6 Outer Ear Pain Causes

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Swimmer’s ear (otitis externa)

Swimmer’s ear, or otitis externa, is an infection of the canal which runs from the eardrum to the opening of the ear.

It is caused by anything that introduces bacteria, fungus, or a virus into the canal. Water that stays inside the ear after swimming is a common cause, as are cotton swabs used for cleaning or earpieces that create irritation.

Most susceptible are children, because they have narrower ear canals that do not drain well.

Early symptoms include redness, itching, and discomfort inside the ear canal, sometimes with drainage of clear fluid.

Even mild symptoms should be treated because they can quickly get worse. The infection can spread and intensify, becoming very painful with increased drainage, swelling, fever, and loss of hearing.

Diagnosis is made through patient history and physical examination of the ear canal. Lab tests may be done on a sample of the discharge from the ear.

Treatment includes having a medical provider clean the ear canal of debris and discharge, and a prescription for antibiotic and/or steroid eardrops.

Rarity: Common

Top Symptoms: fever, ear canal pain, ear fullness/pressure, jaw pain, ear pain that gets worse when moving

Urgency: Primary care doctor

Relapsing polychondritis

Relapsing polychondritis is an episodic, inflammatory and destructive disorder involving primarily cartilage of the ear and nose. It can also potentially affect the eyes, tracheobronchial tree, heart valves, kidneys, joints, skin, and blood vessels.

You should visit your primary care physician for mild severity of relapsing polychondritis. Medications such as NSAIDs and steroids are generally prescribed.

Obstruction

An ear foreign body is anything that gets stuck in the ear canal other than earwax. This may include food, toy pieces, beads, buttons, disk batteries, cotton swab, paper, or insects. Foreign bodies are usually trapped in the outer ear canal.

You should visit your primary care physician within the next 24 hours to have the foreign object removed. This is not a medical emergency requiring a visit to the ER, but the procedure should be performed by a medical professional to avoid damage to the eardrum. It is important to remove the object in a timely manner, however, to prevent discomfort and the possibility of an infection.

Mild frostnip of the ears

Frostnip is damage of the outermost layers of the skin caused by exposure to the cold (at or below 32F or 0C). It is most commonly found in people doing leisurely activities like camping, hunting, or snow sports.

Those with suspected frostnip should have wet clothing removed. Rubbing affected areas worsens damage to the tissue. You should go to an urgent care. If rewarming can occur without chance of refreezing, it can be tried in the field. At urgent care, the doctors will guide you in gently re-warming the wounded area in 98-102F (37C-39C) water. Further, ibuprofen, antibiotics, and a tetanus shot may be necessary

Rarity: Rare

Top Symptoms: ear numbness, outer ear pain, ear redness, turning blue or purple from coldness, cold ears

Symptoms that always occur with mild frostnip of the ears: cold ears

Urgency: In-person visit

Mild frostbite of the ears

Frostbite is tissue damage caused by exposure to the cold (at or below 32F or 0C). It is most commonly found in people doing leisurely activities like camping, hunting, or snow sports. It is also more likely in those who are intoxicated or have a mental disorder.

Those with suspected frostbite should have wet clothing removed. Rubbing affected areas worsens damage to the tissue. You should go to the ER by car, immediately. If rewarming can occur without chance of refreezing, it can be tried in the field. There, the doctors will guide you in gently re-warming the wounded area in 98-102F (37C-39C) water. Further, ibuprofen, antibiotics, a tetanus shot, and possibly surgery will be done to treat the pain and dead tissue. IV fluids will also be started. Hydrotherapy will be done daily to help with the wounded area.

Rarity: Rare

Top Symptoms: swollen ear, ear numbness, outer ear pain, ear redness, turning blue or purple from coldness

Symptoms that always occur with mild frostbite of the ears: cold ears

Urgency: Hospital emergency room

Lymph node inflammation behind the ear

There are lymph nodes behind the ear. Lymph nodes are where your immune cells live, and when they become enlarged, it could be from a nearby infection, immune response, or even backlog of blood.

