We were driving down the canyon after a hiking trip when my son started complaining of ear pain. "Swallow," I told him -- which he did, with no success. By the time we got home, his ears had still not popped, and they hurt.
When pressure changes are too rapid, and your ears don't pop, your ear drum can actually rupture. What's the cause of your ears not popping?
When you ascend or descend rapidly, by flying, diving, or even driving up and down a steep mountain, the air in your middle ear space can sometimes have trouble adjusting to the ambient (environmental) pressure. Under normal circumstances, you should have a popping sensation as your ears adjust. You can usually speed this process along by swallowing or yawning. If your ears cannot keep up with the pressure changes and don't pop, you can experience ear pain and even get a ruptured eardrum (also called barotrauma of the ear).
If you feel pressure and/or pain in your ears and they won't pop, you may have an underlying ear disorder that is affecting the function of your auditory (Eustachian) tube. In my son's case, it is fluid in the ear. The following problems can affect the ability of your ears to pop.
Fluid in the Ear
Fluid in the ear is caused by an obstruction of the auditory tube, which prevents the fluid from draining into the back of the throat. Sometimes this is caused by infection, or the enlargement of surrounding structures, such as the adenoids or sinus tissue. Fluid in the ear is usually treated by the surgical insertion of synthetic ear tubes, which open up the auditory tube and allow it to drain. If the tube is being blocked by surrounding tissue, the removal of this tissue may also be necessary. Other names for fluid in the ear include serous otitis media, glue ear, and otitis media with effusion.
Excessive Ear Wax
Too much ear wax (cerumen) can also impair the function of your auditory tube. This doesn't mean you should run out and buy some ear candles or stick a cotton swab down your ear, though (this will likely just push the wax down further). This type of ear wax blockage needs to be removed by a professional, preferably an ear, nose and throat doctor. There are a few ways that your doctor can remove the wax, and it can be done in their office. Wax can be removed with special ear drops that dissolve the wax, by irrigation, or with a special instrument called a cerumen spoon, which the doctor uses to "dig" the wax out.
Too much mucus can gum up your auditory tube and make it difficult to maintain the pressure in the middle ear space. When my mom's ears would not pop, her doctor told her it was her allergies and recommended she take decongestant medication before getting on an airplane. A cold virus is also a common cause of congestion, but if it lasts longer than about three weeks, you may be dealing with allergies or another condition that should be evaluated by a physician.
Patulous Eustachian Tube
Patulous Eustachian Tube is a very rare disorder in which the auditory tube fails to close and remains open all of the time. Besides feeling as though your ears are plugged, symptoms of Patulous Eustachian Tube include tinnitus, autophony (when your voice seems abnormally loud to you), and hearing your own breathing.
If your ears do not pop and you feel as though they are clogged or you are experiencing significant ear pain, you should make an appointment with a qualified doctor. If you have symptoms of a ruptured ear drum, such as fluid or blood draining from the ear, intense earache followed by a pop and sudden relief of pain, or difficulty hearing, you should see a doctor immediately.
Centers For Disease Control and Prevention. Ear Infections. Get Smart: When Antibiotics Don't Work. Accessed May 15, 2012 from: http://www.cdc.gov/getsmart/antibiotic-use/URI/ear-infection.html
Medline Plus. Wax Blockage. Accessed May 15, 2012 from: http://www.nlm.nih.gov/medlineplus/ency/article/000979.htm
New England Journal of Medicine. Patulous Eustachian Tube. Accessed: May 16, 2012 from http://www.nejm.org/doi/full/10.1056/NEJMicm040779