Air-pressure pain in ears during flights can be eased but experts sceptical about paper cups and towels

Before Jamie Hardiman became a flight attendant, she was the daughter of a flight attendant, so she got to enjoy the perks of the buddy pass with her family from a young age. She took to flying immediately. Her little brother? Not so much.

“My brother always had really bad ear problems,” said Hardiman, 37, who’s based in Seattle, just like her mother was during her 25-year career.

On a flight when Hardiman was 11, she remembers flight attendants coming to her brother’s rescue once they were airborne. They brought him two cups, each stuffed with warm, wet paper towels and instructed him to place them over his ears. Practitioners swear the trick helps steam away ear pain, or at least provide a calming distraction.

The cup technique seemed to work immediately for Hardiman’s brother, “so I knew it worked”, she said. She’s passed the trick on ever since.

While the supposed remedy for curing ear pain on planes has circulated in the flying community for decades, it’s recently made its way on to social media, where videos praising its efficacy have gone viral. Commenters swear the hot cups are a godsend, while others – including medical experts – are more sceptical of what must be a gimmick.

Is there any scientific merit to the hack? Or is it an old wives’ tale? If it works, does it matter? We asked ear experts to set the record straight.

Ear experts are sceptical

Ross Cushing, a clinical audiologist and chief executive of the audiology practice Live Better Hearing + Balance, often sees patients who get ear pain on flights. It’s particularly common for smokers and people with allergies, he says. When it’s a chronic issue, Cushing sends patients to an ear, nose and throat doctor, who may recommend a minimally invasive surgery to implant pressure equalisation tubes in the eardrum. The surgery is “really common” for kids, he added.

Until the Washington Post contacted him for this story, Cushing had never heard of the cup method. He isn’t convinced by the lore; he couldn’t find any peer-reviewed articles on their use and doesn’t believe the arguments in their favour.

“Maybe you’re getting some steam and some warm air in your ear canal, but that doesn’t change the pressure that’s behind your eardrum,” he said. “I can’t imagine how it would change the pressure behind your eardrum.”

Ruth Reisman, a New York audiologist, said much the same.

“There’s really no scientific research behind it,” she said. “There are no articles that solidify that this is something that would work medically … and it really doesn’t make sense even anatomically.”

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A helpful distraction

While there’s no hard data to back up the cup method reducing pressure, the audiologists said there could be other reasons they work.

First, there’s the placebo effect.

“There has been research that sometimes placebos actually work because the individual believes that it’s going to work,” Reisman said. “There is this element of being positive about it and really having the belief that it’s going to help, that sometimes it does work, even though there’s really no scientific basis for it.”

Since the hack is pretty harmless, Reisman says there’s no reason to discourage it. Her one exception: if a person has an ear pathology or perforated eardrum, she would “definitely discourage” trying the hack.

Cushing said the cups may also just distract users from their discomfort. Hardiman believes that’s possible. She’s given the cups to her 8-year-old son when he was uncomfortable “and it just took his mind off of it”, she said. She’s also given the cups to travellers who can’t get their ears to pop, or to parents of crying children. With young kids, it can be hard to tell whether they’re experiencing pain or are just upset by the unfamiliar feeling of pressure changes.

At 30,000 feet, Hardiman says it’s worth trying the hack.

“If the pain is really bad, then we have to take it to the next level and call in to [emergency medical help],” she said. “Then it’s a bigger ordeal.”

The Valsalva maneuver and other methods

Some flight attendants might not oblige your request for cups on board. Elizabeth Simpson, who’s been in the industry for nearly a decade, says depending on when the cup hack is deployed, it can be against US Federal Aviation Administration regulations. During takeoff and landing, the FAA says “service items must be collected from passengers and stowed” so you’re technically not supposed to have the cups when your ears hurt the most.

Putting aside that concern and the potential risk of having a passenger injure themselves with hot water, Simpson says many flight attendants are compassionate and will still provide the cups. She’s empathetic, too: Simpson has ruptured her own eardrums during her career “and it sucks and is so painful”, she said.

However, she doesn’t recommend the cup technique. Instead, Simpson travels with EarPlanes, which are special earplugs that regulate air pressure during the flight, and recommends staying hydrated, or drinking hot beverages to help clear your sinuses.

Cushing usually recommends chewing gum or yawning to open your eustachian tubes, which can close when you experience quick changes in air pressure. There’s also the Valsalva maneuver, aka “plug your nose and blow”, he said.

If you’re dealing with allergies or a cold, Cushing recommends using a nasal spray like Afrin before your flight to reduce inflammation and help you breathe easier, or taking Sudafed 30 minutes before your flight.

Simpson also tells family and friends to hit the pharmacy, especially if they’re feeling any congestion or getting over a sinus issue before a flight. (Travellers should consult their doctor before taking any medication.) Simpson also finds cough drops and hard candies like Jolly Ranchers to be helpful.

For babies and young children who can’t chew gum or yawn on command, Cushing says a pacifier can encourage them to try to swallow, which should relieve pressure. “I have three kids and we travelled a lot and we always brought something for them to suck when we first took off,” he said.

What he does not recommend is getting your medical advice from social media.