If you cannot clear your ears and they hurt on descent, what should be your initial action?

When experiencing ear pain during descent due to an inability to equalize ear pressure, the most appropriate initial action is to level off or ascend if possible. This approach helps alleviate the pressure differential that is causing discomfort. Leveling off or ascending allows the pressure in the middle ear to equalize with the cabin pressure more comfortably, as descending further can exacerbate the situation and cause additional pain or injury to the ears.

This initial response prioritizes the safety and well-being of the individual by reducing the risk of barotrauma, which can happen if the pressure in the ears cannot equalize due to blockage or other issues. By halting the descent or climbing to a higher altitude where the pressure is lower, you give your body a chance to adjust without causing more pain or potential damage.

In contrast, diverting to an airfield or taking medication while continuing the descent may not address the immediate need to equalize ear pressure, and descending more rapidly could worsen the ear pain and risk injury, making these options less suitable.