If you have been diagnosed with migraine, chances are you’ve experienced migraine ear pressure. That more than uncomfortable feeling of fullness and pressure in your ears. Like you have water trapped in your ears and you can’t release it. Worse is when ear pressure fluctuates so it feels or even sounds like bubbling or popping or a fluttering feeling in your ear making it nearly impossible to ignore. These ear pressure fluctuations may cause hearing to become distorted. You may even experience temporary & fluctuating hearing loss with migraine ear pressure changes.
Like most migraine symptoms, frequency & severity can vary. For those with classic migraine, ear pressure often comes just before or during an attack. For those with migraine variants like vestibular migraine, it can be a daily persistent symptom that occurs even between attacks. But, there is no migraine rule book so persistent ear fullness is not found solely in migraine variants. Ear pressure sensations can vary from feeling like someone is holding onto your ear to deep inner ear fullness. Sensations can occur in the outer, middle or inner ear.
While Migraine Strong writes about the latest in migraine treatments, this is not medical advice. We are patient educators and all information you read should be discussed with your doctor
What is migraine ear pressure?
Migraine is not a headache. We’ve been taught to think of migraine as head pain, but the truth is that migraine attacks present as a vast and varied collection of symptoms. Head pain can be hideous and debilitating for some, but for others, headache is not even a significant part of their migraine disease. Migraine ear pressure, tinnitus, vertigo, fluttering in the ear, temporary paralysis, or aphasia etc. may be more prominent symptoms. Migraine is a complaint in ENT practices so often that some believe the diagnostic criteria for migraine does not align with it’s diverse presentation. As someone diagnosed with vestibular migraine that presents outside of textbook diagnostic criteria, I agree.
Is ear fluttering & migraine ear pressure eustachian tube dysfunction?
Let me start by saying migraine ear pressure and sensations of ear fluttering, fullness and popping and the distorted sounds that come with them are not usually a eustachian tube problem. It definitely feels like eustachian tube dysfunction, but typically the eustachian tube continues to function normally. Similar to the way migraine can make your teeth hurt even though your teeth are healthy. And migraine can make you feel like you have sinus congestion, even when there is no sinus issue present. Migraine can make you feel like you have eustachian tube dysfunction even when you don’t.
Migraine variant symptoms like ear pressure and fluttering are often described as being a result of central sensitization from a hyper-responsive, hyper-excitable, sensitive migraine brain. But what does that actually mean? Dr. Teixido, board certified Neurotologist at ENT & Allergy of Delaware says (The brains of) people without migraine disease can adapt to sensory stimulus such as barometric changes, light, noise, strong smells, movement etc. within minutes. Effectively turning stimulus off and moving it into the background. But, for those of us with migraine, our brains don’t easily adapt.
What causes migraine ear pressure?
Let’s say you’re eating at an outdoor café with a friend on a beautiful, sunny day. You both see traffic going by and hear construction noise in the distance. Your friend can quickly ignore the noise, bright light and moving traffic. Her brain turns it off. But because you have migraine, the stimulus of the light, movement and noise continues to build. It’s a progressive assault on your senses that may even make it difficult for you to focus on or engage in conversation.
And outside sensory input isn’t the only trouble maker here. Physiological stimulus like hormones, illness, sleep, stress, hunger, dehydration, exercise and pain are difficult for us to regulate as well. Throw food triggers into that mix and according to Dr. Teixido, instead of adapting, the irritation of the stimulus continues to build and grow until it ends in crisis also known as a migraine attack. This is the reason many of us retreat to a quiet, dark room during our worst attacks. We need to turn off sensory input and soothe our sensory integration system to effectively abort attacks.
How does migraine cause ear symptoms?
A faulty sensory integration system or hyper-responsive brain in migraine causes multi-sensory symptoms, not just a headache. Stay with me here. We actually have more than five senses, but referring back to our kindergarten knowledge of our sensory systems think of multi-sensory migraine symptoms like this…
- Eyes- Light sensitivity, tearing, red or bloodshot eyes & visual aura.
- Ears- Sound sensitivity, tinnitus, ear fullness, pain, pressure & popping. Fluctuating hearing loss & dizziness.
- Nose- Fragrance and odor sensitivity, congestion, runny nose, sinus pain & phantom smells.
- Mouth- Food taste changes, tongue or face numbness, teeth aching, language difficulty & jaw trouble.
- Touch- Allodynia, ticks & twitches, temporary paralysis etc.
The symptom list above is not meant to be comprehensive but to demonstrate how multi-sensory sensitivities lead to multi-sensory symptoms.
