Spray Afrin nasal decongestant spray twice into each nostril one hour prior to flying. Begin taking a decongestant, like Sudafed, one hour before the flight. Both of these medications can be purchased over-the-counter in a drug store.
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If you have any allergy or cold-related symptoms, make sure you take an antihistamine or decongestant spray at least 30-45 minutes before your flight. Following this method can help alleviate any additional sinus pressure.
For frequent fliers, surgically placed tube in the eardrums is generally helpful to aid fluid drainage in the middle air, particularly for those who are prone to severe airplane ear. This tube helps in ventilating air to the middle ear, and equalize the pressure between the outer and middle ear.
It's all due to pressure changes. As the plane starts to lose height, the pressure in the air around you changes. Until the pressure inside the tubes behind your eardrum adapts, the pressure inside and outside your ear is different.