Blocked ear feeling: causes, red flags and when to get it checked

The sensation of a blocked ear is felt when sound is damped or the pressure on either side of the eardrum is unequal. This happens when the ear canal is plugged, when the middle ear fills with fluid, or when the inner ear is affected. The distinction matters because sudden inner-ear hearing loss is time-sensitive.

• Earwax blockage, often after using cotton buds or hearing aids, or following showering or swimming.

• Eustachian tube dysfunction: ear popping, fullness and muffled hearing after a cold, allergy or flight.

• Outer ear infection (otitis externa) with pain, itch, swelling and discharge.

• Middle ear infection or fluid behind the drum (glue ear), with fullness and reduced hearing.

• Allergic rhinitis and sinusitis causing eustachian tube swelling.

• Sudden sensorineural hearing loss: a sudden drop in hearing in one ear, sometimes with tinnitus or dizziness, which needs urgent treatment.

• Meniere disease, with fullness, fluctuating hearing, tinnitus and vertigo attacks.

• Jaw joint problems, and rarely a growth in the nose or ear nerve such as an acoustic neuroma.

Hearing loss over hours to days, new tinnitus, spinning dizziness, facial weakness, ear discharge with severe pain, one-sided symptoms persisting for more than a few weeks, or one-sided nasal blockage with ear fullness warrant assessment.

• Call 999 or go to A&E: facial weakness with ear pain and rash; severe headache with stiff neck; trauma to the head with ear bleeding.

• Same-day or next-day GP or ENT: sudden hearing loss in one ear (treatment is most effective within days).

• GP within a week: ear pain with discharge, fever, or hearing loss with dizziness.

• Pharmacist or routine GP: blocked feeling after a cold or with suspected wax.

Questions cover onset, hearing change, ear pain, discharge, tinnitus, dizziness, recent colds or flights, cotton-bud use, hearing aids and swimming. The ear canal and drum are examined with an otoscope, and tuning-fork tests or a hearing test can show whether hearing loss is conductive or sensorineural.

• Otoscopy: shows wax, infection or fluid behind the drum.

• Tympanometry: measures eardrum movement and middle-ear pressure.

• Pure-tone audiometry: quantifies hearing loss and its type.

• MRI scan: for asymmetric sensorineural loss to exclude a nerve tumour.

• Nasal endoscopy: if blocked tubes are linked to nasal disease.

For wax, olive oil drops used twice daily for several days can soften it. Avoid cotton buds. For eustachian tube problems, try yawning, swallowing, chewing gum or gently blowing against a pinched nose, and treat any allergy or congestion. Keep ears dry if there is infection. Do not use ear drops if you may have a perforated drum without advice.

On the NHS, a GP or practice nurse can assess wax and refer to audiology or ENT. Private audiology offers microsuction wax removal and hearing tests directly.