Why Does My Ear Hurt? Your Guide to Understanding Ear Pain
From minor irritations to serious infections, ear pain can occur for many reasons and quickly disrupt your daily life.
Whether it's a sharp stab or a severe ache, the discomfort can be overwhelming.
Understanding the causes of ear pain is the first step toward getting the relief you need.
What Does Ear Pain Feel Like?
Ear pain – also called otalgia – can be caused by irritation or damage to the ear or surrounding body parts.
The pain can feel like stinging, piercing, burning, or pressure, depending on the cause.
When pain in the ear comes from another part of the body, like the face, nose, throat, eyes, or chest, it’s known as referred pain.
This happens because the nerves in these areas are connected to the nerves in the ear.
If the pain comes directly from a problem inside the ear, it's called primary otalgia.
Secondary otalgia occurs when pain from another part of the body is felt in the ear. This happens because nerves in different areas are connected to the nerves in the ear.
As a result, pain in one part of the body can cause discomfort in the ear.
Earache can vary, with some cases involving mild discomfort and others escalating to severe pain.
What other symptoms accompany ear pain?
Any additional symptoms you experience with ear pain are crucial for helping healthcare professionals identify the underlying cause of your earache.
Symptoms that can appear along with ear pain include:
Itching in or around the ear (pruritus)
Ear discharge or fluid leaking from the ear (otorrhea)
Redness or swelling in or around the ear
Rashes or blisters near the ear
Facial weakness
Hearing loss
Fever, runny nose, sore throat, and other flu-like symptoms
Ringing in one or both ears (tinnitus), which may sometimes sync with your heartbeat
Key Point: Ramsay Hunt syndrome and ear pain
Ramsay Hunt syndrome is a shingles outbreak that affects the outer ear and leads to a blistering rash at the ear’s entrance, ear pain, and facial weakness, all on the same side of the head.
You may be affected by this rare disorder if you experience facial weakness, hearing loss, and rash alongside ear pain.
These symptoms arise from the reactivation of a latent chickenpox infection, with the virus (varicella) impacting the intricate network of nerves in the ear, causing both facial weakness and ear pain.
What are the Most Common Causes of Ear Pain?
Ear pain caused by a problem within the ear itself — referred to as primary otalgia, as mentioned earlier — is one of the most common causes of ear pain in the general population, particularly among males.
Nearly everyone will have ear pain at some point in their lives. Women, on the other hand, experience ear pain due to external causes more frequently.
Ear infections
Ear infections are the most common cause of ear pain, often resulting from bacterial infections, viruses, and more rarely, fungi.
The ear is divided into three parts: the outer, middle, and inner ear. Infections in any of these areas can lead to different symptoms.
Among children, nearly 80% will experience otitis media (a middle ear infection) before the age of three.
Middle ear infection (acute otitis media)
A middle ear infection is one of the most common diagnoses in children visiting emergency departments, alongside upper respiratory tract infections and superficial injuries.
Common bacterial causes of acute otitis media include Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis.
An ear infection occurs when the normal secretions of the middle ear become blocked. This blockage can result from various causes, including a viral upper respiratory tract infection.
The middle ear is sealed off from the external ear by the eardrum. Therefore, pressure from the outside can only be equalized from the inside.
The eustachian tube, a small passage connecting the middle ear, is responsible for this pressure regulation.
When an infection causes inflammation inside the middle ear, the Eustachian tube may become blocked, preventing secretions from draining normally. Bacteria can then breed in this trapped fluid, leading to the production of pus.
As pressure builds up inside the middle ear, it causes the eardrum to bulge outward. This pressure results in sharp, piercing ear pain.
Swimmer’s ear (otitis externa)
Swimmer’s ear – or otitis externa – is an infection of the outer, mostly visible part of the ear.
Statistics reveal that swimmer’s ear symptoms are severe enough to disrupt the daily lives of one in three individuals.
The condition is called swimmer’s ear because it commonly affects swimmers.
Water-containing germs, usually bacteria, enter the ear canal while swimming, leading to infection.
The use of cotton buds (Q-tips) and in-ear earphones has also been implicated in the development of otitis externa.
These infections are typically very painful, especially when the earlobe is tugged, and they often come with an associated itch.
People with swimmer’s ear may experience liquid oozing from the ear canal, which can eventually block the ear and lead to varying degrees of hearing loss.
Sinus infection
The sinuses are a group of four air-filled spaces connected to the nasal passages.
They often become inflamed due to viral or bacterial infections, leading to symptoms such as headaches, pressure sensations, or facial pain.
The complex network of nerves in the head can sometimes misinterpret these signals, causing the brain to perceive ear pain. This is often due to the trigeminal nerve, which transmits signals from both the ears and sinuses.
Allergies
Seasonal allergies, also known as allergic rhinitis or hay fever, often cause ear pain. This occurs due to the physical interconnectivity of the ears, nose, and throat.
When the body encounters a specific allergen, it releases histamine, a chemical that triggers mucus secretion from the nose.
This mucus may then flow toward the eustachian tube, which helps equalize pressure in the middle ear, leading to ear pain or a sensation of fullness.
Additionally, people with allergies often experience itching in the ears.
Hole in the eardrum
A ruptured eardrum can be caused by infections, injury, or sudden changes in environmental pressure.
This condition often begins with sudden, severe pain, which may be followed by a sense of relief as fluid starts to drain from the ear.
Symptoms such as ringing in the ears (tinnitus), hearing loss, and vertigo can also occur.
While many cases of ruptured eardrums heal on their own, you should seek medical attention if you suspect your eardrum has been ruptured.
Earwax buildup
Earwax serves as a protective barrier, safeguarding the ear from germs, debris, water, and even insects.
Excess earwax is typically expelled from the ear through natural jaw movements.
However, if wax accumulates due to insufficient natural drainage, it can lead to clogged ears, resulting in pressure, pain, hearing loss, or itching.
Changes in altitude
Altitude changes, that may occur during flights or mountainous drives, can create pressure differences on the eardrum, leading to discomfort, pain, or even rupture.
Other causes of ear pain
Earache can arise from various underlying conditions, some of which may not directly involve the ear. Here are some additional reasons you may be experiencing ear pain:
Eustachian tube dysfunction, where inflammation impairs pressure equalization in the ear
Referred pain from dental issues or conditions that affect the jaw, such as temporomandibular joint (TMJ) disorders
Certain cancers and ENT disorders that trigger ear pain
What are the Treatments for Ear Pain?
You can find relief from ear pain by using home remedies, OTC and prescription medications, and targeted therapies.
Home care and remedies
Chewing gum: Jaw movements can help equalize pressure in the middle ear, but if jaw issues are causing the pain, this should be avoided.
Special ear plugs for flying: These can help prevent pressure-related ear pain during flights.
Valsalva maneuver: For Eustachian tube dysfunction, gently blow out while pinching your nose and keeping your mouth closed to help equalize pressure on both sides of the eardrum.
Warm or cold compresses: Apply these to the affected area for relief.
Avoid Q-tips: Using them can worsen ear pain or cause damage.
Over-the-counter (OTC) treatments
Take pain relievers: Options include acetaminophen (Tylenol), ibuprofen (Advil), and aspirin.
Use a nasal irrigation device: Helps clear the nose of allergens that may contribute to Eustachian tube dysfunction.
Prescription treatments
You may not be able to treat severe pain or pain caused by certain underlying conditions with home remedies or OTC medication.
The table below contains prescription treatments your doctor may recommend:
Prescription treatment | