The Valsalva Manoeuvre for Ear Health: Technique, Risks, and Benefits

The Valsalva manoeuvre primarily targets the Eustachian tubes, which connect the middle ear to the back of the throat. These tubes play a vital role in regulating air pressure and draining fluids from the middle ear.

When the Eustachian tubes become blocked or fail to function correctly, you may experience symptoms such as:

• Ear pain
• Muffled hearing
• Difficulty equalising pressure during altitude changes, like when flying.

The Valsalva manoeuvre works by increasing the pressure in the nasopharynx. The nasopharynx is the top part of your throat, behind your nose, just above the roof of your mouth.²

Increasing the pressure in your nasopharynx in turn pushes air into the Eustachian tubes. This equalises the pressure on both sides of the eardrum, providing relief and restoring normal function.

To safely perform the Valsalva manoeuvre, follow these steps:

1. Sit or stand upright and take a deep breath.
2. Close your mouth and pinch your nostrils closed using your fingers.
3. Gently and slowly exhale while keeping your mouth and nose closed.
4. You should feel pressure in your ears or a popping sensation as air enters the Eustachian tubes.
5. Release the pressure and inhale slowly to complete the manoeuvre.

Apart from the Valsalva manoeuvre, several other techniques can help decongest ears and drain fluid from the Eustachian tube:

1. Yawning or swallowing: These actions help open the Eustachian tubes and regulate pressure.
2. Chewing gum or sucking on hard candy: Similar to yawning or swallowing, these actions encourage the Eustachian tubes to open.
3. Nasal decongestants: Over-the-counter nasal decongestant sprays or oral medications may temporarily relieve congestion, facilitating fluid drainage.
4. Nasal steroids: Best of the congestion is due to allergies.
5. Grommets or ventilation tubes: In severe cases, having a ventilation tube inserted into the eardrum will help to drain fluid and relieve pressure.³

During the Valsalva manoeuvre, there is a transient increase in blood pressure and heart rate.

This is a normal physiological response as a result of increased intrathoracic pressure (pressure in your chest) while straining.

However, the duration of these changes is typically short-lived, with the blood pressure and heart rate returning to their normal levels. Thus, the Valsalva does not pose significant risks to healthy individuals.⁴

While the Valsalva manoeuvre is generally safe, certain individuals should exercise caution or avoid performing it altogether. These include:

1. Individuals with a history of ear trauma or recent ear surgery.
2. People with a known or suspected perforated eardrum.
3. Those experiencing severe ear pain or acute ear infection.
4. Individuals with a medical condition that affects blood pressure, such as hypertension or cardiovascular disease.

Although the Valsalva manoeuvre is generally considered safe, there are some risks associated with its improper execution or use in certain medical conditions. These risks include:

1. Ear damage: Forceful or excessive application of pressure during the manoeuvre can potentially cause damage to the delicate structures of the ear.
2. Ruptured eardrum: Individuals with a pre-existing perforated eardrum are at increased risk of further damage or rupture.
3. Pain or discomfort: If the manoeuvre is performed incorrectly or forcefully, it can lead to ear pain or discomfort.

The Valsalva manoeuvre is a useful technique for relieving ear congestion and equalising pressure in the Eustachian tubes. When performed correctly and in appropriate circumstances, it can help alleviate symptoms and promote ear health.

However, it is essential to exercise caution, follow the proper technique, and avoid the manoeuvre in specific medical conditions to minimise potential risks.

1. MedlinePlus. (2021). Ear barotrauma. Retrieved from: https://medlineplus.gov/ency/article/001064.htm on 6 June 2023.
2. American Academy of Otolaryngology - Head and Neck Surgery. (2017). Valsalva Maneuver. Retrieved from: https://www.enthealth.org/conditions/valsalva-maneuver/ on 6 June 2023.
3. Orvidas, L. (2022). Plugged Ears: What is the Remedy. Retrieved from https://www.mayoclinic.org/diseases-conditions/common-cold/expert-answers/plugged-ears/faq-20058092 on 12 June 2023. 
4. Valsalva Maneuver. (2022). Retrieved from https://my.clevelandclinic.org/health/treatments/23209-valsalva-maneuver on 12 June 2023.

_{The information contained in this article is for educational and informational purposes only. You should not use the information as a substitute for, nor should it replace, professional medical advice. If you have any questions about your health, you should always consult with a physician or other health-care professional.}