Why does ear pain come and go. What are the most frequent reasons for intermittent ear discomfort. How can you identify the source of recurring ear pain. When should you seek medical attention for ear pain that comes and goes.

Earwax Buildup: A Common Culprit for Intermittent Ear Pain

Earwax, while generally beneficial, can sometimes lead to discomfort when it accumulates excessively. This natural substance, produced by the body to protect and clean the ears, can occasionally cause problems if it builds up and hardens, resulting in what medical professionals refer to as impacted wax.

Can earwax buildup cause intermittent ear pain. Indeed, when earwax becomes impacted, it can lead to periodic discomfort in the ear canal. This pain may come and go as the wax shifts or as external factors, such as changes in humidity or pressure, affect the impacted wax.

Symptoms of Earwax Buildup

• Ear pain that fluctuates in intensity
• Sensation of fullness in the ear
• Temporary hearing loss
• Tinnitus (ringing in the ears)
• Itching or discharge from the ear

Is it safe to remove earwax at home. While it may be tempting to use cotton swabs or other objects to clean your ears, this practice can actually push the wax further into the ear canal, exacerbating the problem. Instead, consider using over-the-counter ear drops designed to soften wax, allowing it to naturally drain from the ear.

For stubborn cases of impacted earwax, it’s best to consult a healthcare professional. They can safely remove the wax using specialized tools and techniques without risking damage to the delicate structures of the ear.

Air Pressure Changes: A Trigger for Intermittent Ear Discomfort

Changes in air pressure can significantly impact ear comfort, often leading to intermittent pain or discomfort. This phenomenon is particularly noticeable during air travel, rapid elevation changes, or even when experiencing congestion from a cold or allergies.

How does air pressure affect the ears. The eustachian tubes, which connect the middle ear to the back of the throat, play a crucial role in equalizing pressure on both sides of the eardrum. When these tubes don’t function properly or when pressure changes occur too rapidly, it can result in ear pain, a feeling of fullness, or temporary hearing loss.

Situations That May Cause Pressure-Related Ear Pain

1. Flying in an airplane, especially during takeoff and landing
2. Driving through mountainous regions
3. Scuba diving or freediving
4. Using elevators in tall buildings
5. Experiencing significant weather changes

How can you alleviate pressure-related ear pain. Several techniques can help equalize ear pressure and reduce discomfort:

• Yawning or swallowing frequently
• Chewing gum or sucking on hard candy
• Performing the Valsalva maneuver (gently blowing out while pinching your nostrils closed and keeping your mouth shut)
• Using filtered earplugs designed for air travel
• Staying awake during airplane descent to actively manage pressure changes

For individuals prone to ear pressure issues, it’s advisable to avoid air travel or diving when experiencing cold symptoms, sinus infections, or allergies, as these conditions can exacerbate pressure-related discomfort.

Swimmer’s Ear: An Outer Ear Infection Causing Recurrent Pain

Swimmer’s ear, medically known as otitis externa, is an infection of the outer ear canal that can cause significant discomfort. Despite its name, this condition isn’t exclusive to swimmers; it can affect anyone exposed to excessive moisture in the ear.

What causes swimmer’s ear. This infection typically occurs when water becomes trapped in the ear canal, creating a moist environment that promotes bacterial growth. While swimming is a common cause, other factors such as excessive cleaning with cotton swabs, humid climates, or skin conditions like eczema can also contribute to its development.

Identifying Swimmer’s Ear

How can you tell if you have swimmer’s ear. Look out for these symptoms:

• Pain that worsens when touching or pulling on the outer ear
• Itching inside the ear canal
• Redness and swelling of the outer ear
• Drainage of clear, odorless fluid
• Muffled hearing or temporary hearing loss

Is swimmer’s ear contagious. No, swimmer’s ear is not contagious. However, the bacteria or fungi causing the infection can spread in communal water sources, potentially affecting others who use the same facilities.

