What are the common symptoms of an earache. How can you identify the underlying causes of ear pain. What are effective treatments for various types of earaches. When should you seek medical attention for ear discomfort.

Understanding Earaches: More Than Just a Pain in the Ear

An earache is a common medical condition characterized by pain in one or both ears. This discomfort can manifest in various ways, from a dull throb to a burning sensation or sharp stabs. While earaches can affect individuals of any age, they are particularly prevalent among children. In some cases, the pain can be intense and disorienting, potentially accompanied by temporary hearing loss.

The origin of ear pain isn’t always limited to the ear itself. Sometimes, the discomfort can stem from other parts of the body, making diagnosis and treatment a bit more complex. Understanding the nature of earaches, their symptoms, causes, and treatment options is crucial for effective management and relief.

Recognizing Earache Symptoms: Key Signs to Watch For

Identifying an earache involves recognizing a set of common symptoms. These can vary in intensity and combination, depending on the underlying cause and individual factors.

• Sharp or dull pain in one or both ears
• Difficulty hearing due to fluid buildup or blockage
• Ear discharge (otorrhea)
• Jaw pain
• Sore throat
• Itching in or around the ear
• Redness and swelling of the ear area

Children experiencing earaches may exhibit additional symptoms, often related to infections:

• Fever
• Irritability and restlessness
• Headache
• Loss of appetite
• Disorientation
• Tendency to scratch or pull at the ears

The Anatomy of Ear Pain: Understanding the Three Ear Regions

To comprehend the various causes of earaches, it’s essential to understand the structure of the ear. Medical professionals divide the ear into three distinct regions: the outer ear, middle ear, and inner ear. Each of these areas can be the source of ear pain, with different factors contributing to discomfort in each region.

Outer Ear Pain: Causes and Concerns

The outer ear comprises the visible part of the ear and the ear canal. Common causes of outer ear pain include:

• Sunburn on the ear
• Skin infections or irritations
• Physical injury or trauma, particularly to the eardrum
• Excessive earwax buildup
• Foreign object penetration
• Water retention in the ear canal (swimmer’s ear)

Middle Ear Discomfort: Infections and Pressure Problems

The middle ear, located behind the eardrum, houses the tiny bones responsible for transmitting sound waves. Middle ear pain often results from:

• Viral or bacterial infections
• Eustachian tube blockage, interfering with pressure equalization

Inner Ear Issues: Beyond Pain to Balance

The inner ear contains the cochlea and vestibular system, crucial for hearing and balance. Inner ear problems can cause:

• Tissue inflammation
• Viral or bacterial infections
• Labyrinthitis, leading to vertigo rather than typical ear pain

Beyond the Ear: Other Sources of Ear Pain

Interestingly, not all ear pain originates within the ear itself. Several conditions affecting nearby areas can manifest as ear discomfort:

• Temporomandibular joint (TMJ) disorders
• Sinusitis
• Toothaches and impacted teeth
• Throat inflammations
• Cranial nerve inflammations
• Tinnitus (ringing in the ears)
• Mastoid infections
• Thyroid disease
• Rapid changes in air pressure (e.g., during flights or scuba diving)

Treating Earaches: From Home Remedies to Medical Interventions

While many earache symptoms resolve on their own as the body heals from infection or injury, there are several strategies to alleviate discomfort during the recovery process.

Home Remedies for Ear Pain Relief

• Over-the-counter pain medications (ibuprofen, acetaminophen, or aspirin for those 16 and older)
• OTC eardrops
• Keeping ears dry during bathing or showering
• Sitting and sleeping upright to reduce eardrum pressure
• Applying warm or cold compresses to the ears
• Chewing gum to relieve ear pressure
• For infants, feeding to distract from discomfort

When to Seek Medical Attention

Is your ear pain severe or accompanied by a high fever? Medical intervention may be necessary if ear pain is intense or associated with a fever of 101°F (38.3°C) or higher. In such cases, a healthcare provider might:

• Prescribe eardrops or antibiotics for infection-related pain
• Flush out ear wax or other buildup
• Treat related medical conditions (e.g., TMJ disorders)
• Refer you to an otolaryngologist (ENT specialist) for advanced treatment

Advanced Treatments: When Standard Approaches Aren’t Enough

In some cases, particularly for chronic or severe ear issues, more advanced treatments may be necessary. Otolaryngologists can provide specialized care for complex ear problems, including:

• Treatment for ruptured eardrums
• Myringotomy: A surgical procedure involving the insertion of small tubes in the ear to improve drainage and pressure equalization

Myringotomy has proven particularly effective in treating children with recurrent ear infections, providing long-term relief and preventing complications.

