The causes of ear pain range from minor issues to serious problems. Children often experience frequent earaches, but adults can have them, too.
Causes of ear pain
Middle ear infection
A middle ear infection, usually just called an ear infection, is a common cause of ear pain. It occurs when fluid gets trapped in the middle ear. Normally, the Eustachian tube allows this fluid to drain, but sometimes that tube gets blocked. If the fluid is trapped in the ear for too long, it can get infected with bacteria.
Blockage of the Eustachian tube
Congestion from allergies, colds, and sinus infections can block your Eustachian tubes, preventing fluid from draining from the middle ear. Sometimes this can cause ear pain even with no infection present.
Outer ear infection (swimmer's ear)
Swimmer's ear is an infection that occurs when water doesn't fully drain from the canal that runs between your outer ear and your eardrum. This often occurs if water gets stuck in your ear after swimming, hence the name.
You can also get it from irritation of the skin in this part of the ear. That may occur from putting things in your ear, like a finger or a cotton swab.
Another name for swimmer's ear is an outer ear infection or otitis externa.
Air Pressure Changes (ear barotrauma)
Ear barotrauma happens when the air pressure changes rapidly. Many people experience this during and after flying in an airplane.
Normally, the air pressure remains the same inside and outside the ear. When you swallow and yawn, your ear "pops," equalizing the pressure between the inner and outer ear. This is one of the functions of the Eustachian tube.
However, when the air pressure changes rapidly, the Eustachian tube may not be able to keep up, leading to discomfort. Additionally, if your Eustachian tube is blocked due to congestion, you may experience barotrauma without any pressure changes. If that is the case, you are also more likely to experience barotrauma in situations with air pressure changes like flying or scuba diving.
Earwax, also called cerumen, is an important substance for ear health. It moisturizes our ears, preventing them from getting itchy. It also helps to keep infections at bay. But sometimes, too much earwax can cause a blockage leading to ear pain.
When ear pain also comes with a sore throat, you may have tonsillitis — an infection of the tonsils. It could also be pharyngitis, the medical term for a sore throat that can be a sign of another infection like strep throat.
Other Serious Health Issues
In rare cases, ear pain may be a sign of a more serious health problem like a tumor or cellulitis.
When to see a doctor for ear pain
You should see a doctor if:
- Your ear pain is very bad
- You have a high fever
- You have a sore throat
- You also have a rash
- Ear pain doesn't go away after a few days of home treatment
Diagnosis for ear pain
In general, doctors will first look in your ears, nose, and throat with an otoscope, a lighted magnification device. They may also test your hearing by rubbing their fingers together next to your ear. If further tests are needed, they may do any of the following:
- Use a pneumatic otoscope to send a puff of air into the eardrum. If the eardrum has no movement, that means there is fluid behind it and you likely have an ear infection.
- Use a tympanometry machine, to measure just how much your eardrum can move.
- Perform acoustic reflectometry to find out how much sound your eardrum absorbs and reflects.
- Take a sample of the fluid from your eardrum to test it for microorganisms that may cause infections. This procedure is called tympanocentesis.
Treatments for ear pain
The treatment for ear pain depends on the cause.
You can treat a minor earwax blockage at home with an over-the-counter kit. Your doctor may prescribe medication if you have chronic earwax buildup or blockages.
Air pressure changes
- Take a decongestant before flying if you have nasal congestion
- Chew gum
- Swallow frequently
- Try to make your ears pop
- Use special ear plugs that help to slow down the pressure changes, reducing the symptoms of barotrauma
While scuba diving:
- Make your ears pop before and during your descent
- Descend feet first
- Slowly ascend if you have ear pain to prevent ear injuries
Doctors usually prescribe antibiotics. They may be ear drops or an oral medication. In some cases, they may prescribe antifungal medicines or steroids if needed.
Middle ear infection
The treatment for this is also usually antibiotics. However, doctors may wait for two to three days before prescribing them to see if the body's immune system will fight the infection on its own.
Doctors may place an artificial tube in the ear to help it drain in people with chronic ear infections.
Before you see a doctor, you can try treating your ear pain at home. If these methods don't work after two to three days, seek medical attention.
Cleveland Clinic: "3 Home Remedies for an Ear Infection."
Harvard Health Publishing, Harvard Medical School: "Earache."
Kidshealth: "What's Earwax."
Mayo Clinic: "Ear infection (middle ear)."
Mayo Clinic: "Earwax blockage."
Mayo Clinic: "Swimmer's ear."
University of Michigan: "Blocked Eustachian Tubes."
U.S. National Library of Medicine: MedlinePlus: "Earache."
U.S. National Library of Medicine: MedlinePlus: "Ear barotrauma."
U.S. National Library of Medicine: MedlinePlus: "Pharyngitis - sore throat."
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Swimmer's Ear (External Otitis)
Swimmer's ear (external otitis) is an infection of the skin that covers the outer ear canal.
Causes of swimmer's ear include excessive water exposure that leads to trapped bacteria in the ear canal. Symptoms of simmer's include a feeling of fullness in the ear, itching, and ear pain. Chronic swimmer's ear may be caused by eczema, seborrhea, fungus, chronic irritation, and other conditions.
Common treatment includes antibiotic ear drops.
A perforated (ruptured, punctured) eardrum (tympanic membrane) is a hole or tear in the eardrum. The eardrum separates the ear canal and middle ear. Most ruptured eardrums do not cause pain, however, the condition can be uncomfortable. Bacteria, viral, and fungal infections are the most common causes a ruptured eardrum. Earwax removal attempts, changes in air pressure, and trauma are other causes of a ruptured eardrum.
If you have a ruptured eardrum you may have symptoms like:
- Ear pain
- Partial or full hearing loss
- A mucousy or pus-like blood-tinged discharge from you ear
- Bleeding from the ear
- Ringing in the ear
- Middle ear infection
Most people do not need medical treatment for a ruptured eardrum, however, some may need surgery depending upon the cause and size of the hole in the eardrum.
REFERENCE: Cleveland Clinic. "Ruptured Eardrum (Perforated Tympanic Membrane)." Updated: Aug 208, 2014.
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