Prevention and Treatment

How can you prevent swimmer’s ear. Consider these preventive measures:

1. Dry your ears thoroughly after swimming or bathing
2. Use earplugs when swimming
3. Avoid inserting foreign objects into your ears
4. Use a swim cap to keep water out
5. Consider using over-the-counter ear drops designed to prevent swimmer’s ear after water activities

What is the treatment for swimmer’s ear. If you develop swimmer’s ear, your healthcare provider will likely prescribe antibiotic ear drops to clear the infection. In some cases, they may also recommend pain relievers or anti-inflammatory medications to manage discomfort and swelling.

Middle Ear Infections: A Frequent Source of Recurring Ear Pain

Middle ear infections, or otitis media, are among the most common causes of ear pain, particularly in children. These infections occur in the space behind the eardrum and can lead to significant discomfort and hearing issues.

What triggers middle ear infections. These infections often develop as a complication of upper respiratory conditions such as colds, allergies, or sinus infections. When the eustachian tubes become blocked or dysfunctional, fluid can accumulate in the middle ear, creating an environment conducive to bacterial or viral growth.

Recognizing Middle Ear Infections

How do you know if you have a middle ear infection. Look for these symptoms:

• Ear pain, often severe
• Difficulty hearing or muffled sounds
• Fever
• Feeling of fullness in the ear
• Dizziness or balance problems
• Fluid drainage from the ear (in case of eardrum rupture)

Are middle ear infections more common in children. Yes, children are more prone to middle ear infections due to their shorter, more horizontal eustachian tubes, which can more easily become blocked.

Treatment Approaches

How are middle ear infections treated. The approach depends on the severity and cause of the infection:

1. Watchful waiting: For mild cases, especially those likely caused by viruses, a wait-and-see approach may be recommended.
2. Antibiotics: If bacteria are suspected, or if symptoms are severe or persistent, antibiotics may be prescribed.
3. Pain management: Over-the-counter pain relievers can help alleviate discomfort.
4. Decongestants or antihistamines: These may be recommended to help clear the eustachian tubes.
5. Ear tubes: In cases of chronic or recurrent infections, surgical insertion of ear tubes may be considered to improve drainage.

Can untreated middle ear infections lead to complications. Yes, if left untreated, middle ear infections can potentially lead to more serious issues such as hearing loss, eardrum perforation, or spread of infection to surrounding tissues.

Referred Pain: When Ear Discomfort Originates Elsewhere

Ear pain doesn’t always stem from issues within the ear itself. In many cases, discomfort felt in the ear can actually originate from other parts of the head, neck, or jaw. This phenomenon, known as referred pain, occurs due to the complex network of nerves that connect these areas.

Why does pain from other areas manifest as ear discomfort. The trigeminal nerve, which is responsible for sensation in the face, and the vagus nerve, which extends from the brain to the abdomen, both have branches that innervate the ear. When these nerves are irritated or stimulated in other areas, the brain can interpret the signals as coming from the ear.

Common Sources of Referred Ear Pain

• Dental issues: Tooth infections, impacted wisdom teeth, or jaw misalignment
• Temporomandibular joint (TMJ) disorders
• Throat infections: Tonsillitis, pharyngitis, or peritonsillar abscess
• Neck problems: Cervical spine disorders or muscle tension
• Salivary gland infections or tumors

How can you differentiate between true ear pain and referred pain. While it can be challenging, there are some clues:

1. Associated symptoms: Referred pain often comes with other symptoms in the source area, such as toothache, sore throat, or jaw discomfort.
2. Pain characteristics: Referred pain may feel more diffuse or radiate across a broader area.
3. Triggers: Pain that worsens with specific movements (like chewing for TMJ issues) may indicate a referred source.
4. Ear examination: A healthcare provider may find no apparent issues with the ear itself.

Is referred ear pain serious. While referred ear pain isn’t typically an emergency, it’s important to identify and address the underlying cause. Some conditions causing referred pain, such as dental abscesses or certain throat infections, can become serious if left untreated.