You should see your primary care doctor tomorrow for a sick visit. There, the doctor can look at what could explain the enlarged node behind your ear.

Eczema (atopic dermatitis)

Atopic dermatitis, also called eczema, dermatitis, atopic eczema, or AD, is a chronic skin condition with an itchy rash.

AD is not contagious. It is caused by a genetic condition that affects the skin’s ability to protect itself from bacteria and allergens.

AD is most often seen in infants and young children. Most susceptible are those with a family history of AD, asthma, or hay fever.

Infants will have a dry, scaly, itchy rash on the scalp, forehead, and cheeks. Older children will have the rash in the creases of elbows, knees, and buttocks.

Without treatment, a child may have trouble sleeping due to the intense itching. Constant scratching may cause skin infections and the skin may turn thickened and leathery.

Diagnosis is made through physical examination, patient history, and allergen skin tests.

AD cannot be cured, but can be controlled through prescribed medications, skin care, stress management, and treatment of food allergies. Those with AD often have allergies to milk, nuts, and shellfish. Keeping the skin clean and moisturized helps prevent flareups.

Cellulitis

Cellulitis is a bacterial infection of the deep layers of the skin. It can appear anywhere on the body but is most common on the feet, lower legs, and face.

The condition can develop if Staphylococcus bacteria enter broken skin through a cut, scrape, or existing skin infection such as impetigo or eczema.

Most susceptible are those with a weakened immune system, as from corticosteroids or chemotherapy, or with impaired circulation from diabetes or any vascular disease.

Symptoms arise somewhat gradually and include sore, reddened skin.

If not treated, the infection can become severe, form pus, and destroy the tissue around it. In rare cases, the infection can cause blood poisoning or meningitis.

Symptoms of severe pain, fever, cold sweats, and fast heartbeat should be seen immediately by a medical provider.

Diagnosis is made through physical examination.

Treatment consists of antibiotics, keeping the wound clean, and sometimes surgery to remove any dead tissue. Cellulitis often recurs, so it is important to treat any underlying conditions and improve the immune system with rest and good nutrition.

Rarity: Uncommon

Top Symptoms: fever, chills, facial redness, swollen face, face pain

Symptoms that always occur with cellulitis: facial redness, area of skin redness

Urgency: Primary care doctor

Questions your doctor may ask about outer ear pain

• Is there anything coming from your ear(s)?
• Any fever today or during the last week?
• Do you use a hearing aid or wear earplugs?
• Do you often come into contact with hot tubs, swimming pools, or other sources of standing water?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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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Otitis externa – causes, symptoms, treatment

What is otitis externa?

This is an inflammation of the tissues of the external auditory canal, eardrum and auricle. Otitis externa is widespread. It is considered acute if it lasts less than 4 weeks, chronic if it lasts longer and/or recurs more than 4 times a year.

IMPORTANT! Information from the article cannot be used for self-diagnosis and self-treatment! Only a doctor can prescribe the necessary examinations, establish a diagnosis and draw up a treatment plan for a consultation!

Symptoms of otitis externa

There are three degrees of severity of otitis externa.

• Mild otitis externa: itching in the ear canal, redness inside the ear, unpleasant sensations in the ear, which are aggravated by pressure on the auricle or tragus (a small protrusion in the center of the auricle). A little clear, odorless liquid may come out of the ear.
• Moderate otitis externa: itching becomes worse, the ear hurts, there is obvious redness inside, the discharge increases, pus may appear. The auditory canal is felt as if filled as a result of edema and retention of the discharge.
• Diffuse (diffuse) otitis externa: severe pain in the ear, radiating to the neck, temple, cheek; the auditory canal is completely blocked; the auricle becomes red and swollen, as are the lymph nodes in the neck. The temperature is elevated, sometimes significantly.

When to go to the doctor?