Preventing Earaches: Proactive Measures for Ear Health

While not all earaches are preventable, certain practices can reduce the risk of developing ear pain or infections:

• Practicing good hygiene, especially hand washing
• Avoiding exposure to secondhand smoke
• Maintaining up-to-date vaccinations
• Breastfeeding infants when possible (it boosts immunity)
• Using earplugs during swimming or when exposed to loud noises
• Avoiding the use of cotton swabs or other objects to clean ear canals

Earaches in Children: Special Considerations

Children are particularly susceptible to earaches, especially middle ear infections. This vulnerability is due to their shorter, more horizontal Eustachian tubes, which can more easily become blocked. How can parents help children cope with ear pain?

• Encourage rest and plenty of fluids
• Use age-appropriate pain relievers as recommended by a pediatrician
• Apply a warm compress to the affected ear
• Elevate the child’s head while sleeping
• Monitor symptoms closely and seek medical attention if pain persists or worsens

For children with recurrent ear infections, a pediatrician might recommend preventive measures such as long-term, low-dose antibiotics or the surgical insertion of ear tubes.

The Impact of Lifestyle on Ear Health

Do your daily habits affect your ear health? Certain lifestyle factors can influence the likelihood of experiencing earaches or ear-related issues:

• Smoking: Increases the risk of ear infections and can exacerbate existing ear problems
• Diet: A balanced diet rich in vitamins A, C, and E supports overall ear health
• Stress: Chronic stress can weaken the immune system, potentially increasing susceptibility to ear infections
• Sleep: Adequate sleep is crucial for maintaining a strong immune system
• Exercise: Regular physical activity can boost overall health, including ear health

By making conscious lifestyle choices, individuals can potentially reduce their risk of ear-related issues and promote better overall ear health.

When Earaches Persist: Chronic Ear Pain and Its Implications

What happens when ear pain becomes a recurring issue? Chronic ear pain, defined as discomfort lasting more than three months, can have significant impacts on quality of life. It may indicate underlying conditions such as:

• Chronic otitis media (middle ear infection)
• Cholesteatoma (abnormal skin growth in the middle ear)
• Meniere’s disease
• Acoustic neuroma

Persistent ear pain warrants thorough medical evaluation to identify and address the root cause. Treatment approaches for chronic ear pain may involve a combination of medications, lifestyle modifications, and in some cases, surgical interventions.

The Future of Earache Treatment: Emerging Research and Innovations

As medical science advances, new approaches to diagnosing and treating earaches are emerging. What innovations are on the horizon for ear health?

• Gene therapy for hereditary hearing loss
• Improved diagnostic tools for more accurate and rapid identification of ear infections
• Novel antibiotic delivery systems for more targeted treatment of ear infections
• Advanced cochlear implant technologies for severe hearing loss
• Stem cell research for regenerating damaged ear tissues

These developments hold promise for more effective, personalized treatments for various ear conditions, potentially revolutionizing the management of earaches and related disorders.

Understanding earaches, their causes, and treatment options empowers individuals to take proactive steps in maintaining ear health. While many earaches resolve on their own or with simple home remedies, it’s crucial to recognize when professional medical attention is necessary. By staying informed and attentive to ear-related symptoms, you can ensure optimal ear health and overall well-being for yourself and your loved ones.

What Is An Earache? Causes, Symptoms & Treatment

What Is an Earache?

An earache is a medical condition involving pain in one or both ears. The origin of that pain may be the ear itself or another part of the body. Earache pain can take a variety of forms: a regular dull throb, a burning sensation, or occasional sharp stabs. Earaches have been linked to a wide range of medical issues and concerns. They can occur at any age but are most common in children. 

In extreme cases, earache pain can be intense, disorienting, and associated with hearing loss, usually temporary. If you or your child is suffering from an earache, visit your nearest Baptist Health Urgent Care location.

Signs and Symptoms

Earache signs and symptoms typically include:

• Sharp or dull pain in one or both ears
• Difficulty hearing (due to fluid or other forms of blockage)
• Discharge from the ears (otorrhea)
• Jaw pain
• Sore throat
• Itching
• Redness and swelling around the ear

Children often exhibit additional, infection-related symptoms, including fever, irritability, headache, loss of appetite, nighttime restlessness, disorientation, and a tendency to scratch or pull at their ears.  

Causes

The ear is a complex sensory organ that enables us to perceive sound. Medical practitioners have divided it into three parts: the inner, middle, and outer ears. Ear pain can have its origin in any of the three parts of the ear. Earaches have a variety of causes, many of them involving infections or irritation in one or more parts of the ear.