Temporomandibular Joint (TMJ) Disorders: A Hidden Cause of Ear Pain

Temporomandibular joint (TMJ) disorders are a group of conditions affecting the joint that connects your jawbone to your skull. These disorders can cause a wide range of symptoms, including ear pain, which is often mistaken for a primary ear problem.

How does TMJ cause ear pain. The temporomandibular joint is located very close to the ear canal and shares nerve connections with the surrounding area. When this joint is inflamed or dysfunctional, it can lead to pain that feels like it’s coming from the ear itself.

Identifying TMJ-Related Ear Pain

What are the signs that ear pain might be TMJ-related. Look for these accompanying symptoms:

• Clicking or popping sounds when opening or closing the mouth
• Jaw pain or tenderness
• Difficulty or discomfort while chewing
• Facial pain or aching
• Locking of the jaw joint
• Headaches, particularly around the temples

Can TMJ disorders cause other ear symptoms besides pain. Yes, TMJ issues can sometimes lead to tinnitus (ringing in the ears), a feeling of fullness in the ears, or even vertigo-like symptoms.

Managing TMJ-Related Ear Pain

How can TMJ-related ear discomfort be alleviated. Several approaches can help:

1. Applying hot or cold packs to the jaw area
2. Practicing gentle jaw exercises and stretches
3. Using over-the-counter pain relievers or anti-inflammatory medications
4. Wearing a nightguard to prevent teeth grinding during sleep
5. Adopting stress-reduction techniques, as stress can exacerbate TMJ issues
6. Avoiding hard or chewy foods that strain the jaw

When should you seek professional help for TMJ-related ear pain. If home remedies don’t provide relief or if symptoms persist or worsen, it’s advisable to consult a dentist or healthcare provider specializing in TMJ disorders. They may recommend additional treatments such as physical therapy, prescription medications, or in severe cases, surgical interventions.

Serious Causes of Ear Pain: When to Seek Immediate Medical Attention

While many causes of ear pain are benign and can be managed at home, some situations require prompt medical evaluation. Recognizing the signs of potentially serious conditions is crucial for preventing complications and ensuring appropriate treatment.

What are some serious causes of ear pain. Several conditions can lead to severe or concerning ear pain:

• Mastoiditis: An infection of the mastoid bone behind the ear
• Malignant otitis externa: A severe infection that can spread to surrounding tissues
• Cholesteatoma: An abnormal skin growth in the middle ear
• Temporal arteritis: Inflammation of blood vessels near the temples
• Tumors: Rarely, growths in or near the ear can cause pain
• Cellulitis: A bacterial skin infection that can affect the ear area
• Herpes zoster oticus (Ramsay Hunt syndrome): A viral infection affecting facial nerves

Red Flags: When to Seek Immediate Care

How do you know if ear pain requires emergency attention. Watch for these warning signs:

1. Severe pain that doesn’t respond to over-the-counter pain relievers
2. Sudden hearing loss accompanying the ear pain
3. High fever (over 102°F or 39°C) along with ear pain
4. Dizziness, vertigo, or loss of balance
5. Facial weakness or paralysis
6. Swelling or redness extending from the ear to the face or neck
7. Blood or pus draining from the ear
8. Ear pain following a head injury

Can delaying treatment for serious ear conditions lead to complications. Yes, prompt treatment is essential for potentially serious ear conditions. Delaying care can lead to complications such as:

• Permanent hearing loss
• Spread of infection to surrounding tissues or bones
• Meningitis (in severe cases of untreated ear infections)
• Facial nerve damage
• Chronic pain or discomfort

What should you do if you suspect a serious ear condition. If you experience any of the red flag symptoms mentioned above, or if you’re uncertain about the severity of your condition, it’s best to err on the side of caution. Seek medical attention promptly, either through your primary care physician, an urgent care center, or the emergency department, depending on the severity and timing of your symptoms.

