If you have mucous in your sinuses (and/or ears) the sudden changes in pressure can result in sharp pains. In that case, a decongenstant (psuedofed) or an antihistamine (claritan, benadryl) can help.

You might also be pressure sensitive - which can also happen as you get older (or when an infant).

It can also be due to severe dryness. In that case, saline spray is a better option than the above drugs, which will just dry you out.

You can try the same remedy that works for brain freeze - press your thumb on you upper soft palate - that stimulates nerves which turn off the pain response. Perhaps not in public. There are also accupressure magnets (these go on parts of your ear lobes and are small an unobtrusive) which can work for headaches if you get them in right place, and certainly can't hurt.

Thanks for this. The flight was basically fine, although I was pretty nervous the whole time. Took a decongestant and used nasal spray, plus kept the Ear Planes in the entire flight.

I'll keep in mind the pressure on the soft palate--willing to try anything! Hopefully, though, this is only something I'm going to need to do if congested. I fly at least 50K miles a year, and would like to be able to keep doing so without courting pressure-related panic attacks and pain.