Outer Earaches

The outer ear includes the visible part of your ear and the ear canal. Common causes of outer earaches include:

• Sunburn
• Skin infections or irritations
• Physical injury or trauma, especially to the ear drum
• Waxy buildup in the ear canal
• Penetration of the ear by a foreign object
• Water retention in the ear canal (“swimmer’s ear”)

Middle Earaches

Inside the eardrum is the middle ear, which includes the tiny, soundwave-sensitive bones known as the hammer, anvil, and stirrup (the malleus, incus, and stapes). Middle earaches are caused by:

• Viral or bacterial infections
• Blockage of the Eustachian tube, which connects the middle ear to the throat, allowing for equalization of air pressure at the eardrum.
• Infections of the middle ear interfere with the equalization process. Unequal pressure on the two sides of the eardrum irritates nerve endings and causes pain. 

Inner Earaches

The inner ear includes the cochlea, which helps convert soundwaves to heard sound, and the vestibular system, which plays a role in maintaining the body’s sense of balance. Inner earaches are caused by:

• Tissue inflammations
• Viral or bacterial infections
• Labyrinthitis is an inner ear infection that causes vertigo, or loss of the sense of balance, rather than ear pain. 

Other Sources of Earaches

Earaches are sometimes tied to medical conditions originating outside the ear. Common among these are:

• Pain in the temporomandibular joint (where the jaw attaches to the skull)
• Sinusitis
• Toothaches and impacted teeth
• Throat inflammations
• Cranial nerve inflammations
• Ringing in the ears (tinnitus) 
• Infection of the bony hollows adjacent to the ears (the mastoids)
• Thyroid disease
• Abrupt changes in air pressure (e. g., jet takeoffs and landings, scuba diving, etc.)

Treatment 

Earache symptoms are often temporary and diminish as you recover from infection or injury. There are, however, steps you can take to reduce discomfort while you’re waiting on your body’s healing process:

• Take over-the-counter pain medications such as ibuprofen, acetaminophen, or aspirin (the latter being limited to persons 16 years or older) 
• Use over-the-counter eardrops
• Keep the ears dry while bathing or showering
• Sit and sleep upright to reduce pressure on the ear drums
• Apply warm or cold compresses to the ears (or both in alternation) 
• Chew gum to relieve ear pressure
• Feed infants to distract from their discomfort
• If ear pain is severe, or associated with a fever that is 101F or higher, seek medical attention. Your physician might: 
• Prescribe eardrops or antibiotics, if ear pain is a symptom of infection
• Flush out ear wax or other buildup in the ears
• Arrange for treatment of a related medical condition (such as temporomandibular joint pain), if it is the source of the earache

Depending on the severity of your condition, your physician may refer you to an otolaryngologist – an ear, nose, and throat (ENT) specialist. The latter can provide advanced treatment for more serious ear problems, such as a ruptured eardrum. One common surgical procedure called myringotomy involves the insertion of small tubes in the ear to improve drainage and assist in equalizing air pressure. This has proven effective in treating children with recurrent ear problems.

Prevention

Earaches aren’t always preventable, but you might consider:

• Wearing earplugs and drying your ears thoroughly after bathing or being in the water
• Avoiding pollen, dust, and other allergens
• Keeping physical objects out of your ears (including Q-Tips)
• Limiting your exposure to cigarettes and other smoke sources

Children are especially vulnerable to developing earaches. They should have their ears checked regularly by a physician.

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Symptoms, Causes, Treatments, and Prevention

Earaches usually occur in children, but they can also occur in adults. Injury, infection, irritation in the ear, or referred pain may cause earaches.

An earache may affect one or both of your ears. But most of the time, it’s in one ear. It may be constant or come and go, and the pain may be dull, sharp, or burning.

If you have an ear infection, you may also get a fever, and temporary hearing loss may occur. Young children who have ear infections tend to be fussy and irritable. They may also tug or rub their ears.

Read on for other symptoms, causes, treatments, and more.

Earaches can develop from ear infections or injury. Symptoms in adults include:

• ear pain
• impaired hearing
• fluid drainage from ear

Children can typically show additional symptoms, such as:

• ear pain
• muffled hearing or difficulty responding to sounds
• fever
• sense of fullness in the ear
• difficulty sleeping
• tugging or pulling at the ear
• crying or acting irritable more than usual
• headache
• loss of appetite
• loss of balance

Ear pain is felt somewhere other than the infection or injured site. For example, pain in the jaw or teeth may be felt in the ear.

Causes of earaches can include:

Ear infections

Ear infections are a common cause of earaches or ear pain. Ear infections can occur in the outer, middle, and inner ear.

Outer ear infection can be caused by swimming, wearing hearing aids or headphones that damage the skin inside the ear canal, or putting cotton swabs or fingers in the ear canal.

Skin in the ear canal that gets scratched or irritated can lead to infection. Water softens the skin in the ear canal, which can create a breeding ground for bacteria.