The relationship between migraine and ear disease
Getting back to migraine ear pressure specifically, there is increasing evidence of a connection between migraine and inner ear disease. The blood vessels that feed the tiny inner ear are connected to the same larger branches of blood vessels associated with migraine. As a result, the inner ear may suffer its own migraine attack symptoms often seen in vestibular migraine (Dr. Texiedo). Migraine attacks may result in temporary changes to normal inner ear function like tinnitus or ear pressure that occurs only during an attack. Newer theories suggest migraine attacks can result in long lasting injury to the delicate inner ear causing ongoing tinnitus, migraine ear pressure or a fluttering sensation in your ear. This is of particular interest to me since I developed Meniere’s Disease four years after my vestibular migraine diagnosis.
Half of Meniere’s disease patients also suffer from migraine according to Dr. Shin Beh in his book Victory over Vestibular Migraine. Being aware of possible associations like this is important because they stress the need to treat migraine attacks as early as possible to reduce the possibility of long term damage. Migraine isn’t typically thought of as a neurological disease that can leave behind lasting damage, but the relationship between Meniere’s Disease and Vestibular Migraine points to the need for more research in this area.
What can I do about migraine ear pressure?
The first place you should always start if you are experiencing ear pressure is in a doctor’s office. Meniere’s disease, allergies, fungal ear infection, acoustic neuroma, having a foreign object stuck in your ear and yes even migraine are just some of the many possibilities that cause ear pressure. There are many more possible causes behind this awful sensation. Receiving a proper diagnosis will help you implement an effective treatment plan to find the most relief. Proper treatment really depends on cause. So even if you have migraine, always, always see your doctor first.
How to relieve migraine ear pressure
Reliable treatments that have been used effectively for years to treat classic migraine head pain are generally effective against atypical symptoms of migraine as well. That means migraine ear pressure can be treated with migraine preventative and abortive medications. In fact, even those who have ear pressure caused by other conditions such as Meniere’s Disease may improve this symptom with migraine treatment.
Proven migraine preventative supplements can also help improve migraine ear pressure. Particularly magnesium. Your goal in life if you have migraine is to keep your hyper-responsive brain calm and magnesium works to help that happen by blocking the excited pain pathway in the brain. In addition to migraine preventative and abortive medications there are other treatment strategies that may help improve ear pressure symptoms.
Over the counter treatment options
The following over the counter treatments are recommended by members of our Migraine Strong facebook group who experience migraine ear pressure. Over the counter and natural treatment suggested here should be discussed with and approved by your doctor before implementing.
- Ibuprofen- My personal treatment plan includes Advil every four hours until symptom reduction occurs.
- Allergy medication- Many reported relief from allergy medications such as Zyrtec & Flonase- Be aware this one is on the list of medications that may make migraine worse.
- Decongestants like Claritin D, Mucinex & Afrin bring relief for some.
- Ear Plugs that regulate inner ear pressure can help too. Best if you’re triggered by barometric pressure.
Natural Treatment options
- Hydration– This is the first line of treatment in Eastern medicine and is very effective in regulating inner ear pressure.
- Lower salt intake- Sodium holds fluid. Eating less may reduce pressure. Check out this article from The Vertigo Doctor for great tips to reduce your salt intake.
- Migraine diets like Keto or Heal Your Headache– Help lower migraine attack thresholds and calm down hyper-responsive migraine brains.
- Ginger or turmeric to reduce inflammation.
- Ginko Biloba, Lemon Bioflavonoids or Vinpocetine- Dilate blood vessels and increase blood flow in the tiny vessels in the ear bringing relief. The Lemon bioflavonoid linked also contains quercetin which reduces inflammation.
- CBD– Some users reported relief from the use of CBD. Likely because it helps to calm the central nervous system. Save 10% on CBD linked with code STRONG10
- Peppermint oil behind the ears- Works to change the focus of the sensation.
- Deep breathing exercises– I’m picturing your eye roll here. But, this may be the single most important strategy on this list as regulating your central nervous system is key to calming down a hyper-responsive brain. Slow, intentional, deep breathing helps your brain compensate for a faulty sensory integration system. The same way vestibular rehab therapy helps your brain compensate for dizziness. Deep breathing is therapy for your central nervous system.
How to pop your ears safely
As discussed above migraine ear pressure and sensations of fluttering are not really a eustachian tube problem, but may make you feel the need to pop your ears. You can safely open your eustachian tubes the following ways.
- Chew- Chewing gum or crunchy foods.
- Suck- Suck on hard candy or drink through a straw.
- Swallow- Swallowing naturally opens your eustachian tube.
- Yawn- Forcing a yawn can pop your ears as well.
If you feel an urgency to pop your ears please do this gently through the techniques listed above. There are no other techniques to release pressure in your ears that are safe to try at home. I’m cringing even mentioning the following techniques, but I do see them mentioned in support groups so they should be addressed. Holding your nose and blowing is dangerous and can perforate your ear drums or push fluid into your middle ear. Unless directed by a doctor avoid putting anything into your ears including devices that suck and blow air. No putting your palm over your ears and pumping in an attempt to force pressure changes. All of these techniques can be dangerous and do long lasting damage to your middle or inner ear. I beg you, not to try them. Yawn, chew, suck and swallow only.