Table of ContentsView AllTable of ContentsPrimary CausesSecondary CausesSee a Healthcare ProviderDiagnosisTreatmentPrevention
Table of ContentsView All
View All
Table of Contents
Primary Causes
Secondary Causes
See a Healthcare Provider
Diagnosis
Treatment
Prevention
For example, ear cartilage pain can be from an injury or infection of the outer ear.Ear canalpain is commonly due to swimmer’s ear. Deeper ear pain can be related to an infection, a blockage, or a ruptured ear drum.
How ear pain feels (aching, sharp, dull, etc.), its intensity, location, and other symptoms (e.g., fever, dizziness) can help your healthcare provider diagnose your ear pain. Treatment may include ear drops, oral medications, and at-home treatments to ease the pain.
This article discusses ear pain. It explains the different causes of ear pain and how ear pain is treated.
Verywell / Alexandra Gordon
How to Unclog Your Ears
Primary Causes of Ear Pain
Primary causes of ear pain originate within the middle ear or outer ear. The following conditions can cause primary ear pain.
Middle Ear Pain: Otitis Media
Otitis media describes amiddle ear infectionin which fluid and inflamed tissue build up in the middle ear space—the area between your eardrum (tympanic membrane) and the oval window of your inner ear.
Besides moderate to severe aching painfelt deep in the ear, you may experience several days of nasal congestion and/or a cough preceding the ear pain. Sometimes, a fever may occur.
If the eardrum ruptures as a result of the pressure buildup, purulent (containing pus)ear drainagemay result.
Preauricular Lymph Nodes: What to Know
Swimmer’s Ear: External Otitis
External otitis—an infection of the ear canal—causes a feeling of ear fullness, itchiness, and significant ear pain when the earlobe is pulled.Yellowish or clear-colored ear discharge may also occur, along with decreased hearing and swelling of the ear canal.
The reason external otitis is commonly called “swimmer’s ear” is that it often develops when water gets trapped in the ear canal.
A severe complication of external otitis isnecrotizing (malignant) external otitis, in which the ear canal infection spreads to the base of the skull.This condition is more common in older people with diabetes mellitus.
What Causes Fluttering in the Ear, and What Can You Do About It?
Ear Cartilage Pain: Perichondritis
Perichondritisarises from an infection of your ear cartilage, resulting in pain, swelling, and redness over the skin.
Cartilage piercings carry an increased risk of perichondritis due to infection. While it can occur with piercings of the helix (the outer rim) or antihelix (inner ridge), post-piercing perichondritis commonly affects the scapha (flat surface between the helix and antihelix).
What Black Earwax Means
Otitis Media With Effusion
Otitis media with effusion (OME)describes the presence of middle ear fluid without signs of infection.
In other words, there is fluid buildup without tissue inflammation. Overall, the ear pain of OME is generally mild and associated with a feeling of ear fullness and/or decreased hearing.
Rarely, OME occurs as a result of tumor blockage of the eustachian tube—a tunnel that connects the middle ear to the upper throat and back of the nose.
All About Middle Ear Infections
Perforated Eardrum
A perforated eardrum is a hole, or tear, in the eardrum.
Aside from sharp ear pain, people who have a perforated eardrum may experiencesudden hearing loss, fluid leaking from the ear, or a ringing or buzzing sound in the ear.
Earwax Blockage
The purpose of earwax (cerumen) is to protect your ear canal from water, bacteria, and injury.
Sometimes though, too much earwax is produced or the wax gets pushed back too deep into the ear canal (which is why healthcare providers recommend not using cotton swabs toclean out your ears).
If anearwax blockageoccurs, ear discomfort—often reported as a full or congested sensation—may occur.Problems hearing and ringing in the ear (tinnitus) may also result from earwax blockage.
RememberRemoving earwax with cotton swabs, fingers, or other objects can make your ear blockage worse and damage the eardrum.
Remember
Removing earwax with cotton swabs, fingers, or other objects can make your ear blockage worse and damage the eardrum.
Eustachian Tube Blockage
The eustachian tube is a narrow tunnel that connects your upper throat to your middle ear.It regulates the air pressure in and drains excess fluid from your middle ear.
If the eustachian tube becomes blocked, often as a result of allergy, infection, or a rapid altitude change, the following symptoms may occur:
Ear Skin Problems
Sometimes ear pain originates from the skin of the ear.
There are three related conditions:
Cellulitis or Perichondritis?Cellulitis and perichondritis are both infections that can affect the outer ear. While cellulitis can affect skin anywhere on the body, perichondritis only affects ear cartilage and does not spread to the ear lobe.
Cellulitis or Perichondritis?
Cellulitis and perichondritis are both infections that can affect the outer ear. While cellulitis can affect skin anywhere on the body, perichondritis only affects ear cartilage and does not spread to the ear lobe.
Scab in the Ear: Causes, Symptoms, and Treatment
Meniere’s Disease
In addition to the classic triad of symptoms—vertigo, ringing in the ears, and hearing loss—some people with Meniere’s disease reportear pressure.
Tumor
Although not common, a cancerous or noncancerous tumor may be the source of a person’s ear pain.
For example,nasopharyngealcancer (a type ofhead and neck cancer) may cause ear fullness, along with hearing loss, ringing in the ears, and recurrent ear infections.