Middle ear infection can be caused by infections that stem from a respiratory tract infection. Fluid buildup behind the ear drums caused by these infections can breed bacteria.

Labyrinthitis is an inner ear disorder that’s sometimes caused by viral or bacterial infections from respiratory illnesses.

Other common causes of earaches

• change in pressure, such as when flying on a plane
• earwax buildup
• a foreign object in the ear
• strep throat
• sinus infection
• shampoo or water trapped in the ear
• use of cotton swabs in the ear

Less common causes of earaches

• temporomandibular joint (TMJ) syndrome
• perforated eardrum
• arthritis affecting the jaw
• infected tooth
• impacted tooth
• eczema in the ear canal
• trigeminal neuralgia (chronic facial nerve pain)

You can take several steps at home to reduce earache pain. Try these options to ease the ear pain:

• Apply a cold washcloth to the ear.
• Avoid getting the ear wet.
• Sit upright to help relieve ear pressure.
• Use over-the-counter (OTC) ear drops.
• Take OTC pain relievers.
• Chew gum to help relieve pressure.
• Feed an infant to help them relieve their pressure.

If you have an ear infection, your doctor will prescribe oral antibiotics or eardrops. In some cases, they’ll prescribe both.

Don’t stop taking the medication once your symptoms improve. It’s important that you finish your entire prescription to ensure that the infection will clear up completely.

If a buildup of wax is causing your ear pain, you may be given wax-softening eardrops. They may cause the wax to fall out on its own. Your doctor may also flush out the wax using a process called ear lavage, or they may use a suction device to remove the wax.

Your doctor will treat TMJ, sinus infections, and other causes of earaches directly to improve your ear pain.

If you or your child has a persistent fever of 104ºF (40 ºC) or higher, seek medical attention. For an infant, seek medical help immediately for a fever higher than 101ºF (38ºC). The Healthline FindCare tool can provide options in your area if you don’t already have a doctor.

You should also seek immediate medical attention if you have severe pain that stops suddenly. This could be a sign of the eardrum rupturing.

You should also watch for other symptoms. If any of the following symptoms appear, make an appointment with your doctor:

• severe ear pain
• dizziness
• bad headache
• swelling around the ear
• drooping of the facial muscles
• blood or pus draining from the ear

You should also make an appointment with your doctor if an earache gets worse or doesn’t improve in 24 to 48 hours.

You can book an appointment with a primary care doctor in your area using our Healthline FindCare tool.

Some earaches may be preventable. Try these preventive measures:

• Avoid smoking and exposure to secondhand smoke.
• Keep foreign objects out of the ear.
• Dry the ears after swimming or bathing.

Avoid allergy triggers, such as dust and pollen.

Read this article in Spanish.

Ear pain | Symptoms. Directory KLRTS

Moscow, st. Partizanskaya, 41

Kuntsevsky
medical and rehabilitation center.

Pain in the ear is a rather unpleasant symptom that can cause mild discomfort or make life difficult for a person. They can be sharp, aching, shooting, accompanied by tinnitus, discharge, hearing loss, and so on.
In this case, self-diagnosis and treatment at home can cause serious complications that can lead to complete hearing loss. If you experience ear pain, do not delay a visit to the doctor.

Causes of pain in the ear

Pain in the ears can occur for completely different reasons and appear both in healthy people and serve as a symptom of various diseases.
Causes of ear pain in a healthy person:

• Long stay in strong wind,
• Permanent ingress of water into the hearing aid (“swimmer’s ear”),
• If the pain is combined with dryness, then this indicates a lack of sulfur in the ears,
• Also, excess sulfur can cause discomfort.

Inflammatory processes that cause pain in the ears:

• Otitis externa – this disease is characterized by damage to the auricle and ear canal,
• Otitis media – inflammation of the middle ear,
• Otitis media, the most dangerous type of disease when the inner ear is affected,
• Myringitis – inflammation of the eardrum,
• Eustachitis – occurs when an infection enters the Eustachian tube.

Pain in the ears due to various injuries:

• Foreign body in the ear,
• Bruising of the auricle from falls and blows,
• Frostbite and ear burns,
• Barotrauma – occurs due to a sharp increase in pressure inside the tympanic cavity, the cause may be a pressure drop or a loud sound,
• Rupture of the tympanic membrane.

Pain in the ears due to diseases of neighboring organs:

• Osteoarthritis of the temporomandibular joint – manifested by shooting pains in the ear on one side,
• Mastoiditis – inflammation in the mastoid process,
• Mumps – inflammation of the salivary gland,
• Lymphadenitis – inflammation of the lymph nodes located near the auricle,
• Inflammation of the throat – pharyngitis, tonsillitis, etc.,
• Sinusitis,
• Mumps or mumps.

