Ear Pain

Ear pain can range from mild discomfort or a feeling of fullness to severe, intense pain. Often ear pain results from conditions of the outer or middle ear. Ear pain usually results from conditions that may be caused by infection or trauma to the ear, or blockage of the ear canal or the eustachian tube, the tube leading from the middle ear to the back of the nasal cavity.

When a person complains of ear pain, the healthcare professional needs to know:

• when the pain started
• whether the pain is constant
• whether it is getting worse, better, or staying the same
• whether anything decreases the pain or make the ear pain worse
• if there is any ringing in the ear
• if a change in position increases pain
• if there are any other symptoms, such as fever, vomiting, headache, itching, or pain in other areas of the face, such as the sinuses or jaw
• if there is drainage from the ear and, if so, the color and consistency of the drainage
• if there is any hearing impairment
• if the individual has a feeling of dizziness or vertigo, a sensation that the room is spinning around
• what medications, drugs, or herbs the person takes, if any
• what other medical problems the person has, if any

There are many possible causes of ear pain, including:

• trauma to the ear, including damage caused by use of cotton swabs
• sudden changes in pressure, such as changes in altitude when flying
• blockage of the ear canal from earwax or foreign object
• otitis externa, that is, swimmer's ear
• acute otitis media, an infection of the middle ear
• mastoiditis, which is a serious bacterial infection of the bone behind the ear
• allergic reactions and allergies
• ruptured eardrum
• acute or chronic sinusitis
• tooth abscess
• sore throat with referred pain to the ears
• Meniere's disease, which is a disorder of the inner ear
• tumors of the ear, which may be cancerous or benign
• temporomandibular joint syndrome

Protecting the ear from such conditions as trauma and loud noises may decrease the risk of ear pain. Seeking early care for upper respiratory infections may decrease the risk of ear infection. When swimming, a person should avoid putting his or her head under water, or wear earplugs to prevent water from getting into the ear canal. A person should not insert a cotton swab into the ear canal. Many causes cannot be prevented.

A healthcare professional will look in the ear with an instrument called an otoscope. Based on the medical history and exam, further hearing tests may be needed. Blood tests may be ordered if an infection is suspected. Blood cultures, x-rays, and cranial CT scans may be done.

Ear pain from an injury may heal without any long-term effects. Some injuries or infections may lead to permanent hearing impairment or chronic pain. A person who has a tumor in his or her ear or throat causing ear pain may require surgery and medications over a long period of time.

Ear pain itself is not contagious and poses no risk to others. If the pain is caused by an infection such as strep throat, that infection may be contagious.

Heat may be recommended for some causes of ear pain. Eardrops may be prescribed to relieve pain and treat swimmer's ear. Antibiotics are used to middle ear infections. Over-the-counter pain medications such as ibuprofen (i.e., Advil, Motrin) or acetaminophen (i.e., Tylenol) may be used to decrease the pain

Those with cancer may need surgery, chemotherapy, or radiation therapy. Surgery may be needed for those who have damage to their ear from an injury or recurrent infections.

Side effects to treatment will depend on the treatment used. There may be stomach upset or allergic reactions to antibiotics or ibuprofen. Surgery can be complicated by bleeding, infection, or reactions to anesthesia.

A person with minor ear pain and no other conditions may heal completely and not need further treatment. If a person has surgery, he or she may need to rest for a few days to a few weeks and need follow up care. Some people may need hearing aids to improve their hearing or may need to learn sign language if hearing is impaired.

Any new or worsening symptoms should be reported to the healthcare professional.