01 Sep Ear pain while diving can come from several sources:
- Ear Drum Pain (Myringits) If you hit the water with your head to the side, you can slap your ear drum and this can be painful. This is called a myringitis or pain of the ear drum . After diving, this is a common cause of ear pain, the eardrum has been shoved around so much with clearing too hard, or striking the water too hard, or just a lot of up and down action. Sometimes plain olive oil or baby oil will relieve it. Any soothing ear drop such as auralgan is good. Prevention consists of wearing a hood while making a leap from the boat and clearing the ears GENTLY.
- Outer Ear Infection (External Otitis)Ear pain, especially after several dives, is most commonly caused by an irritation of the ear canal. The problem here is that once the canal starts to swell, it is surrounded by bone and this acts like a pliers squeezing on the sore ear canal. Generally pain here is much greater than the same swelling on your hand or cheek. If the canal swells completely shut it is VERY painful. Fortunately the severity of the pain doesn’t mean it is more serious, just that the swelling is in a tender sensitive area.You can prevent outer ear pain by NEVER washing your ears with soap and water. You need the wax in your ear to protect you from the ravages of swimming and diving. Alcohol and peroxide both take away natural wax and make one prone to outer ear infections. I advise divers to always put olive oil in the ear canal before washing their hair and any activity where soap or water can enter the canal. Because of the shape of the ear canal, like a bent baby bottle, once the soap gets in there, you cannot take it out and it just lays there and reduces wax and oil formation.Treatment should be started at once. Do not put heat to the ear. The pain is due to the swelling, so heat will cause it to swell more. Take an antihistamine such as chlorpheniramine 4 milligrams (no prescription)4 times a day.Proteolytic enzyme tablets are good for reducing swelling (Papaya Enzyme). Your doctor may elect to give an antibiotic. Ear drops such as Cortispoin Otic Solution can be given by prescription. If the canal is very painful and swollen a wick or drain can be put in it. This allows the drainage to come out and the medicine to go in. It is important to clear this type of condition as quickly as possible because the longer the outer ear infection stays, the more tendency to reoccur. Therefore you should stay out of the water until clear. Once you have had this type of infection I advise my divers to take an antihistamine the moment they feel this coming on. Do not take antihistamine while diving. Any antihistamine can make you drowsy and add to nitrogen narcosis -remember, every 33 feet is equal to one martini.
- Middle Ear InfectionEar pain can come from the middle ear. This may be a regular middle ear infection (otitis media.) Except for when the ear drum is bulging outward severely, this type of infection is not especially painful. In children is painful because pus builds up and bulges the ear drum. It may be caused by blowing the nose too hard and forcing the nasal pus up the eustachian tube into the middle ear cavity where the bacteria multiply. If there is heavy phlegm or pus in the nose, using the pulsating sinus irrigator daily 5 days before diving may prevent eustachian tube blockage.
- Blockage On Descent.Water presses on the ear drum because the ear doesn’t equalize. The drum becomes irritated just like having a 15 pound weight on your eyeball would. Once your down, if the ear blocks, the air can expand and if the pressure is not relieved could rupture the ear drum. A ruptured ear drum as a rule is not painful and is not a medical emergency. Just avoid putting drops in the canal which can carry bacteria into the middle ear. 90% of ruptured ear drums heal without problems.
- Rupture of the Round WindowA rupture of the round or oval window of the inner ear, also called a perilymph fistula, is never painful. This leaves an opening so that inner ear fluid escapes and can cause permanent hearing loss. This is caused by forcing the blocked ear open with too much pressure. Therefore always be gentle. If you can’t clear, go up 5 feet and try again.Any chronic issues is your ear must be properly diagnosed and appropriate medical care is important. I tell my patients that circulation is key to any area of your body healing. When your skull is jammed and you have dural adhesions,, which I discuss is detail at FunctionalCranialRelease.com, you will have poor circulation and function of your ears. Treatment can help dramatically in these cases.Here is an ER doctor who received fCR with excellent results.
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