See a doctor even if you have mild otitis externa. If you have severe pain and a fever, you should call an ambulance or go to the hospital immediately.

Causes of otitis externa

• water that enters the ear when swimming is a breeding ground for bacteria;
• picking the ears with fingers, cleaning them with cotton swabs. As a result, a person damages the thin surface of the skin of the ear canal, which makes it vulnerable to infections;
• eczema, seborrhea, neurodermatitis, local skin irritation (from insect bites, etc.), allergy to earrings or hair products – may cause non-infectious external otitis media.

Otitis externa risk

• The habit of cleaning the ears with cotton swabs, sticks, fingers.
• Frequent swimming, especially in natural waters where the water is not purified.
• Narrow ear canal, eg in children.
• Wearing headphones, hearing aids.

Possible complications of otitis externa

As a rule, otitis externa does not cause complications and is easily treated. However, if complications do occur, they can be as follows:

• temporary hearing loss in the affected ear. Passes after recovery from otitis media;
• chronic otitis externa. It usually occurs when there are difficulties with the treatment of otitis externa, for example, with fungal and mixed bacterial-fungal forms;
• spread of infection to deep tissues – cellulitis of the neck, lymphadenitis, osteomyelitis. Similar complications (malignant otitis media) can occur in patients with immunodeficiency conditions, diabetes, and those receiving chemotherapy. Such complications can be life-threatening.

How to prevent otitis externa?

• Gently dab your ear after bathing, but don’t rub anything on your ear canal.
• If water gets in your ear, you can shake it out by jumping on one leg and tilting your head to the same side. You can also dry the water in your ear with a hair dryer, setting it to the lowest setting and holding it about 30-40 cm from your ear.
• If you know that your eardrum has been damaged or punctured, you can use ear drops that will prevent bacteria from growing in your ear after water gets in.
• Do not swim in dirty waters.
• Do not get into the ear canal with a finger, a stick, a cotton swab or a swab – in a word, nothing.
• Protect your ears when using hairspray if you know it can irritate the skin inside the ear canal;
• If you have had ear surgery or ear infections, visit an ENT before swimming.

Diagnosis of otitis externa

Usually it is not difficult. Otitis externa is easily identified by its symptoms and the appearance of the ear and ear canal. The doctor may examine your ear with an otoscope. If he wants to make sure that the eardrum is not damaged, he can use a curette to clean the ear and take a deeper look.

If the otitis media is diffuse, the doctor may need additional diagnostics of the condition of the middle ear, determining the nature of the otitis media (bacterial or otherwise), etc.

Treatment of otitis externa

the passage to clear itself, as it happens normally.

• Cleaning and irrigation of the ear canal. As a rule, the doctor cleans it with a curette to free it from particles of skin, stuck earwax and dried discharge (serous or purulent). This is necessary so that the ear drops can spill to the entire depth of the ear canal.
• Ear drops prescribed by an ENT or general practitioner (GP). Usually these are drops with antibiotics and / or corticosteroids. For severe pain, analgesics may be used.
• In case of severe swelling of the external auditory canal, the doctor may first replace the drops with turunda soaked in medicine. When the edema subsides, it is easy to remove the turunda from the ear, and you can continue to be treated with drops.
• When applying cold drops, hold them in the palm of your hand for a while to reduce discomfort. After the drops are in your ear, lie down for a few minutes on your healthy side so that the drops are better absorbed. You can ask someone to administer the drops for you – it’s more convenient.
• If the infection is widespread, the doctor may prescribe oral antibiotics in addition to drops.

How to help the treatment?

• Don’t wear headphones while your ear hurts.
• Do not swim or dive. Avoid getting liquid in your ears.
• Avoid flying until you are cured.

You can sign up for a consultation by phone: + 7 812 327 03 01.

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09 June

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.

Otitis externa pain

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.

Otitis internal pain

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.

Otitis externa pain

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

Otitis externa pain

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.

Otitis externa pain

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.