Ear barotrauma treatment in Phuket
Pressure that will not equalise, on a descent or under water, and the pain that follows. Ear barotrauma treatment in Phuket matters for divers and for anyone flying with a blocked nose, and the first question is always whether the eardrum is still intact.
What is actually happening
The middle ear is a sealed air space connected to the throat by the eustachian tube. Pressure changes have to be equalised through that tube.
When it is blocked — by a cold, an allergy, or inflammation — pressure cannot equalise and the eardrum is pulled or pushed against, which causes pain and eventually damage.
Descending is worse than ascending, both in aircraft and under water, because the pressure change works against the tube rather than with it.
How it presents
Pain during descent, a blocked or full feeling, muffled hearing and sometimes ringing.
In the worse cases: bleeding from the ear, sudden relief of pain accompanied by discharge, dizziness or vertigo, and hearing loss.
Sudden severe vertigo underwater is dangerous in itself, because a disoriented diver at depth is a diver in trouble.
Diving, where it matters most
Most divers experience mild barotrauma at some point. It becomes a problem when somebody forces a descent through a blocked ear rather than aborting it.
Equalise early and often, starting at the surface and continuing every metre or so. If it will not clear, ascend slightly and try again. If it still will not clear, the dive is over.
Never dive with a cold, and never use decongestants to get through one — they wear off at depth and produce a reverse block on the way up, which is worse.
Flying with it
A head cold and a descending aircraft is the commonest cause seen here, and it is why so many people arrive off a flight in pain.
Decongestants started the day before, a nasal spray used shortly before descent, and swallowing, yawning or chewing through the descent.
Where an ear is genuinely blocked and a flight is imminent, treatment plus a written opinion is worth having — see pre-flight medical checks.
Children suffer worst on descent because their tubes are narrower and more horizontal. Something to suck or drink through the last twenty minutes does more than any amount of telling them to yawn.
Examining it
The eardrum is looked at directly, which is the only way to distinguish mild congestion from fluid behind the drum, bleeding into it, or a perforation.
That distinction determines everything that follows, including which drops are safe. Antibiotic drops that are fine on an intact drum are not fine through a perforation.
Hearing is checked where there has been any loss, and anything not recovering is referred.
The treatment
Decongestants, nasal steroid sprays and antihistamines where allergy is part of the picture, to open the tube.
Analgesia, properly dosed. Antibiotics only if there is infection rather than simply pressure damage.
Most cases settle over days to a couple of weeks. A perforation usually heals on its own within six to eight weeks with the ear kept scrupulously dry.
A perforated eardrum
Sudden relief of severe pain, followed by discharge, is the classic sequence and people often think they are getting better.
Nothing in the ear, nothing in the water, and no drops except those specifically safe for a perforation. Cotton wool and petroleum jelly for showering.
No diving until it has healed and been confirmed healed, and no flying without an assessment — see fit to fly certificates.
When it is decompression illness instead
Joint pain, tingling, numbness, weakness, unusual fatigue, a mottled rash or confusion after diving is not barotrauma and is an emergency.
Inner ear decompression illness in particular produces vertigo and hearing loss and can be mistaken for a simple ear squeeze.
That needs recompression treatment. Ring 1669 and give oxygen if it is available — see emergency medical care.
Sinus barotrauma
The same physics applies to the sinuses. Blocked sinuses on descent produce severe pain across the forehead or cheeks, and sometimes a nosebleed.
Treatment is much the same: decongestants, steroid sprays, and not descending through a blockage.
Recurrent sinus problems on every flight or dive are worth investigating rather than tolerating.
A deviated septum, chronic allergy or nasal polyps sit behind a good proportion of it, and all three are treatable. People who assume they simply have bad ears are frequently people with an untreated nose.
Getting back in the water
Only when the drum is intact, the ear equalises normally on land, and there is no residual fluid, dizziness or hearing loss.
That means being examined rather than deciding for yourself, because the drum cannot be assessed from the outside.
Dive schools here will usually want a written clearance, which is issued after examination — see medical certificates.
Where to be seen
Bang Tao, Kata and Patong, at any hour, with otoscopy on the spot rather than a referral to have somebody look tomorrow.
A doctor can attend your accommodation with the same equipment — see doctor hotel visits.
Anything suggesting decompression illness is treated as an emergency and moved immediately — see hospital transfer.
Bring the dive computer or the logged profile if there is one. Depth, time and ascent rate change the assessment substantially, and reconstructing a dive from memory an hour later is far less reliable than people believe it is.
Frequently asked questions
Why does my ear hurt after diving?
Pressure that did not equalise, usually because the eustachian tube was blocked. The eardrum needs looking at to see how far it went.
Can I dive with a cold?
No. And do not use decongestants to get through one — they wear off at depth and cause a worse reverse block on the way up.
How do I equalise properly?
Start at the surface and continue every metre or so. If it will not clear, ascend slightly and try again. If it still will not, the dive ends.
The pain stopped suddenly and my ear is running.
That is the classic sequence for a perforated eardrum. Keep it completely dry and get it examined — the drops matter.
How long does a perforation take to heal?
Usually six to eight weeks on its own, with the ear kept scrupulously dry and nothing put into it.
Is this decompression sickness?
If there is joint pain, tingling, weakness, unusual fatigue or confusion after diving, treat it as such. Ring 1669 and give oxygen if available.
Can I fly with a blocked ear?
It is painful and can perforate the drum on descent. Treat it first, and get an assessment if the flight is imminent.
When can I dive again?
Once the drum is intact, the ear equalises on land, and there is no fluid, dizziness or hearing loss. That requires examination, not self-assessment.
Three clinics, none of which close
English-speaking doctors, on duty 24 hours a day. Phuket is bigger than visitors expect and the traffic is worse than the map suggests, so Takecare Medical Clinic works from three separate buildings rather than one: Bang Tao on the north-west coast, Kata in the south, and Patong between them. Each is open every hour of every day, takes people without an appointment, and asks nothing about residency or referrals.
Beyond the island, Takecare Medical Clinic is one of the Takecare Clinic group‘s clinics working across Phuket, Krabi and Chon Buri. That matters mainly for what happens afterwards: move on mid-treatment and the next clinic already holds the notes, so a handover is a call between colleagues rather than a folder you carry through an airport.
Getting seen, and how to choose a branch
There is somebody on the end of +66 81 718 9080 or WhatsApp 24 hours, every day. Say what has gone wrong and the reply will be honest about which of three things you are dealing with: come in now, this will keep until the morning, or skip us entirely and go where there is a surgeon. No appointment exists to be made, and there is no hour at which asking is a nuisance.
Pick whichever branch is nearest rather than whichever sounds largest — they run the same hours and carry the same equipment. Patong suits the west-coast beaches and Bangla Road, Kata covers Karon and the south, and Bang Tao serves Layan, Surin and Cherngtalay. Cannot get out to a clinic? Ask for a doctor hotel visit instead and somebody comes to your room. And if what you need turns out to be beyond any clinic, referral and hospital transfer is arranged from the same conversation. You are made stable before anybody moves you, a colleague rings ahead so the team on the other end knows what is arriving, and the transport is organised for you rather than handed over as one more thing to sort out.