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Earache

Otalgia; Pain - ear; Ear pain

 

An earache is a sharp, dull, or burning pain in one or both ears. The pain may last a short time or be ongoing. Related conditions include:

  • Otitis media
  • Swimmer's ear
  • Malignant otitis externa

Considerations

 

The symptoms of an ear infection may include:

  • Ear pain
  • Fever
  • Fussiness
  • Increased crying
  • Irritability

Many children will have minor hearing loss during or right after an ear infection. Most of the time the problem goes away. Lasting hearing loss is rare, but the risk increases with the number of infections.

 

Causes

 

The eustachian tube runs from the middle part of each ear to the back of the throat. This tube drains fluid that is made in the middle ear. If the eustachian tube becomes blocked, fluid can build up. This may lead to pressure behind the eardrum or an ear infection .

Ear pain in adults is less likely to be from an ear infection. Pain that you feel in the ear may be coming from another place, such as your teeth, the joint in your jaw ( temporomandibular joint ), or your throat. This is called "referred" pain.

Causes of ear pain may include:

  • Arthritis of the jaw
  • Short-term ear infection
  • Long-term ear infection
  • Ear injury from pressure changes (from high altitudes and other causes)
  • Object stuck in the ear or buildup of ear wax
  • Hole in the eardrum
  • Sinus infection
  • Sore throat
  • Temporomandibular joint syndrome (TMJ)
  • Tooth infection

Ear pain in a child or infant may be due to infection. Other causes may include:

  • Ear canal irritation from cotton-tipped swabs
  • Soap or shampoo staying in the ear

 

Home Care

 

The following steps may help an earache:

  • Place a cold pack or cold wet washcloth on the outer ear for 20 minutes to reduce pain.
  • Chewing may help relieve the pain and pressure of an ear infection. (Gum can be a choking hazard for young children.)
  • Resting in an upright position instead of lying down can reduce pressure in the middle ear.
  • Over-the-counter ear drops can be used to relieve pain, as long as the eardrum has not ruptured.
  • Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can provide relief for children and adults with an earache. (DO NOT give aspirin to children.)

For ear pain caused by a change of altitude , such as on an airplane:

  • Swallow or chew gum as the plane descends.
  • Allow infants to suck on a bottle or breastfeed.

The following steps can help prevent earaches:

  • Avoid smoking near children. Secondhand smoke is a major cause of ear infections in children.
  • Prevent outer ear infections by not putting objects in the ear.
  • Dry the ears well after bathing or swimming.
  • Take steps to control allergies. Try to avoid allergy triggers.
  • Try a steroid nasal spray to help reduce ear infections. (However, over-the-counter antihistamines and decongestants DO NOT prevent ear infections.)

 

When to Contact a Medical Professional

 

Call your health care provider if:

  • Your child has a high fever, severe pain, or seems sicker than is usual for an ear infection.
  • Your child has new symptoms such as dizziness, headache, swelling around the ear, or weakness in the face muscles.
  • Severe pain suddenly stops (this may be a sign of a ruptured eardrum).
  • Symptoms (pain, fever, or irritability) get worse or do not improve within 24 to 48 hours.

 

What to Expect at Your Office Visit

 

The provider will do a physical exam and look at the ear, nose, and throat areas.

Pain, tenderness, or redness of the mastoid bone behind the ear on the skull is often a sign of a serious infection.

 

 

Open References

References

Bauer CA, Jenkins HA. Otologic symptoms and syndromes. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 156.

Coker TR, Chan LS, Newberry SJ, et al. Diagnosis, microbial epidemiology, and antibiotic treatment of acute otitis media in children: a systematic review. JAMA . 2010;304(19):2161-2169. PMID: 21081729 www.ncbi.nlm.nih.gov/pubmed/21081729 .

Lieberthal AS, Carroll AE, Chonmaitree T, et al. The diagnosis and management of acute otitis media. Pediatrics . 2013;131(3): e964-e999. PMID: 23439909 www.ncbi.nlm.nih.gov/pubmed/23439909 .

O'Handley JG, Tobin EJ, Shah AR. Otorhinolaryngology In: Rakel RE, Rakel DP eds. Textbook of Family Medicine . 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 18.

 
  • Ear anatomy

    Ear anatomy - illustration

    The ear consists of external, middle, and inner structures. The eardrum and the 3 tiny bones conduct sound from the eardrum to the cochlea.

    Ear anatomy

    illustration

  • Medical findings based on ear anatomy

    Medical findings based on ear anatomy - illustration

    The external structures of the ear may aid in diagnosing some conditions by the presence or absence of normal landmarks and abnormal features including: earlobe creases, preauricular pits, and preauricular tags.

    Medical findings based on ear anatomy

    illustration

    • Ear anatomy

      Ear anatomy - illustration

      The ear consists of external, middle, and inner structures. The eardrum and the 3 tiny bones conduct sound from the eardrum to the cochlea.

      Ear anatomy

      illustration

    • Medical findings based on ear anatomy

      Medical findings based on ear anatomy - illustration

      The external structures of the ear may aid in diagnosing some conditions by the presence or absence of normal landmarks and abnormal features including: earlobe creases, preauricular pits, and preauricular tags.

      Medical findings based on ear anatomy

      illustration

    Self Care

     

      Tests for Earache

       
         

        Review Date: 4/21/2015

        Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Internal review and update on 07/24/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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