Two examples of noncancerous tumors or growths that may develop in the ear and cause pain include:
What Is Red Ear Syndrome (RES)?
Secondary Causes of Ear Pain
These conditions may cause ear pain, though they originate outside of the ear.
Sinusitis
Sinusitisrefers to infection or inflammation of the sinuses, which are hollow spaces located behind your nose, between your eyes, and within your cheekbones and lower forehead.
Sinusitis may cause a variety of symptoms, such as:
Dental Problems
TMJ Disorder
The temporomandibular joint (TMJ) connects your lower jaw to the temporal bone of your skull.Arthritis or erosion of the joint or stress/overuse of the surrounding muscles may causeTMJ disorder.
TMJ-Related Hearing Loss
The pain of TMJ disorder is often described as a constant and dull jaw joint pain that worsens with opening or closing the mouth. Headaches and tenderness around the ear canal are also common.
Giant Cell Arteritis
Giant cell arteritis (GCA)refers to inflammation of the branches of the external carotid artery, a large artery located in your neck.
This inflammation may cause pain in the ear canal or outer ear, along with temple and/or forehead pain, fever, fatigue, and a loss of appetite. Vision changes and pain with chewing may also be present.
Mastoiditis
If a middle ear infection remains untreated, the infection may spread to the mastoid bone—a spongy, air-filled bone that is part of your skull.
A mastoid bone infection (mastoiditis) causes pain, redness, and swelling behind the ear.
If mastoiditis is not recognized and treated promptly, it can lead to complications like a brain or skull bone abscess,meningitis, facial nerve paralysis, or hearing loss.
When to See a Healthcare Provider
If you are experiencing ear pain that is worsening, severe, or persisting for two or more days, it’s important to seek medical attention.
Other examples of situations that warrant a healthcare provider’s attention include:
Diagnosing Ear Pain
Imaging and blood tests are less commonly needed.
Medical History
When you see your healthcare provider for ear pain, expect them to ask several questions related to the details of your pain:
Physical Examination
During your physical exam, your healthcare provider will inspect the outer ear, ear canal, and tympanic membrane (eardrum) with an otoscope.
They will also inspect your nose, mouth, and sinuses, press on your TMJ, look at your back molars to check for signs of grinding or frequent clenching of the teeth, and examine your neck to look for enlarged lymph nodes or other masses.
Specialized Tests
ENTs are able to examine your ear pain and its effects using specific in-office tests:
Imaging
Imaging is sometimes needed to sort out an ear pain diagnosis:
Blood Tests
Blood tests may be used to help diagnose various ear pain conditions.
For instance, if your healthcare provider suspects a severe infection, especially mastoiditis, he may order awhite blood cell countand inflammatory marker tests, namelyerythrocyte sedimentation rate (ESR)andC-reactive protein (CRP).
Blood tests may also be used to rule out concerns like thyroid disease, diabetes, and syphilis, all of which may have symptoms similar to those of Meniere’s.
As there are many different causes of ear pain, there are similarly many possible treatments. The treatment of choice will specifically depend on the root cause of your ear pain.
Self-Care Strategies
Simple, at-home therapies can sometimes go a long way in easing your ear pain, especially if the pain is related to fluid build-up from a virus or allergies.
For instance, in order to ease the congestion of sinusitis, otitis media, or eustachian tube blockage, your healthcare provider may recommend taking an over-the-counter decongestant or using a nasal spray.
Other self-care strategies that may be helpful include:
5 Ways to Drain Fluid From the Middle Ear At Home
Self-care strategies also play an important role in managing TMJ syndrome:
Ear Flushing
Earwax Buildup and Blockage
Medications
Several different medications may be used to treat your ear pain:
Ear Drops
Likewise, ear drops are the primary treatment for external otitis. There are many different types of ear drops available, including antibiotics, acidifying solutions, and steroids.
Many of these ear drops work in combination to reduce inflammation, treat the infection, and ease pain.
Oral or Intravenous Antibiotics
Severe infections, like perichondritis and cellulitis, may require IV antibiotics given in the hospital.
Pain Relievers
To soothe your ear pain, your healthcare provider may recommend over-the-counter Tylenol (acetaminophen) ornonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil or Motrin (ibuprofen).
For the pain of TMJ syndrome, your healthcare provider may also prescribe a muscle relaxant or a tricyclic antidepressant.
20 Ways to Relieve Ear Pain
Surgery
A surgical procedure called amyringotomyis sometimes needed to treat chronic middle ear infections or persistent eustachian tube dysfunction.
A small hole is made in your eardrum to ease pressure and let the fluid drain. An ear tube may then be placed in the eardrum to allow airflow into the middle ear and to prevent fluid from re-accumulating.
Surgery may also be indicated for other ear pain diagnoses like a tumor, severe mastoiditis, or abscess formation in perichondritis.
What’s Involved in Ear Tube Surgery
Here are a few strategies that may helppreventcertain ear pain diagnoses:
To prevent earwax buildup:
To prevent external otitis (“swimmer’s ear”):
How to Prevent Ear Infections and Fluid in the Ears
Summary
Ear pain can sometimes be relieved with at-home treatment like a hot or cold compress, OTC pain relievers, and ear drops.
Prescription medications and ear drops may be needed to clear up ear infections. Severe infections, like perichondritis, may require hospitalization. In some cases, surgery may be needed to treat the cause of ear pain.
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