by Neil Bauman, Ph.D.

I receive a number of emails from people who have a feeling of pressure (or blocked feeling) in their ears . Here is a recent example. A man wrote:

I am 33 years old and have never had any trouble with my hearing. I woke up about a month and a half ago with what felt like a bubble (pressure) in my left ear. It also sounded like everyone was talking in a bubble for a few days. Several weeks ago the pressure returned and I went to my internist. She said I did not have an ear infection and thought that it might be a Eustachian tube problem. She prescribed Nasonex and said that if it didn’t clear up in a week or so to call an ENT. It didn’t so I called the ENT.

The ENT did a pressure test, visual observation, and a hearing test. It turns out I have a mild loss in the lower tones for my left ear. He said that I most likely had a viral infection in my inner ear and that the only way to treat it was with steroids and Valtrex. He also said he wished I’d have come in much sooner, but how the heck was I supposed to know it was more than congestion or an ear infection?

Good question. The thing you have to determine right away is whether you have a middle ear infection that will resolve itself in a few weeks without any treatment and won’t cause any lasting damage to your hearing, or whether you have something destroying your hearing which requires immediate treatment.

With the former you can take a wait and see attitude. The latter is a medical emergency and needs to be treated as such.

When you go to a doctor and complain of a feeling of pressure in your ear, or that your ear feels blocked, the doctor typically uses his otoscope to inspect your ear canal and eardrum. If he sees any signs of inflamation, infection or fluid behind your eardrum, he diagnoses it (correctly) as a middle ear infection.

The typical treatment is to take decongestants, take antibiotics, or do nothing and let nature run its course.

However, when the doctor doesn’t see any signs of middle ear infection, he assumes that either there is Eustachian tube dysfunction, or there is nothing wrong and you are complaining about nothing. This attitude is wrong and could cost you your hearing.

For some reason, doctors can’t seem to understand that there are two reasons for the “blocked feeling” or “feelings of pressure.” The first one, described above, is real physical pressure from either a middle ear infection or blocked Eustachian tube, or because the “infectious gunk (fluid)” in your middle ear is truly blocking sounds from reaching your inner ear as they would normally do.

The second kind is a psychological feeling of blocking or pressure. Since the feeling is psychological, not physical, doctors can’t find anything wrong, and typically write it off as being nothing.

In actual fact, when you rapidly lose some hearing, whether you realize it or not, your brain senses that it is not getting the normal sound signals from that ear. It “reasons” that obviously that ear must be “blocked” or else it would hear, wouldn’t it? Thus it generates a psychological feeling that people variously describe as a blocked feeling or a feeling of pressure in their ear, or ears.

This feeling of pressure is an important symptom warning you that you have rapidly lost a significant amount of hearing, and you need to find out why right now!

Thus, if your doctor can’t see any signs of middle ear infections or Eustachian tube dysfunction, hurry to an otologist (find an otologist near you) or knowledgeable ENT and get effective treatment for whatever is causing the hearing loss. You do not have any time to waste if you want a chance of getting this lost hearing back.