Diagnosis of ear pain

If you experience ear pain, it is recommended to consult an ENT. Diagnosis usually does not cause problems. Based on the patient’s complaints and detailed analysis, the doctor can make a diagnosis and prescribe treatment.
Main diagnostic methods:

• Otoscopy – in order to assess the condition of the middle ear, the doctor uses an otoscope,
• Laboratory tests – are prescribed in case of detection of inflammation in order to find out what caused it.

If any discharge appears in the ear, they are also sent for examination.

Pain in the ear is a symptom that may occasionally disturb the patient after hypothermia or prolonged exposure to water (with regular contact with water in the ear). In this case, you should visit the otorhinolaryngologist of our center in order to prevent diseases of the ENT organs. However, often patients complain of chronic ear pain, which significantly reduces the quality of life.

IMPORTANT! At the same time, self-treatment is categorically contraindicated, because the pathology often goes into the background for a short period of time, returning with renewed vigor after a while.

Make an appointment with an otorhinolaryngologist at the Kuntsevo Medical and Rehabilitation Center to get rid of ear pain!

Make an appointment

Treatment of ear pain

Treatment should be carried out in a timely manner and should be aimed at combating the disease that caused the pain.
Treatment is prescribed depending on the diagnosis. There are a number of first-aid remedies that can relieve ear pain before you seek medical help: taking painkillers, warm compresses. The patient is advised to stay in bed, avoid drafts and loud sounds.

References:

1. Shevrygin B.V., Mchedlidze G.P. Handbook of otorhinolaryngology. – M.: TRIADA – X, 1998
2. Otorhinolaryngology: national guidelines / ed. V.T. Palchun. – M.: GEOTAR-Media, 2008
3. Zagoryanskaya M.E. and others // Modern methods of diagnostics and rehabilitation of patients with pathology of the inner ear: Proceedings. conf. M., 1997
4. Medical decision support system. Otolaryngology: Clinical treatment protocols / Compiled by: A. I. Kryukov, S. G. Romanenko, N. A. Daihes [and others]; executive editor O. A. Pivovarova. – M.: GBU “NIIOZMM DZM”, 2021

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Ear pain: causes and treatment

The article was checked by a doctor: Kogan Elena Lvovna

Anatomy of the ear

The ear is a paired organ located in the temporal bones of the skull. Its main function is the perception of sound, the position of the body in space and the maintenance of balance.

The ear is made up of three sections:

• Outer ear. Forms the auricle and external auditory canal. Picks up sound vibrations and transmits them to the middle ear.

• Middle ear. It is formed by the tympanic cavity and three auditory ossicles: anvil, stirrup and malleus. Picks up sounds from the outer ear and amplifies them.

• Inner ear. It contains the cochlea, semicircular canals and vestibular apparatus. Perceives sound vibrations, and transmits auditory information to the cortex of the temporal lobe of the brain.

The structure and function of each part of the ear is different. Any pathological processes in all three departments also proceed differently.

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Causes of pain in the ears

Ear pain has a different intensity (from moderate to severe), duration (from short-term to permanent), character (sharp, dull, shooting, spreading to neighboring areas). Separately, there is an acute form of pain, lasting about 10 days, and chronic, which can be permanent or episodic. At the place of occurrence, there is one- and two-sided pain in the ear.

Otalgia occurs for various reasons. In 80% of cases, pain is associated with infectious and inflammatory diseases of the ear, throat and nose. Due to the anatomical proximity, inflammation of one of these organs provokes pain in other adjacent cavities.

Most often, pain inside the ear is a symptom of otolaryngological diseases:

• otitis,

• mastoiditis,

• eustachitis,

• boil,

• sulfur plug,

• ear tumors,

• boil,

• myringitis,

• otomycosis.

The patient experiences pain in the ear with craniocerebral injuries, the ingress of a foreign body into the ear canal. Otalgia can be a non-specific manifestation of mumps, neurological disorders, dental diseases, and nasopharyngeal cancer.

Otitis

This is inflammation in different parts of the ear of an acute or chronic course. It is equally common in children and adults. The disease is provoked by various infections, more often these are influenza viruses and SARS, pneumococcus, candida (fungi). The likelihood of developing otitis media increases after surgical operations in the nasal cavity and nasopharynx, with immunodeficiency states, adenoids.

The first sign is pain in the ear of a different nature: throbbing, shooting, aching. The pain is often unilateral, but there is also bilateral inflammation. Simultaneously with otalgia, there is a general malaise, high temperature, tinnitus, hearing loss.

Pain inside the ear appears different variants of the inflammatory process:

• Otitis externa. The pain is throbbing, intense, gives to the neck, eyes and teeth, intensifies during conversation and chewing. On examination, a reddened auricle and the visible part of the ear canal are found. Hearing, as a rule, is not disturbed.

