Ear Pain, Scuba Diving

When to Seek Medical Care

The majority of cases of ear pain or ear squeeze force the diver to abort the dive before the eardrum ruptures. In these cases, symptoms often resolve shortly after the diver reaches the surface. If symptoms continue or the cause of the ear pain is not known, seek medical care. Disorientation, vomiting, and hearing loss are symptoms of a ruptured eardrum and require medical care.

If a ruptured eardrum is present or suspected, the diver should be evaluated in a hospital's Emergency Department. Transport by car is acceptable. No further dives should be undertaken until the diver is medically cleared.

Exams and Tests

The physician will evaluate the possibility of ear squeeze with a series of questions regarding the dive. These questions not only help diagnose the ear squeeze but also detect other potential dive injuries.

• Did the diver experience difficulty clearing the ear?
• Did the symptoms begin during descent or ascent?
• Were the symptoms present during the dive or after reaching the surface? 
• How long did the symptoms last? 
• Is there a history of ear or sinus infections?

The physician will then examine the ear with an otoscope or ear scope. The exam may reveal a normal eardrum, swelling and redness of the eardrum, or a hole in the eardrum. Hearing loss or facial paralysis may also be present. X-rays and blood tests are not needed.

Diving Ear Pain Treatment - Self-Care at Home

The treatment of ear squeeze begins during the dive. If fullness or pain is experienced, do not continue to dive deeper. If ear clearing techniques fail, the dive must be ended. Always complete the decompression stops if necessary when returning to the surface.

If the eardrum ruptures, the diver may become disoriented or vomit, which may lead to panic. Panic may lead to ascending too rapidly. The dive partner should carefully observe and assist, if needed, during the ascent, making sure all decompression stops are made. On the surface, no objects or eardrops should be placed into the ear. Keep the ear dry.

Medical Treatment

The most important treatment was done by aborting the dive and ascending to the surface, making any necessary decompression stops.

• Initial treatment involves the use of oral decongestants and nasal spray to help open the eustachian tube. Antihistamines may also be prescribed if an allergy is a contributing factor.
• Pain medications are helpful, and eardrops to relieve pain may be used if the eardrum is not ruptured.
• A ruptured eardrum will require antibiotics by mouth to prevent infections.
• Hearing exams or audiograms may be needed if the eardrum is ruptured or hearing loss is present.
• If the person has a facial paralysis, oral steroids may be prescribed.