Blocked Ears: Causes, Symptoms, and When to See a Clinician
A blocked ear can come from wax, infection, eustachian-tube problems, water trapped from swimming, allergies, sudden altitude change, or a developing middle-ear issue. Most resolve simply once you identify the cause. A small number need prompt medical attention. Below I'll walk through the common causes, how to tell them apart, and when to act fast.
What a blocked ear actually means
"Blocked" is a sensation, not a diagnosis. It can mean any of: actual physical blockage (wax, foreign body, swelling), pressure imbalance (eustachian tube dysfunction), fluid behind the eardrum (otitis media with effusion), or perceived blockage from sudden hearing change (sudden sensorineural hearing loss, SSNHL, a medical emergency).
Identifying the cause is what determines whether it resolves on its own, needs a wax removal, needs antibiotics, or needs urgent referral.
The most common causes
Ear wax (cerumen impaction)
By far the most common cause of blocked ears in adults. Wax migrates outward normally. Impaction happens when something pushes it inward (cotton buds, hearing aids, earplugs, or just an unfortunate canal shape).
Symptoms: dull blockage, often gradual, hearing reduced in the affected ear, sometimes a ringing or echo, rarely pain unless very impacted.
Treatment: olive oil drops for 3 to 5 nights to soften, then professional removal (microsuction, irrigation or manual). Done in a single visit. £50 single ear, £70 both ears at Hear Now Clinic.
Eustachian tube dysfunction (ETD)
The eustachian tube connects the middle ear to the back of the throat and equalises pressure. When it's not working (usually due to a cold, allergies or sinus inflammation) the middle ear can develop negative pressure or fluid, producing a sensation of blockage.
Symptoms: blocked sensation, popping or crackling, sometimes mild discomfort, often follows a cold or accompanies allergies.
Treatment: time (most resolve in 1 to 2 weeks), Otovent nasal balloons, decongestants if appropriate, treating the underlying cold/allergy, and Valsalva manoeuvres (gentle pressure equalisation). Persistent ETD beyond a few weeks needs ENT review.
Middle ear infection (otitis media)
Common in children, less so in adults. Bacterial or viral infection of the middle ear behind the eardrum.
Symptoms: pain (often significant), fever, hearing reduction, sometimes discharge if the eardrum perforates.
Treatment: see your GP. Usually treated with analgesia and sometimes antibiotics. Don't put anything in the ear at home.
Otitis externa
Infection of the outer ear canal, bacterial or fungal. Common after swimming, particularly in summer, or after over-cleaning with cotton buds.
Symptoms: pain (often worse when you tug the outer ear), itching, discharge, blocked sensation, sometimes swelling that closes the canal entirely.
Treatment: see your GP. Usually treated with topical antibiotic or anti-fungal drops. Don't syringe or microsuction an active infection. We can review afterwards.
Water trapped after swimming
Self-explanatory: water gets in and doesn't drain out. Usually resolves with gentle head tilt, jumping on the opposite leg, or a small amount of alcohol-based drying drops. If it doesn't resolve in 24 hours and discomfort develops, consider otitis externa.
Sudden altitude change
Flying, driving up hills, scuba diving. Usually resolves with yawning, swallowing or a gentle Valsalva. Severe cases (barotrauma) can cause middle-ear fluid or eardrum injury and need ENT review.
The one cause you must not ignore
Sudden sensorineural hearing loss (SSNHL), sudden hearing loss in one ear often perceived as a blocked sensation, is a medical emergency. Treatment with steroids within 72 hours significantly improves recovery. If you wake up with one ear suddenly muffled and otoscopy doesn't find wax, get to an ENT department or A&E the same day. Don't wait for a GP appointment in three days.
Red flags to act on:
Sudden onset hearing loss in one ear
Severe one-sided pain or discharge
Hearing loss with dizziness or vertigo
Hearing loss following a head injury
Pulsatile tinnitus (in time with the heartbeat) in a blocked ear
What not to do at home
Don't use cotton buds. They push wax in and irritate the canal.
Don't use ear candles. No evidence, real risk of burns.
Don't use online ear-cleaning curettes without training.
Don't pour anything other than olive oil or recommended drops into your ear.
Don't ignore one-sided sudden symptoms. See a clinician promptly.
What to expect at our appointment
We start with a video otoscope examination. You'll see images of your own ear on the screen. We diagnose visually before doing anything. If it's wax, we remove it. If it's infection or another medical issue, we refer you to the right place and don't intervene. We won't microsuction an actively infected ear. That's a GP or ENT issue first.
Frequently asked questions
How long should I wait before getting wax removed? If it's causing notable hearing reduction, discomfort, or interfering with hearing aids, book sooner rather than later. There's no benefit to waiting and impacted wax just gets harder to remove.
Will the NHS remove ear wax? Provision varies across NI Trusts. Some GP practices do it, many no longer offer routine wax removal. Private clinics are often the practical route.
Can I use olive oil indefinitely? No. Short-term softening (a week) is fine. Long-term use can macerate the canal skin and trap debris.
Why do my ears keep getting blocked? Some people produce wax faster, have narrower canals, or wear hearing aids/earphones that prevent natural migration. We can advise on a maintenance schedule.
Is microsuction safe with a perforated eardrum? Yes. Microsuction is the safe choice. Irrigation is not.
Can a blocked feeling be caused by something other than wax? Absolutely. Eustachian tube issues, fluid behind the eardrum, ear infections and sudden hearing loss all produce the same sensation. That's why a proper examination matters before treatment.