Remember, while many cases of ear pain are not emergencies, being aware of the signs of serious conditions can help you make informed decisions about when to seek professional medical help. Early intervention can often prevent more serious complications and lead to better outcomes in treating ear-related issues.

Why Does My Ear Hurt? 7 Possible Causes of Ear Pain

Written by Stacey Jones, MS, BA

• Earwax
• Air Pressure
• Swimmer’s Ear
• Middle Ear Infection
• Other Causes

Parents know how common earaches are in children, but adults can get frequent ear pain, too. You don’t have to have an infection, or even anything wrong with your ears, to have ear pain.

These are the most common causes:

Your ear makes and gets rid of wax all the time. When the process doesn’t work well, the gunk builds up and hardens so your ear canal gets blocked. Your doctor will call this impacted wax. Sometimes, it causes pain.

Don’t use cotton swabs or other objects to try to get wax out. You’ll just push it farther into your ear canal and make it more likely to get impacted. Your ear might hurt, itch, discharge gunk, or get infected. You could even lose your hearing for a while.

You can treat mildly impacted ears at home with over-the-counter ear drops that soften the wax so it can naturally drain. Or go see your doctor if the wax has hardened. She can get the wax out without damaging the eardrum. Learn more about earwax.

Most of the time, your ear does a great job of keeping pressure equal on both sides of your eardrum. That little pop you feel when you swallow is part of the process. But quick changes, like when you’re on an airplane or in an elevator, can throw off the balance. Your ear might hurt, and you could have trouble hearing. This is typically a eustachian tube dysfunction which can be a chronic in some people.

To avoid problems on a plane:

• Chew gum, suck on hard candy, or yawn and swallow during takeoff and landing.
• Stay awake while the plane descends.
• Take a deep breath, pinch your nostrils shut, then gently try to blow air out of your nose.
• Avoid air travel and diving when you have a cold, a sinus infection, or allergy symptoms.

Learn more about air pressure and your ears.

If your ear hurts when you pull on your earlobe or push on the tiny flap that closes it, you probably have this outer ear infection. You get it when water trapped in your ear canal begins to breed germs. Your ear might get red, swollen, or itch and leak pus. It isn’t contagious. To avoid it, keep your ears dry during and after swimming. Your doctor will probably prescribe antibiotic ear drops to clear it up. Learn more about swimmer’s ear.

A cold, allergies, or a sinus infection can block the tubes in your middle ear. When fluid builds up and gets infected, your doctor will call it otitis media. This is the most common cause of ear pain. If your doctor thinks the cause is a bacteria, she may prescribe antibiotics. If not, then she may recommend a decongestant allergy treatment with an antihistamine and a nasal steroid. Let her know if your pain doesn’t improve or returns. If it isn’t treated, a middle ear infection can spread or cause hearing loss. Learn more about ear infection treatments.

You may feel pain in your ears even when the source is somewhere else in your body, like a toothache. That’s because the nerves in your face and neck pass very close to your inner ear. Doctors call this type of pain that starts in one area but is felt in another “referred pain.”

If your earache comes with a severe sore throat, it could be an infection like tonsillitis or pharyngitis. In fact, ear pain is often the worst symptom of one of these conditions. Learn more about sore throat symptoms.

Tooth abscesses, cavities, and impacted molars also can cause ear pain. Your doctor will be able to tell if your teeth are to blame by tapping on a tooth or your gums to see if they feel sore. Learn more about toothaches.

The temporomandibular joint, or TMJ, is the “hinge” of your jaw that sits directly below your ears. You might get TMJ pain from grinding your teeth, or it could be a symptom of arthritis. The ache in your ears or face comes after you chew, talk, or yawn. To treat it, take over-the-counter pain medicine and put warm compresses on your jaw. Try not to clench your teeth. You may benefit from using a mouth guard when you sleep. This can help ease the tension that causes ear pain. Eating soft foods will help, too. Learn more about causes of jaw pain.

