Ear Pain: Causes, Symptoms, Diagnosis and Treatment

Ear pain (otalgia) commonly occurs in children, but it can also happen in adults. Pain that begins inside the ear is known as primary otalgia, whereas pain that originates outside the ear is known as secondary otalgia.

    Ear Pain

    Ear pain can arise gradually or all of a sudden. The pain can feel dull, sharp, or burning, and can be temporary or ongoing. Usually, the pain arises in only one ear, but sometimes it can appear in both ears.

    Signs and Symptoms of Ear Pain

    Symptoms that can accompany ear pain include:

    • Fever
    • Drainage from the ear
    • Hearing loss
    • Headache
    • Difficulty chewing
    • Jaw pain
    • Clicking or popping
    • Fussiness and irritability (in children)
    • Increased crying (in children)
    • Loss of appetite (in children)

    Causes and Risk Factors of Ear Pain

    Ear pain is often caused by a blockage in the eustachian tube, the passageway that extends from the middle ear to the back of the nasal cavity and the throat. When the eustachian tube is blocked, air and fluid can’t flow through the passageway, causing a buildup of pressure and pain.right up arrow
    Ear infections are a common cause of ear pain, especially in children. Middle ear infections, called otitis media, occur when fluids build up in the tubes inside the middle ear.right up arrow This fluid can then become infected by a bacteria or virus.
    Children are more likely to get ear infections than adults, in part because their eustachian tubes are smaller and straighter, which makes it harder for fluid to drain out. Their immune systems are also still developing, which makes them more susceptible to infections.right up arrow
    Swimmer’s ear — also known as otitis externa (infection of the outer ear and ear canal) — can be caused by unclean water that gets stuck in the outer ear canal after swimming, creating an ideal environment for infection-causing bacteria.right up arrow
    Ear pain can be caused by scratching the inside of the ear with a finger, cotton swab, or other object.right up arrow

    Other possible causes of ear pain include:

    • Allergies
    • Sinus infection
    • Sore throat
    • Tooth infection
    • Buildup of earwax
    • Ruptured eardrum
    • Altitude pressure changes (barotrauma)
    • Temporomandibular joint syndrome (TMJ, or problems with the joint that connects your jaw to the side of your head)
    • Arthritis of the jaw
    Ear infections usually aren’t the main cause of ear pain in adults. Rather, the pain may stem from a problem such as TMJ.

    How Is Ear Pain Diagnosed?

    A doctor can diagnose ear pain based on your symptoms and medical history. They will also likely examine your ears, nose, and throat with an otoscope (an instrument with a light) to check for redness and other symptoms in order to find the cause of your ear pain.right up arrow
    To diagnose an ear infection, a doctor can also use the otoscope to blow a puff of air against the eardrum to see if it’s moving normally.right up arrow
    Prognosis of Ear Pain
    The prognosis of ear pain depends on the cause. Ear infections, for example, tend to clear up on their own within a week or two.right up arrow
    A ruptured eardrum also tends to heal by itself within a few months. The prognosis tends to be good; rarely, long-term hearing loss and symptoms like dizziness and vertigo can occur.right up arrow
    Duration of Ear Pain
    Ear pain often goes away on its own within a few days, and your doctor may wait a few days before prescribing an antibiotic. Once you start antibiotics for an infection, you should see improvement within two to three days.right up arrow
    Treatment and Medication Options for Ear Pain
    The treatment for ear pain often depends on what’s causing the problem. Common treatments include medication, surgery, and home remedies.

    Medication Options

    To reduce ear pain, your doctor may recommend over-the-counter (OTC) drugs such as Tylenol (acetaminophen) or ibuprofen (Advil, Motrin). Your doctor may also recommend OTC ear drops to relieve the pain, but these should never be used if there’s a chance the eardrum has ruptured.right up arrow
    Antibiotics are sometimes prescribed for ear infections, but in many cases, they aren’t necessary. In children, antibiotics such as amoxicillin may be used to treat ear infections that are severe or last for more than a few days.right up arrow
    A buildup of earwax in the ear canal can cause an earache. Still, never stick anything into your ear — including a cotton swab, which will just push the wax deeper into the ear instead of removing it. Excessive earwax should be diagnosed and treated by a healthcare professional.

    Home Remedies and Alternative and Complementary Therapies

    Many people experience ear pain and mild hearing loss or muffling due to sudden changes in air pressure, such as when they’re traveling on an airplane, taking an elevator, or diving to the bottom of a swimming pool. When this occurs, swallowing repeatedly — for example, by chewing gum or sucking on hard candy — can help clear your ears.right up arrow (This kind of ear pain is usually temporary and rarely leads to lasting problems.)
    A cold compress can help relieve ear pain. Place a cold pack or wet washcloth on the affected ear for about 20 minutes.right up arrow Both hot and cold packs can be used to ease the symptoms of TMJ (as can stress-reduction techniques or mouth guards).right up arrow
    Instead of lying flat, try resting with your head propped up. This can help ease the pressure in the middle ear

    What Are the Possible Complications of Ear Infections?

    A review of studies published in February 2016 in the journal Medicine considered a number of complementary and alternative treatments for pediatric otitis media, including homeopathy, phytotherapy, xylitol (a sugar alcohol), vitamin D supplements, and probiotics. Researchers found that there may be some benefits to these therapies, but evidence is limited and more research is needed.

    Surgery Options

    Children who are prone to earaches from ear infections may need to have a surgical procedure in which a small tube is inserted into the eardrums to prevent fluid buildup. Short-term tubes usually last about 6 to 9 months before falling out on their own.right up arrow
    Long-term tubes are larger and secured in place.
    Prevention of Ear Pain
    Ear pain isn’t always preventable, but there are some things you can do to reduce your risk of ear injuries and ear infections.

    Keep all foreign objects out of your ears, and always dry your ears after swimming, showering, or bathing. You can also wear a bathing cap, earplugs, or use custom-fitted swim molds when swimming.right up arrow
    If you smoke, quit; likewise, try to avoid secondhand smoke, which has been linked to ear infections in children.right up arrow
    One good step to stay healthy is to get a flu vaccine every year.right up arrow Children should get the pneumococcal vaccine as well, since the bacteria Streptococcus pneumoniae can cause middle ear infections.right up arrow
    Complications of Ear Pain
    The complications of ear pain largely depend on what’s causing the problem.

    Ear infections such as swimmer’s ear can lead to an infection that spreads to areas surrounding the ear; this condition, called malignant otitis, can be serious, requiring high doses of antibiotics and urgent medical attention.

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