When your plane is descending, the tube behind your eardrum is forced to work overtime to adjust to the rapidly changing air pressure.

“It’s opening and trying to equalize the pressure, which is why almost everyone feels some popping in their ears,” says Jennifer Derebery M.D., otolaryngologist and president of House Clinic in Los Angeles.

But sometimes—especially if you’re sick or are dealing with allergies—popping alone isn’t enough to equalize the pressure. Sometimes, congestion can cause a vacuum to form in your middle ear.

The vacuum actually sucks in your eardrum, which can result in serious ear pain or a headache, Dr. Derebury says.

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