• otitis media. The disease begins with a sudden shooting pain in the ear, which periodically worsens. Sometimes the pain is so pronounced that it disrupts the usual way of life and sleep. Painful sensations persist from one to three days, after which the tympanic membrane ruptures, and mucopurulent discharge comes out of the ear canal. At this moment, the patient’s condition stabilizes, body temperature normalizes, and the intensity of otalgia decreases. The eardrum heals slowly without hearing loss.

• Otitis media or labyrinthitis. A typical symptom of the disease is a severe sudden attack of dizziness, nausea, and vomiting. Some patients complain of noise and ringing in the ears. Otalgia is moderate, and is more felt in the temporal zone. Hearing is usually reduced.

With the unfavorable development of otitis media, pus does not pour outward, but inward, which is dangerous with irreversible hearing loss, inflammation of the temporal bone, brain abscess (formation of a purulent cavity), meningitis (inflammation of the membranes of the spinal cord and brain).

A separate place among the causes of otalgia is occupied by diffuse otitis externa (swimmer’s ear). This is an inflammation of the external acoustic canal, with possible damage to the auricle and tympanic membrane, due to water entering the ear.

The main signs of the disease:

• discharge from the ear of different consistency and color;

• itching in the ear canal;

• throbbing pain inside the ear, which spreads to the upper and lower jaw, temporal zone.

Pressure on the ear, pulling on the lobe, chewing increase the pain. The general condition usually does not worsen, there are no signs of intoxication. Sometimes the parotid lymph nodes are enlarged.

Eustachitis or tubo-otitis

This is an inflammatory lesion of the auditory (Eustachian) tube, which leads to a violation or complete cessation of air flow into the tympanic cavity. Eustachitis is characterized by unilateral, rarely bilateral pain, hearing loss, a feeling of pressure and fullness in the ear canal. Some patients feel heaviness in the head, a feeling of overflowing liquid when moving the head, increased perception of one’s own voice. Symptoms of intoxication and high body temperature indicate the development of purulent tubo-otitis.

Mastoiditis

This is an infectious inflammation of the mastoid process of the temporal bone, which is located behind the auricle. Usually, mastoiditis occurs as a complication of otitis media, and develops 7–14 days after its onset. It starts with headache, temperature, intoxication. In parallel, there is pain inside the ear and behind the ear, hearing loss, a feeling of pulsation in the ear canal. On examination, the behind-the-ear area is reddened and edematous, the auricle protrudes, and there is a copious outflow of pus from the ear.

Injuries

Ear injuries occur for various reasons: a blow with a blunt object, a foreign object, a bullet and knife wound, a burn, damage during medical procedures. Often, the outer ear is injured due to its unprotected anatomical position, less often the eardrum, ear canal, middle and inner ear.

Ear pain is the main symptom of any injury. The pain has a different intensity, from minor discomfort to unbearable. Other symptoms depend on the nature and extent of the damage. Trauma of the auricle is accompanied by the formation of a hematoma, bleeding, hearing loss. Damage to the eardrum is characterized by tinnitus, the release of perilymph (a viscous fluid that is involved in the conduction of sound vibrations).

If an ear injury is one of the consequences of a traumatic brain injury, then headache, dizziness, nausea, flushing of the face, tinnitus and coordination disorder come to the fore. The pain is felt not only inside the ear, but also radiates to the temporal part, the mastoid process. Possible external bleeding.

Diseases of the teeth

Running inflammation of the tissues surrounding the tooth (pulpitis, periodontitis, periodontal disease), deep caries of chewing teeth provoke painful sensations inside the ear. The pain is intense, constant, throbbing, radiating to the neck and temple. Patients simultaneously experience nasal congestion, headache.

Help! A characteristic sign of otalgia against the background of dental diseases is an increase in pain inside the ear when pressing on the diseased tooth.

Sulfur Plug

With an increase in the amount of earwax formation, it accumulates and thickens in the bone part of the external auditory canal. The presence of sulfur plug leads to blockage of the ear canal. For a long time, there are no symptoms, until the auditory canal is completely blocked. Clinically, this is manifested by hearing loss, ear congestion, noise and pain inside the ear. If the sulfur plug puts pressure on the eardrum, then the general condition is complicated by dizziness, headache and nausea.

Mumps (mumps)

This is an infection of the salivary glands and nervous tissue. Has a similar clinic with otitis media and eustachitis. A typical symptom is inflammation of the salivary glands, their swelling and soreness. There is pain and swelling in the parotid region. Unpleasant sensations are aggravated at night, when chewing, pressing behind the earlobe. Disturbs the noise inside the ear, sometimes hearing is reduced.

