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An earache can be a sharp, dull, or burning pain in one or both ears. The pain may be temporary or constant.
Otalgia; Pain - ear; Ear pain
The symptoms of an ear infection may include:
- Ear pain
- Increased crying
Many children will have temporary and minor hearing loss during or right after an ear infection. Permanent hearing loss is rare, but the risk increases with the number of infections.
The eustachian tube runs from the middle part of each ear to the back of the throat. This tube drains fluid that is normally 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. What you think is ear pain may actually be coming from another location, such as your temporomandibular joint, teeth, throat, or other location. This is called "referred" pain.
Causes of ear pain may include:
- Arthritis of the jaw
- Acute ear infection
- Chronic ear infection
- Ear injury from pressure changes (from high altitudes and other causes)
- Object stuck in the ear or severely impacted ear wax
- Ruptured or perforated eardrum
- Sinus infection
- Sore throat with referred pain to the ears
- Temporomandibular joint syndrome (TMJ)
- Tooth infection
Ear pain in a child or infant may be due to infection, or the following causes:
- Ear canal irritation from cotton-tipped swabs
- Soap or shampoo staying in the ear
The following steps may help an earache:
- A cold pack or cold wet wash cloth applied to the outer ear for 20 minutes may reduce pain.
- For children old enough to safely chew gum, chewing may help relieve the pain and pressure of an ear infection.
- If a child is uncomfortable lying down, resting in an upright position can help reduce pressure in the middle ear.
- Over-the-counter ear drops are gentle and effective, 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.)
You can relieve ear pain caused by rapidly descending from high altitudes by swallowing or chewing gum. Allowing infants to suck on a bottle or breastfeed while the plane is descending can help.
When to Contact a Medical Professional
Call your doctor if:
- Your child has a high fever or severe pain or seems sicker than is usual for an ear infection
- New symptoms appear, especially:
- Severe headache
- Swelling around the ear
- Weakness of 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 - 48 hours
What to Expect at Your Office Visit
The doctor will do a physical examination, and examine 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.
The following steps can help prevent earaches:
- Avoid smoking near children. Smoking has been shown to cause millions of ear infections each year in children.
- Prevent outer ear infections by not putting objects in the ear, and drying the ear after bathing or swimming.
- Take steps to control allergies. In particular, avoid allergy triggers. Steroid nasal spray may help reduce ear infections. However, over-the-counter sedating antihistamines and decongestants do NOT prevent ear infections.
Ely JW, Hansen MR, Clark EC. Diagnosis of ear pain. Am Fam Physician. 2008;77(5):621-628.
American Academy of Pediatrics Subcommittee on Management of Acute Otitis Media. Diagnosis and management of acute otitis media. Pediatrics. 2004;113(5):1451-1465.
Coker TR, Chan LS, Newberry SJ, Limbos MA, Suttorp MJ, Shekelle PG, et al. Diagnosis, microbial epidemiology, and antibiotic treatment of acute otitis mediain children: a systematic review. JAMA. 2010 Nov 17;304(19):2161-9.
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.