Barotrauma occurs when environmental pressure changes too quickly for the body to keep up. In the case of the ear, the eustachian tube that connects the ear to the nose and throat is responsible for balancing the pressure. Barotrauma can thus also result from problems with the eustachian tube, nose, or upper throat. Being hit on the ear can cause similar problems by changing the ear's internal pressure. Barotrauma causes pain and damage when the expanding or contracting gas pushes or pulls too hard on the enclosing membranes.