Ear pain is quite common in kids, however, even adults may suffer from a frequent earache. In most cases, it affects only one ear but in some, it can cause pain in both the ears. The pain might be dull, sharp or burning depending upon the cause and may lead to a consistent or an on and off pattern of an earache. If you have an ear infection, it can also cause other symptoms such as fever and temporary hearing impairment. In some, it can also lead to fluid drainage from the ears. Ear pain is mostly accompanied by a headache, jaw pain, difficulty in sleep and irritability.
There are many causes of ear pain in both kids and adults such as injury, infection, or pain in the jaw. Here are some of the common causes of ear pain explained in detail.
5 common causes of ear pain
Otalgia (ear pain), a common symptom, is broadly classified into primary otalgia and secondary otalgia. The pain that originates from the ear is called as primary otalgia. It is mostly caused due to infection of the middle ear (otitis media) and external ear (otitis externa). If the pain originates from the outside the ear, then it is called as secondary otalgia. The most common causes of secondary ear pain include dental infections and temporomandibular joint syndrome (jaw disorder). Primary otalgia is more common in children whereas secondary otalgia is common in adults.
Some of the common causes of ear pain include:
1. Earwax: As the name suggests, your ear canal produces a waxy substance known as cerumen, which is commonly called earwax. Your ear produces and gets rid of the wax from time to time. When the process fails to function properly, it causes a buildup of earwax in the canal. This, in turn, gets hardened and accumulates in the ear canal blocking the canal, which may lead to ear pain.
In certain cases, when you clean your ears with a cotton bud or any other objects, there are chances that you might have accidentally pushed the wax deeper in the ear. This not only causes blockage of the canal but also lead to ear pain. If left unattended, it can increase the risk of an ear infection. This may even cause temporary hearing loss along with severe earache.
Most people use home remedies such as baby oil to soften hardened earwax and remove it. There are over the counter kits which help you to clean your ears and remove earwax at home. But if not done with care, it can damage the ears as well. Hence, it is always advised to consult an ENT specialist to remove earwax and treat ear pain.
2. Air pressure: One of the common causes of ear pain is a change in air pressure. Usually, the pressure on both sides of the eardrum is well balanced. However, there are certain factors that can affect the air pressure in the ears. For example, when you are on a plane or are in an elevator, there is a shift in the air pressure. The popping of the ears usually relieves the pressure in the ears. But when it is not, it might hurt the ears and lead to ear pain. This can also affect the hearing for a short time.
To prevent the buildup of pressure in the ears in a plane, chew gum, yawn or swallow while takeoff and landing as it helps to pop out the ear and lead to de-clogging of ears on a flight. Also, if you have an ear infection or suffer from cold, allergy or sinus infection, it is wise to avoid flight journey as it can increase the risk of ear infection and worsen ear pain.
3. Swimmer’s ear: There are times when you do not wear an earplug while swimming or water gets leaked into your ears while taking a bath. This not only leads to hearing impairment but also causes discomfort in the ears. If the water, which is trapped in the ears is not cleared, it can act as a breeding ground for germs. The affected ear might appear red, swollen and can cause itching and leaking of pus. Your ear might hurt when the earlobe is pulled or pushed. This is a sign of an outer ear infection, which if not treated can lead to hearing loss. However, it is not a contagious condition, which means it doesn’t spread from one person to other.
The best way to avoid swimmer’s ear and prevent ear pain is to keep the ears dry during swimming. You can even opt for a shower cap to avoid entry of water when taking a bath. In most cases, doctors prescribe antibiotic ear drops to clear the infection if any, and painkillers to relieve earache. Avoid self-medication and always consult a doctor to prevent serious damage to the ears.
4. Ear infection: Infections of the ear are the key causes of ear pain which can lead to mild to severe ear pain. Certain conditions such as allergies, cough, cold and sinus infection can cause a middle ear infection or otitis media. Mucus which is produced during cold and cough can block the tubes present in the middle ear. This causes excess fluid build up in the ear canal, which in turn, can cause an infection.
Outer ear infection, known as otitis externa, can be caused due to use of headphones or hearing aids which can damage the skin inside the ear canal. Putting fingers or cotton swabs can also irritate the skin in the ear canal, increasing the risk of infection.
Your doctor might prescribe antibiotics to clear the infection and soothe ear pain. In certain cases, medications to treat the underlying causes of ear pain such as cold and allergy is required for providing relief. Do consult a doctor if the pain worsens or fails to go away in a day or two because if left untreated it can damage the ears and even cause hearing loss.
5. Other conditions: Certain conditions such as a toothache can also cause pain in the ear. This is because, the nerves present in your face and neck are closely related and hence, any nerve injury or damage in the neck or face can impact the ears as well. This type of pain is known as referred pain as the pain starts in one area but is felt in another area. Similarly, if you have a sore throat along with ear pain, it could be a sign of a respiratory infection such as tonsillitis or pharyngitis. Moreover, tooth cavities or abscesses can also cause ear pain.
A condition known as temporomandibular joint (TMJ) disorder, which causes pain and discomfort in the TMJ can also cause ear pain. TMJ acts like a hinge connecting the jawbone to the skull and present just below your ears. In such a case, your doctor has to treat the underlying causes of ear pain to provide relief from the symptom. Avoid use of over-the-counter pain medicine as it might cause more harm than good.
Most often than not, we tend to ignore ear pain or try simple home remedies to get rid of an earache. However, if the ear pain is severe and doesn’t go away in two-three days, consult a doctor. Ear pain associated with other symptoms such as a sore throat, jaw pain, or high fever, could be a sign of an underlying condition and hence, it is wise to get a doctor’s appointment.
(The article is reviewed by Dr. Lalit Kanodia, General Physician)
1. Earwood JS, Rogers TS, Rathjen NA. Ear Pain: Diagnosing Common and Uncommon Causes. Am Fam Physician. 2018 Jan 1;97(1):20-27.
2. Informed Health Online [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006. Middle ear infection: Overview. 2009 Jun 29.
3. Informed Health Online [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006. Outer ear infection: Overview. 2013 Oct 29.
4. Worrall G. Acute earache. Can Fam Physician. 2011 Sep;57(9):1019-21, e320-2.