Some causes of ear pain can be serious such as tumors or infections, including cellulitis or shingles. If your ear pain is severe, doesn’t go away within a few days of home treatment, or comes with a high fever or sore throat, or you get a new rash, visit your doctor right away for treatment and to rule out something more serious.

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Swimmer’s Ear (Otitis Externa): Causes, Diagnosis, Treatment

Written by WebMD Editorial Contributors

• Why Do People Get Swimmer’s Ear?
• What Are the Symptoms of Swimmer’s Ear?
• How to Diagnose and Treat Swimmer’s Ear
• Swimmer’s Ear Complications
• When to Call Your Doctor

If you’re like a lot of folks, you probably think of swimmer’s ear as an unwelcome souvenir of a beach vacation. And while the painful ear condition is often linked to a dunk in the ocean or the pool, the truth is you can get it on dry land, too.

No matter how you got your swimmer’s ear, once you learn to recognize the signs, you have plenty of options to treat it.

Swimmer’s ear, which has the medical name of otitis externa, is an infection in your ear canal. That’s the tube that runs from the hole on the outside of your ear to your eardrum.

Swimmer’s ear is different from the common ear infection that your young child often gets after a cold. Those are middle ear infections, or “otitis media” in doctor speak, and they happen deeper in the ear, behind the eardrum.

Usually, swimmer’s ear is caused by bacteria, but it can sometimes be brought on by a virus or fungus. Symptoms you may get are:

• Itchiness in the ear
• Pain, which can become severe
• Trouble hearing (sound may seem muffled as your ear canal swells)
• Fluid or pus draining out of the ear

Here’s one way to tell which type of ear infection you have. If it hurts when you tug or press your ear, you may have swimmer’s ear.

Most of the time, your ear fights off the germs that cause swimmer’s ear on its own. You can thank your earwax for that. While it doesn’t get much respect, earwax helps protect the ear canal from damage and makes it hard for germs to grow.

But if the skin gets scratched, germs can get into your ear canal and cause an infection. Some common reasons you may get swimmer’s ear are:

Sticking stuff in your ear. If you use cotton swabs, fingers, hairpins, pen caps, or anything else to clean your ears, it can rub away the protective earwax or scratch your skin. Even ear buds, earplugs, and hearing aids can have this effect, especially if you use them a lot.

Moisture trapped in your ear. When water gets stuck in your ear canal after swimming — or after you soak in a hot tub or even take a shower or bath — it can remove some of the earwax and soften the skin, which makes it easier for germs to get in.

Humid weather and sweat can cause the same problem. Germs like a warm, wet place to grow, so moisture trapped in your ear is perfect for them.

Other things can play a role in swimmer’s ear, like:

Your age. While swimmer’s ear can happen to anyone, it’s most common in kids and early teenagers.

Narrow ear canals. Kids often have ear canals that are small and don’t drain as well.

Skin reactions and conditions. Sometimes hair products, cosmetics, and jewelry can irritate your skin and raise the odds of getting swimmer’s ear. So can skin problems like eczema and psoriasis.

Whether you got your swimmer’s ear after a dunk in the pool or because an infection set in while you were on dry land, the symptoms are the same. You may notice things like:

• Itchy feeling inside your ear
• Pain in the ear, which can be severe
• Your ear hurts when you move your head or gently pull on your earlobe
• Tenderness inside your ear
• Fluid drains out of the ear
• A bad-smelling, yellowish discharge from the ear
• You don’t hear as well (things sound muffled)

If you have ear pain, don’t wait — see your doctor right away. Getting treatment quickly can stop an infection from getting worse.

During your appointment, your doctor will look in your ear and may gently clean it out. This will help treatments work better.

Then, you’ll probably get eardrops that may have antibiotics, steroids, or other ingredients to fight the infection and help with swelling. In some cases, you may need to take antibiotic pills, too.

Most of the time, swimmer’s ear starts to feel better within 2 days of starting treatment. But sometimes, it can get worse or lead to other problems, such as:

Long-term swimmer’s ear (chronic otitis externa). This is when swimmer’s ear doesn’t go away within 3 months. It can happen if you have hard-to-treat bacteria, fungus, allergies, or skin conditions like psoriasis or eczema. Your doctor may need to test a sample of any fluid in your ear to help you decide on the best treatment.