Concomitant symptoms – general weakness, chills, malaise, dry mouth, fever. The oval of the face is deformed, pear-shaped.

Neurological disorders

Neuralgia of the ear node is characterized by bouts of otalgia in the parotid region and inside the ear from the side of the lesion. The pain is intense, burning, throbbing, spreading to the back of the head, ear, shoulder girdle and lower jaw, sometimes even to the arm and upper chest. Hearing is not broken.

The attack of pain lasts from several minutes to an hour, and even more. During an attack, increased salivation is observed, which is not observed in the interictal period. Reception of hot food, stress, hypothermia increase painful sensations.

With neuralgia of the glossopharyngeal nerve, pain is felt at the root of the tongue, but often also radiates to the ear. Chewing, coughing, taking cold and hot food, drinks provoke a painful attack.

Tumors of the ear

Neoplasms are benign and malignant. Predominantly occur in the outer and middle ear. For a long time they do not manifest themselves clinically. For the first time, painful sensations in the ear occur at the time of active growth of the neoplasm, which puts pressure on the surrounding tissues.

A tumor in the tympanic membrane compresses the vestibule of the ear, which causes neurological disorders: dizziness, lack of coordination, involuntary oscillatory eye movements.

Malignant tumors of the ears are characterized by burning and baking pain, similar to a burn. At first, the pain is episodic, but as the neoplasm grows, it becomes permanent and radiates to the temple. Another characteristic sign of oncopathology is purulent bloody discharge from the ear.

Foreign body in the ear

The presence of a foreign object in the ear canal is accompanied by bursting pain. The pain is constant, not stopped by painkillers, ear drops. A foreign body disrupts the ventilation and pressure of the auditory tube, which leads to a feeling of pressure and congestion, and a decrease in hearing acuity.

Injury to the ear canal with a sharp object can cause bleeding. Rarely, patients experience dizziness and headache.

Long-term presence of a foreign body in the ear canal is complicated by the inflammatory process. In this case, the intensity of pain increases, acquires a pulsating character, mucopurulent discharge from the ear appears.

Furuncle

This is a purulent inflammation of the sebaceous gland or hair follicle of a part of the outer ear, the auricle. The disease begins with itching and discomfort inside the ear. Then there is a feeling of fullness, pressure, and only then does pain appear. The pain is pulsating, is of a constant nature, spreads to the temporal and occipital zone, neck and head. Any touch, chewing increases the intensity of pain.

The skin of the auricle and the visible part of the auditory canal is swollen and reddened. The purulent-inflammatory process disrupts the ventilation of the auditory canal, which causes hearing loss. There is also an intoxication syndrome, fever, febrile temperature. Relief brings a breakthrough of the abscess, which on average occurs 5-7 days after the onset of the disease. After that, suppuration appears, a decrease in the severity of pain, an improvement in hearing and general condition.

Myringitis

This is an acute or chronic inflammation of the eardrum. It often occurs as a complication of other ear diseases. The first symptom is severe unilateral throbbing pain inside the ear. It intensifies when chewing, is practically not stopped by painkillers, disturbs sleep.

In some patients, instead of otalgia, discomfort and a feeling of heaviness in the ear canal are felt. In parallel, hearing acuity decreases, ear congestion occurs. There is a small amount of serous discharge from the ear canal.

Otomycosis

This is a fungal infection that most often affects the middle and outer ear. Pathology has no specific signs, and is manifested by otalgia, noise and congestion in the ear, expiration of secretions, and a decrease in the quality of hearing. Puffiness of the skin of the outer ear develops, partial or complete overlap of the auditory lumen, the temporomandibular joint and the parotid gland become inflamed.

Help! At risk for otomycosis are those who swim, have undergone organ surgery or surgical treatment of mastoiditis.

Cancer of the nasopharynx

This is a malignant tumor of the nasal part of the pharynx. Usually the disease debuts at the age of over 50 years. The reasons are not exactly clear. Risk factors include alcohol abuse, smoking, chronic rhinosinusitis, infection with the Epstein-Barr virus (herpesvirus type 4), and hereditary predisposition.

In the nasopharyngeal region, sarcoma, carcinoma and other types of malignant neoplasms can occur. The clinical picture depends on the stage of cancer and the presence of metastases. In the early period, asymptomatic course is possible.

As the disease progresses, signs from the ear, throat and nose appear:

• nasal congestion,

• nasal bleeding,

• nasality,

• the presence of painful compaction in the nasopharynx,

• Ear ache,

• hearing loss,

• noise and ringing in the ears.

Ear pain is more often unilateral from the side of the localization of the tumor, it is felt simultaneously in the zone of the lower jaw and tongue. There is a gradual violation of the perception of speech and surrounding sounds.

