Sometimes, after many dives, get piercing ear pain in the 20-30ft range

Hi,

Sometimes when I have done many dives continuously over a period of days, on the following dives, I would have this acute pain in the ear when I have descended to around 20-30 ft range. When I felt it for the first few time or so, I thought it was an equalization issue and went up a few feet and kept trying to further equalize, but the extreme discomfort does not go away and I would further descend, then the pain would go away below 30 ft.

Now it happens sometimes when I go on dive trips after having done 3 days worth of diving, so I usually quickly descent below 30ft and it becomes all fine. I sometimes also feel the same thing on my ascent, but much milder and it does not get worse and worse as I ascent like when I descent.

Is there some chambers in my head that opens up from pressure as I go deeper? And it frequently happening after a few days of diving, maybe that is due to having more sinus swelling after a few days in the colder water?

These are all tropical water diving.

Best bet is to talk to an ear specialist in your area that is familiar with diving and explain the situation to the doctor. Anything you get on here is likely to be guesswork. (Even more than the guesswork a doctor will provide.)

Sounds like a sinus squeeze or related issue but I AM NOT A DOCTOR.

I have sinus issues and have had problems with pain ranging from my ears to sharp pains from my forehead straight down the back of my eye and to my teeth while diving. It sucks. Some of us are more prone to sinus issues than others. I take a nice long acting sudafed the morning before any dive where I feel even slightly congested. 2 different diver friendly doctors have suggested the same to me. It helps but can only do so much in some cases so calling the dive may be best.

When it comes to ascending and descending my rule is SLOW DOWN. It helps with more than just your ears/sinuses. Also, equalize often and gently. Some people really blow hard trying to clear and that can take a toll over a few days on a dive vacation. Be safe and take it easy.

scubadobadoo gives good advice. (He also has a pretty catchy ScubaBoard username.)

Pain in the ear does not usually imply a sinus-related issue.
However, it is not unheard of for pain to be referred from one area (specific area of injury) to another.

Your "quick" descents during your early days of diving on a trip are likely inducing some middle ear barotrauma which results in inflammation and may be causing the issues you describe on later dives.
Slow down your descents. Equalize early and often during the descent. Consider pre-pressurizing at the surface.
If you are feeling any ear pain at all, whatever ear equalization you are doing is probably inadequate.
Experiment with as many ear equalization techniques as possible until you find the method that works best for you. Click on the link in my sig to get more info on this topic on Dr. Kay's website.

If you find this pattern of ear pain concerning, then by all means see a dive-savvy ear specialist. It's certainly possible that the anatomy of your Eustachian tubes is such that ear equalization is problematic. If there are any separate issues which might be hindering ear equalization (e.g., allergies, nasal/sinus congestion), you should certainly be addressing them.

I encounter sinus issues if it is on a 2nd or 4th dive of the day and water temp and/or SI is on the cooler side, but I usually alleviate that with extra equalization. With this discomfort, I am usually down past 30ft. Once my wife/buddy asked me what's the rush when I ditched her near the surface and sank down.

Anyway, I am hyperaware of equalization and do on every breath during descent, never waiting until it is uncomfortable and trying to blow real hard. It is just in the above 30ft range that I can't get this piecing pain I sometimes get, no matter how much I equalize or stay at that depth, or even going from 28-22ft. It was only when I dropped to below 30ft, that it felt normal again. And my free descent does not involve kicking upward to get myself down any faster like freedivers. I just sink down at the same rate as every other diver.

Maybe next time, I will try all the variations of equalization,

Don't know if it was related, but a few days after coming back from 28 dives over 5 1/2 days, everything sounded far away, when I try to equalize, sounds like gurgling sound in my ear and felt like a slight onset of vertigo. Also felt real weak and tired. Took dramaline and toughed it out until it disappeared in a week or so. Felt like the flu with no bacterial infection. Must have caught a viral infection somewhere.

Based on what you've written in this thread, my impression is that your quick descents to depths greater than 30 fsw (ostensibly performed to avoid ear pain) are actually leading to some middle ear barotrauma. This only has to occur once and, from that point on (while on vacation), you will experience ear pain upon descent and "ear squishiness"/muffled hearing while topside.

Some people just require more time to equalize their ears during descent. Descend slowly and under control. If it takes 30 seconds to descend 1 foot, then that's the preferred descent rate for you. Discuss all of this with your buddy ahead of time so that he/she knows what to expect once you're in the water.

FWIW, muffled hearing is one common symptom that's associated with middle ear barotrauma.

Differential diagnosis of middle ear barotrauma vs. otitis externa (outer ear infection) is not always so straightforward. When in doubt, schedule an appointment with a health care professional. A simple ear exam with an otoscope would probably reveal whether any damage has been done to your eardrum. Depending on the diagnosis, the physician should be able to give you treatment options. For mild cases of middle ear barotrauma featuring "squishiness" in the ear, decongestants can be helpful.

scubadobadoo:

sharp pains from my forehead straight down the back of my eye and to my teeth while diving. It sucks. Some of us are more prone to sinus issues than others. I take a nice long acting sudafed the morning before any dive where I feel even slightly congested. 2 different diver friendly doctors have suggested the same to me. It helps but can only do so much in some cases so calling the dive may be best.

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Had this very issue diving in the Keys back in April. Was worse when I went head down and lessened when I went vertical with head up. Sure enough, a month after returning, I had a full blown sinus infection and was taking anti-biotics. I'm pretty sure I had the early stages of a sinus problem due to spring allergies and the diving aggravated them. Not taking any chances in a few weeks when I hit OBX. Making sure I take both my 12 hour Zyrtec-D and my 24 hour Flonase spray with me.

Lwang:

...28 dives over 5 1/2 days, everything sounded far away, when I try to equalize, sounds like gurgling sound in my ear and felt like a slight onset of vertigo. Also felt real weak and tired. Took dramaline and toughed it out until it disappeared in a week or so. Felt like the flu with no bacterial infection. Must have caught a viral infection somewhere.

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Be careful. 5 dives a day on vacation can really take a toll on more than just your ears. Slow down those descents and ascents, stay hydrated, get sleep, eat as healthily as possible or as one can on vacation and try to stay more shallow. That's a lot of (literally) pressure on your body and it will take a toll. I'm not saying you were bent but I doubt it was a viral infection. I like to dive dive dive on vacation too so I understand.

Cixelsyd:

Had this very issue diving in the Keys back in April. Was worse when I went head down and lessened when I went vertical with head up. Sure enough, a month after returning, I had a full blown sinus infection and was taking anti-biotics. I'm pretty sure I had the early stages of a sinus problem due to spring allergies and the diving aggravated them. Not taking any chances in a few weeks when I hit OBX. Making sure I take both my 12 hour Zyrtec-D and my 24 hour Flonase spray with me.

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Nothing worse than feeling this pain on your first dive of a week long vacation and suddenly realizing that you are gonna spend more time on the beach than you thought. Ugh.

Are you new to diving? Or do yo dive once in awhile? Or you dive a few days or so every once in awhile. These dive profiles can have an affect. Your system needs to relax more on those dives where the pain starts. This usually occurs within the 10m/33ft 2ATA range. As pressure is high in this range. As you ascend past this depth it gets better.

Change the dive profile to have a greater SI between dives and descend slow, equalize, etc. If you get too sensitive abort the dive. As the swelling can ruin your diving day. Avoid medication unless prescribed by a diving physician.Rest a day to dive another day

Have fun and enjoy.