Ear pressure in the chamber: how to equalize comfortably
The most common side effect of hyperbaric oxygen therapy has nothing to do with oxygen. It's ear pressure, the same thing you feel on a plane or at the bottom of a swimming pool.
Why it happens
Behind your eardrum is a small air-filled space, the middle ear. It connects to the back of your nose through a narrow passage called the Eustachian tube. When the chamber pressure rises, the air outside your eardrum pushes inward. To balance it, air needs to flow up through the Eustachian tube into the middle ear. That flow is the "pop."
If the tube doesn't open easily, pressure builds and can feel uncomfortable or painful. Ignoring it can injure the ear, a condition called middle ear barotrauma, which is why we take it seriously.
Techniques that help
Start equalizing as soon as pressurization begins, and keep going little and often. Don't wait for discomfort.
- Swallow. Sip water if allowed, or just swallow repeatedly.
- Yawn, or move your jaw side to side as if starting a yawn.
- Gentle Valsalva. Pinch your nose, close your mouth and blow gently, as if blowing up a balloon through your nose. Never force it.
- Toynbee maneuver. Pinch your nose and swallow at the same time.
- Chew gum or suck a lozenge, if the center allows it.
Tell the operator
If you feel pain, signal right away. The operator can stop, back off the pressure slightly and let you try again. Chambers can be pressurized more slowly for people who need it.
When to reschedule
Skip your session and reschedule if you have:
- A cold, sinus congestion or allergies flaring badly
- An ear infection
- Recent ear surgery or a perforated eardrum (check with your doctor first)
Congestion makes the Eustachian tubes swell shut, which makes equalizing much harder.
On the way back up
Depressurizing is usually easier: the air in your middle ear vents out on its own. If one ear feels stuck, swallowing or yawning usually clears it.
Does it get easier?
For most people, yes. After a few sessions equalizing becomes second nature. If you consistently struggle, talk to your doctor; an ear, nose and throat specialist can check how well your Eustachian tubes work.