The patient’s condition is aggravated by neurological disorders: headache, dizziness, chewing and speech disorders, paralysis of the facial muscles. Usually, in cancer of the nasopharynx, metastases affect the lungs, liver, and bones.

Diagnosis of causes of ear pain

Get expert advice:

• ENT (otolaryngologist)
• ENT for children (otolaryngologist)

A person who has an earache needs to consult an otolaryngologist. Children under 18 are under the supervision of a pediatrician or pediatric otolaryngologist.

A preliminary diagnosis is made after examining the external auditory canal, nasopharynx, oropharynx, paranasal sinuses visually and using endoscopic equipment. From a conversation with the patient, the doctor specifies the conditions for the onset of pain and frequency, a possible antecedent factor, and other accompanying symptoms.

To study the cause of otalgia and choose further treatment tactics, laboratory and instrumental diagnostics is carried out:

• Otoscopy. Examination of the external auditory canal and tympanic membrane with the help of special instruments and a lighting device. With the destruction of the tympanic membrane, the middle ear is available for examination.

• Audiometry. This is the definition of hearing acuity and auditory sensitivity in different ways: speech, computer, tonal.

• X-ray of the temporal bone. The study makes it possible to study in detail the structure of all structures of the ear, to identify inflammation, tumors, bone fractures.

• bacteriological analysis. The biological material from the ear canal is examined for the presence of infection, the resistance of the pathogen to antibacterial drugs is determined.

• General and biochemical analysis of blood. The results reflect the presence of infection, allergies, inflammation in the body.

• CT scan of the skull, MRI of the brain. Assign after traumatic brain injury, fracture of the skull, to clarify the localization of the tumor and a foreign object.

If necessary, a consultation of other specialists is prescribed – a traumatologist, neurologist, oncologist, dentist, and additional studies.

Ear pain treatment

The choice of treatment tactics depends on the underlying disease, the severity of the symptoms. In the acute period of infectious and inflammatory diseases, all patients are recommended to rest, half-bed and bed rest, drink plenty of water, and have a sparing diet.

First aid before diagnosis

Self-treatment is unacceptable, because due to the anatomical proximity of the ear, the brain and skull bones are quickly involved in the pathological process. With unbearable intense pain before a visit to the otolaryngologist, it is permissible to use drops with an anesthetic effect or painkillers in tablets.

Important! Drops are contraindicated if ear pain occurs after an injury.

Conservative treatment

As a symptomatic treatment to reduce the intensity of pain, different drugs are used:

• Non-steroidal anti-inflammatory drugs. They have anti-inflammatory and analgesic effects, normalize body temperature.

• Ear drops. Anti-inflammatory and antiseptic agents are prescribed. They well disinfect the mucous membranes, eliminate the sensation of a foreign body in the ear canal, relieve inflammation.

• Antiallergic drugs. They are necessary for infectious and inflammatory diseases, as they inhibit the production of mediators of inflammation and pain. These are first-line drugs for allergic diseases. Assign in the form of tablets and drops.

• Antibiotics. It is used for bacterial infections, and is not effective for treating complications of viral diseases. Take a course of 5-10 days. After cancellation, a control bacteriological culture is done to monitor the effectiveness of treatment. With candidiasis, antifungal drugs are needed.

• Vitamins and immunomodulators. They help to fill the deficiency of vitamins, micro- and macroelements, stimulate the protective mechanism, accelerate the recovery time.

If ear pain is a symptom of neurological diseases, then neurometabolic stimulants, metabolic drugs are needed. In the presence of external or otitis media, an ear toilet is performed. Cotton is wound around the probe and pus is collected from the ear canal, after which the passage becomes clean and dry.

In the process of treating infection, inflammation of the ear, throat and nose, physiotherapy methods are effective:

With otitis media, sensorineural hearing loss at the stage of recovery, pneumomassage of the tympanic membrane is performed – the supply of pulses of different amplitudes and frequencies.

Surgical treatment

With purulent otitis media, myringotomy is performed to create conditions for the outflow of pus, eliminate inflammation and the consequences of a purulent process. In various ways (with a radio wave knife, a laser scalpel), a small incision is made in the eardrum, the purulent contents are removed, and washed with antibacterial drugs.

The ineffectiveness of drug therapy, chronic otitis media are indications for atticoanthrotomy. This is an opening of the mastoid process of the temporal bone and the epitympanic space in order to remove pathological tissues in the middle ear region.

The consequences of middle ear injuries are eliminated with the help of reconstructive operations:

• myringoplasty – restoration of the integrity of the tympanic membrane with a piece of skin that is taken behind the auricle;

• mastoidoplasty – overlapping of the defect of the mastoid process with a muscular-fascial flap, bone or cartilage tissue;

• tympanoplasty – closing the perforation hole with a thin skin flap.