Other infections. Sometimes, the bacteria can spread deeper into your skin or to other parts of your body. One rare condition is malignant otitis externa, which happens when the infection moves into bone and cartilage in your head. It’s a medical emergency, and it’s most common in older people with diabetes and people with HIV or other immune system problems.

Treatment for these infections is with more powerful antibiotics, either by mouth or through a needle (IV).

Always check with your doctor if you see any signs of an ear infection. Call if you feel dizzy or have ringing in your ears, which means you may have a more serious problem that needs to get checked out.

Also call your doctor if you have:

Severe pain. They can suggest medicine that can give you relief.

Rash on your scalp or near your ear. You may have seborrheic dermatitis or herpes zoster (shingles). Your doctor can recommend treatment.

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Ear pain: causes, types, treatment

Ear pain is a common problem that can affect both adults and children. A qualified doctor should deal with the problem, usually an otolaryngologist (ENT), but in some cases, the intervention of other specialists (neurologist, therapist, dentist, etc.) may be required.

Types of pain in the ears

Depending on the cause, ear pain can be of a different nature: develop abruptly or gradually, be mild or severe. Pain can be both constant and periodic, shooting in nature. The pain may be described by the patient as dull, aching, or burning. Ear pain may be accompanied by hearing loss, noise or crackling in the ears; may radiate to the jaw, teeth, or temple.

If an adult is able to independently distinguish and describe painful sensations that disturb him, then a child, especially of a younger age, is not capable of this. Therefore, parents should be wary if the child lies on the side of the diseased ear, rubs it with his hand, shakes his head. First of all, this applies to children who have ARVI, because otitis media is a common complication of colds.

Causes of ear pain

More often than not, ear pain is caused by an inflammatory process called otitis media. The development of otitis media usually provokes a viral, bacterial or fungal infection, it can be a complication of diseases of the nose (for example, sinusitis) or throat, previous respiratory illness or trauma. The same reasons can cause eustachitis – inflammation of the mucous membrane of the auditory tube, which is also accompanied by pain.

Earache is often caused by accumulations of wax in the ear canal – wax plugs, discomfort in which can vary from minor discomfort to severe pain in the ear. In such cases, the ENT performs a flush, removing the sulfuric plug.

A common cause of ear pain is a foreign body in the ear – this is especially true for young children who tend to push small objects into their ears or nose. The removal of a foreign body from the ear is carried out only by a doctor; self-extraction is strictly prohibited, as it threatens to injure the ear. Also, the cause of pain in the ear may be the ingress of liquid (for example, water when bathing).

Ears often hurt due to injuries, which can be either mechanical (shocks, penetration of foreign bodies) or barotrauma – a sharp increase in pressure (for example, very loud sounds, pops, explosions).

Ears may also hurt:

• due to inflammation of nearby lymph nodes;
• trigeminal neuralgia;
• dental problems;
• temporomandibular joint lesion;
• mastoiditis;
• high blood pressure.

Which doctor treats ear pain?

Diagnosis and treatment is carried out by an otolaryngologist (ENT), who during the consultation analyzes the patient’s complaints, conducts an examination, collects an anamnesis, and, if necessary, prescribes additional studies. He determines the causes of ear pain and deals with its treatment, if the cause is an otolaryngological disease. If the pain is provoked by neurological, vascular or dental diseases, he refers to a specialized specialist. It can be a neurologist, dentist, internist or cardiologist.

Diagnosis and treatment of ear pain

To make a diagnosis, an examination is performed, in some cases an ear swab may be taken, and a blood test may also be ordered. Additional examinations may be useful if the pain is of dental, neurological, or vascular origin. All laboratory studies necessary to diagnose the causes of ear pain can be quickly and efficiently carried out in the Medlab laboratory. Flushing and physiotherapy procedures may be prescribed.

