowing and yawning help the Eustachian tube open.
Can I do HBOT with a cold or congestion? Often it's best to wait. Congestion makes it harder for your ears to equalize, so we may reschedule.
How long does the ear fullness last? Usually just during pressurization. Many people feel the pressure ease once the chamber reaches treatment depth.
Will I get better at clearing my ears? Most patients do. With practice, equalizing becomes automatic within a few sessions.
Have questions about what to expect from your first session? Call our team. We're happy to walk you through it.
