Alternative
Names
otalgia; pain in the ear
Definition
Pain in the ear that may be sharp, dull, burning, transient, or constant.
Common Causes
- obstruction of the outer
ear (due to a foreign object or ear wax)
- infection of the outer
or inner ear
- otitis externa
- acute otitis media
- otitis externa;
chronic
- otitis externa;
malignant
- otitis media;
chronic
- high altitudes (and
other causes of acute barotrauma)
- ruptured or perforated
eardrum
- tooth infection
- sinus infection
- arthritis of the jaw
- sore throat (pharyngitis,
tonsillitis, and so forth) with referred pain to the ears
Note: This list is not all
inclusive and the causes are not presented in order of likelihood. The
list of all possible causes can be extensive and include unlikely diseases
and medications. Furthermore, the list will vary based on the age and
gender of the individual as well as on the specific characteristics of the
symptom, such as location, quality, timing, aggravating factors, relieving
factors, and associated complaints. Use the Symptom Analysis option to
explore the possible explanations for this symptom occurring alone or in
combination with other problems.
Considerations
Ear pain is caused by a build-up of fluid and pressure in the portion of
the ear behind the eardrum (called the middle ear).
The middle ear is drained by a short narrow tube (the Eustachian tube)
into the nasal passages. A cold or allergy can cause the Eustachian tube
to become swollen shut, especially in small children where the tube is
smaller. When the Eustachian tube closes, the normal flow of fluid from
the middle ear is prevented, and the fluid begins to accumulate which can
cause stuffiness, pain, and hearing loss.
Ear pain is not necessarily due to a disease of the ear. Infections and
other problems of the nose, mouth, throat, and jaw joint can cause pain in
the ear.
When dealing with young children:
Increased irritability or pulling at the ears is often a sign of ear pain
in infants. Ear infection symptoms may include fever, ear pain, fussiness,
increased crying, irritability, or pulling at the ears. Ear infections are
very common in infancy and childhood and are often associated with colds.
Most children will have a temporary and minor hearing loss during and
right after an ear infection, but there is rarely any permanent hearing
loss as long as the problem is properly managed by a health care provider.
Call
Your Health Care Provider If
- a child has an earache
and discomfort is severe or lasts for longer than 2 days. All ear
infections, even mild ones, require treatment.
What
To Expect At Your health Care Provider's Office
The medical history will be
obtained and a physical examination performed.
Medical history questions documenting ear pain in detail may include:
- time pattern
- When did it begin?
- Is it getting
better, worse, or staying the same?
- Is the pain
constant?
- other
- What other symptoms
are also present?
- Is there ear
pressure?
- Is there drainage
from the ear?
- Are there unusual
ear noises?
- Is there a fever?
- Is there pain in the
bone behind the ear?
Physical examination may
include examination of the ear, nose, mastoid (bony part behind the ear),
and throat. Pain, tenderness, or redness of the mastoid often indicates a
serious infection.
Possible diagnostic tests include blood culture and sensitivity studies
(if there is discharge).
Intervention:
Antibiotics and medications (such as decongestants and antihistamines) to
open the Eustachian tube(s) are often prescribed. It is important to take
ALL of the prescribed antibiotic on schedule.
The insertion of ear tubes may be recommended for children who have
persistent otitis media in order to reestablish proper functioning of the
middle ear. Inserting ear tubes is a simple and very effective procedure.
After seeing your health care provider:
If a diagnosis was made by your health care provider related to an
earache, you may want to note that diagnosis in your personal medical
record.
Home
Care
A vaporizer can help by
adding moisture and humidity that can keep the mucus thin.
Over-the-counter analgesics can provide partial pain relief for adults
with an earache.
Opening the Eustachian tube can help. Antihistamines, decongestants, or
nose drops decrease the amount of nasal secretion and shrink the mucus
membranes. Use these products for only a few days; if symptoms last longer
than this you should consult your health care provider.
Ear pain caused by rapidly descending from high altitudes can be relieved
by swallowing, chewing gum, or other methods. Allowing infants to suck on
a bottle during descent can help.
Pediatric home care:
- Give the child
pain-relieving tablet or liquid (acetaminophen - oral or ibuprofen).
Follow the dosage recommended on the package label.
- Avoid cigarette smoke
near the child (possible increased risk of infection).
- If previously prescribed
by the doctor, give the child eardrops for pain.
- Apply a warm heating pad
or warm water bottle to the ear to reduce discomfort.
- If the child is
uncomfortable lying down, resting in an upright position may help
reduce pressure in the middle ear.
- Avoid the use of aspirin
in teenagers or children who might have the flu or chicken pox because
of the risk of Reye's syndrome, which is a serious problem of the
brain and liver.
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