For most patients, outpatient treatment is sufficient, only in severe cases hospitalization is carried out in a hospital. However, even at home, treatment should be carried out only under the supervision of a physician. Self-treatment of ear pain can lead to a deterioration in the patient’s condition, up to complete hearing loss.

Ear hurts

Arthritis

Otitis

Labyrinthite

Mastoiditis

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Ear hurts – the causes of the appearance, in which diseases it occurs, diagnosis and methods of treatment.

Ear pain can be caused by diseases of different parts of the hearing organ, nearby organs, head injuries, and can also appear due to the spread of pain from other parts of the body. Such pain is caused by inflammatory, skin, neurological, dental, rheumatic, infectious pathologies.

The nature of such pain does not explain the cause of the disease. The doctor should evaluate the results of laboratory and instrumental examinations in order to clarify the diagnosis.

Types of pain in the ears

Most often, these pains are the result of otitis media – a disease of the outer, middle or inner ear.

Mastoiditis, arthritis of the temporomandibular joint, inflammation of the cervical lymph nodes – these are pathologies of nearby organs that often cause ear pain.

Ear pain can occur due to the spread of pain along the cranial nerves. For example, a toothache radiates through the auditory branch of the trigeminal nerve to the ears.

Traumatic rupture of the eardrum is the cause of ear pain due to damage from falls, blows to the head.

We will talk about the diseases that most often cause ear pain.

Possible causes

Mastoid pain

Mastoiditis, that is, purulent inflammation of the bone tissue of the mastoid process of the temporal bone, located behind the auricle, is the most characteristic complication of otitis media and a frequent consequence of its improper treatment.

Pain in otitis externa

Otitis externa is an inflammation of the outer ear, which consists of the auricle, the external auditory canal and the tympanic membrane separating it from the middle ear. The main symptom of the disease is a boil – a purulent inflammation of the hair follicle that captures the sebaceous gland. Sometimes boils can appear after cleaning the ears too hard, when microtraumas form on the skin of the ear canal, through which the infection penetrates.

Pain in otitis media

Behind the tympanic membrane begins the middle section of the organ of hearing. It is a small, air-filled space in the temporal bone between the external auditory meatus and the inner ear.

There are three tiny bones here: the hammer, anvil, and stirrup. The eardrum vibrates under the influence of acoustic waves. The vibrations are transmitted to the bones. Through the oval window separating the middle and inner ear, the stirrup sends a signal to the fluid that fills the inner ear – the perilymph.

Otitis media begins as a complication not of otitis externa, but of acute respiratory infections, influenza, tonsillitis.

With these ailments, an excess amount of mucus is formed, which enters the Eustachian tube. The Eustachian tube connects the middle ear to the nasopharynx and equalizes air pressure in both directions. If this organ becomes inflamed, eustacheitis develops – a frequent companion of otitis media.

Pain in otitis media

Otitis media is also called labyrinthitis, because the inner ear is called a labyrinth because of its peculiar shape. Its main function is to conduct sound waves and convert them into electrical impulses for the brain. The cochlea, which is part of the labyrinth, belongs to the organ of hearing. The other two parts – the vestibule of the cochlea and the semicircular canals – to the organ of balance.

Labyrinthitis is usually a complication of otitis media.

Less commonly, this disease occurs as a result of microtrauma through the tympanic membrane and middle ear with sharp objects, which are sometimes recklessly cleaned ears, or as a result of damage to the temporal bone during head injuries.

What diseases occur

Mastoid pain

Ear pain is very severe, often covering half of the head on the side of the lesion, aggravated at night.

The remaining symptoms of mastoiditis occur in severe otitis media. These are noise in the ear, severe hearing loss, fever, a significant deterioration in the general condition, suppuration from the ear, detected during otoscopy.

