Why Your Ear Hurts When Blowing Your Nose

Dr. K. R. Meghanadh

Introduction

Blowing your nose can cause ear blockage, pain, or both despite being a common remedy for nasal congestion or a cold.

Otitis media, a prevalent middle ear infection, often starts with a nasal infection like the common cold.

This article explores the link between your nose and ears, highlighting how blowing your nose can be hurt your ears.

Anatomy: Connection Behind the Pain

To understand why blowing your nose can cause ear pain, it's essential to consider the connection between your nose and ear.

The ear can be divided into three main parts: the outer ear, middle ear, and inner ear, with the eardrum between the outer and middle ear.

The middle ear is connected to the back of your nose (nasopharynx) and throat by a small passage called the Eustachian or Auditory tube.

Effective vibration of the eardrum is necessary to transmit sound to the inner ear, requiring equal air pressure on both sides. The Eustachian tube regulates this pressure by supplying air from the nasopharynx (back of the nose) to the middle ear, ensuring the pressure of the middle ear matches the external environment.

To know more about the anatomy of the middle ear, check this article.

Middle ear anatomy and its Role in Otitis Media

What Happens When You Blow Your Nose?

Forceful nose blowing, especially when one nostril is blocked by the disease or closed by you, increases the pressure in your nasopharynx (the back part of your nose), pushing the nasal discharges or any fluids in nasopharynx into the eustachian tube.

Thick nasal discharges can block the Eustachian tube, altering middle ear air pressure and causing discomfort or pain.

When blown forcefully, if the nasal discharge is thin, it can freely move into the middle ear, creating a breeding ground for bacteria. This can lead to swelling in the middle ear and pain.

Both scenarios, whether the fluid moves into the middle ear or blocks the Eustachian tube, can result in an infection in the middle ear called Otitis Media.

It's important to note that 90% of ear infections occur in the middle ear, and all middle ear infections are secondary infections. The primary infection is usually a nasal infection like the common cold.

Role of Mucosa Lining

The mucosa lining is a continuous skin layer that runs through the nose, sinuses, throat, voice box, lungs, and even the Eustachian or auditory tube.

Inflammation in this layer can affect the Eustachian tube as it runs through it. Inflammation can be caused by nasal infections, throat infections, or even allergies.

Common Cold Hurts Ears

Nasal infections like the common cold can inflame the mucosa lining. If the mucosa lining in the eustachian tube swells, it can partially or fully block the air supply to the middle ear, causing ear pain.

This is more common in a few people with allergies or those with a thinner-than-average Eustachian tube from birth. This is why some people experience ear pain more frequently during a cold than others.

If you want to know more about why you experience ear pain during a cold, please read our article

"Why Do We Experience Ear Pain and Blockage During Cold?"

How Do Allergies Affect Eustachian Tubes And Hurt Our Ears?

Not all allergies contribute to ear infections. Some people's allergies primarily affect their noses, causing a runny nose. Others may experience allergies that affect their throat, leading to a sore throat. Similarly, some individuals may have allergic reactions that target the Eustachian tube, resulting in frequent ear pain or blockage.

Partial blockages in Eustachian Tubes

For people with a partially blocked Eustachian tube due to nasal infection or allergies, blowing the nose when the fluids are thick can easily block the tube further. If the fluids settle in the middle ear due to partial blockage, the draining of the fluids can take longer, leading to complications.

How Do I Know If I Ruptured My Eardrum?

In extreme cases, the increased pressure from blowing your nose vigorously can cause the eardrum to rupture. The eardrum, a thin membrane separating the outer and middle ear, is delicate and susceptible to damage under excessive pressure.

You can easily identify the ruptured eardrum by these symptoms.

1. Ear pain

2. Hearing loss or hearing loss can be perceived as blockage

3. Ear discharge

If you experience any of these symptoms after blowing your nose, it's essential to seek medical attention to assess the extent of the injury.

Preventive Measures

Here are some prevention measures you can take to alleviate this issue:

1. Don’t blow your nose: Instead of forcefully blowing your nose, gently clean the fluid that drips out of your nose.

2. Staying hydrated: It is crucial for maintaining thin and flowing mucus, which makes it easier to clear the nasal passages without forceful blowing.

3. Steam inhalation: Inhaling steam can help thin the mucosa lining. A slight rise in temperature of the mucosa layer can occur with just 5 minutes of steam; this will result in thinning of the mucosa layer that is inflamed due to nasal infection or allergy, allowing the fluids to flow out and clear the blockage.

4. Nasal drops: Use nasal drops when you have a cold; although the drops give you relief and do not fix the nasal infection, they will prevent complications that can occur from a cold, like otitis media, sinusitis, etc.

5. Use Anti-allergy medication: As mentioned above, allergy is a contributing factor, using anti-allergy medication can be useful in totally preventing the occurrence of not only ear infections but also other complications like sinus infections.

Treatment

If you visit a doctor complaining of ear pain during a cold, they are likely to recommend trying steam inhalations and nasal drops for a couple of days.

They will ask you to return if your ear blockage or pain persists after two days if the symptoms don’t disappear. If you have an allergy, they will prescribe anti-allergic medication accordingly.

Conclusion

• Most ear infections in humans are avoidable as they are triggered by cold or a nasal infection.

• Ear pain or ear blockage can be triggered when you blow your nose.

• Avoid blowing your nose with a cold, especially with one nostril blocked.

• Use steam inhalations and nasal drops when you have a cold to prevent complications.

• Don't skip your anti-allergic medication.

Dr. K. R. Meghanadh