Pain in otitis externa

The pain gradually increases as the follicle matures, it can radiate to the jaw, neck, intensify when chewing and pressing on the tragus – a cartilaginous protrusion on the outer ear. The pain is accompanied by itching, a feeling of fullness in the ear. Hearing may deteriorate, body temperature may rise.

Pain in otitis media

Pulsating, aching, shooting, often radiating to the teeth and back of the head, earache usually appears with fever. Ear pain with otitis externa and otitis media is easy to distinguish. In the first case, it intensifies if you press on the tragus, in the second it remains unchanged.

Pain due to labyrinthitis

Such pain in the ear is accompanied by hearing loss, nausea and vomiting, dizziness, headaches, staggering when walking, involuntary twitching of the muscles of the eyeball.

Diagnostics and examinations

Pain in otitis externa

Otoscopy – examination of the external auditory canal and eardrum by an ENT doctor using specialized instruments.

Pain in otitis media

Hearing assessment using an audiometric examination, including tuning fork tests. These are tests with tuning forks, which make it possible to determine whether hearing loss is associated with inflammation in the middle ear or with damage to the auditory nerve. Bacterial culture from the middle ear is performed to determine sensitivity to an extended spectrum of antimicrobials, radiography or CT of the temporal bone, as well as tympanometry, in which the mobility of the tympanic membrane is assessed.

Pain associated with labyrinthitis and mastoiditis

Audio and vestibulometric examinations, bacterial culture from the middle ear with the determination of sensitivity to an extended spectrum of antimicrobials, radiography or CT of the temporal bone.

The procedure in which the doctor removes material from the middle ear cavity for analysis is called tympanocentesis. This method, performed after local anesthesia, is also used to pump out pus from the middle ear cavity.

What should be done when pain occurs?

If you experience ear pain, see your doctor right away.

If the pain is accompanied by fever and hearing loss, do not go outside, call a doctor at home.

Which doctors should I contact?

Inflammatory skin diseases that cause otitis externa can be treated by a general practitioner or surgeon, but it is better to consult an ENT doctor. And only this specialist should treat otitis media and mastoiditis. An ENT doctor and a neurologist will help in the treatment of labyrinthitis.

Treatment

Mastoid pain

The basis of the treatment of mastoiditis, as well as labyrinthitis, is antibiotic therapy, which is prescribed only by a doctor. Depending on the severity of the disease, operations are used: puncture of the eardrum to ensure the outflow of pus; mastoidectomy (rarely) – removal of pus from the air cells of the mastoid process.

Pain in otitis externa

The treatment of otitis externa is based on the use of drops, ointments, creams containing antiseptics in combination with anti-inflammatory and analgesic components. According to indications, surgical treatment is used (opening of mature boils).

Pain in otitis media

Drops with anti-inflammatory and analgesic effects are instilled into the ears, vasoconstrictor drops are instilled into the nose, reducing swelling of the nasopharynx and pharyngeal mouth of the Eustachian tube, and reducing the formation of mucus. The doctor may prescribe antibiotics. In the case of advanced otitis media, a puncture of the eardrum is used to free the middle ear cavity from pus.

Pain due to labyrinthitis

Labyrinthitis is treated only in a hospital by an otolaryngologist and a neurologist, and, if necessary, by an infectious disease specialist and a neurosurgeon. In addition to antibiotic therapy, a labyrinthotomy operation is often needed. This is the name of the opening by the surgeon of the semicircular canals of the ear labyrinth to ensure the outflow of pus and stop the infection from entering the cranial cavity.

Sources:

1. Clinical guidelines “Otitis externa” (children). Developed by: Union of Pediatricians of Russia, National Medical Association of Otorhinolaryngologists, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy. – 2021.
2. Clinical guidelines “Otitis externa” (adults). Developed by: National Medical Association of Otorhinolaryngologists. – 2021.
3. Clinical recommendations “Otitis media acute”. Developed by: National Medical Association of Otorhinolaryngologists. – 2021.
4. Clinical guidelines “Chronic otitis media”. Developed by: National Medical Association of Otorhinolaryngologists. – 2021.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment.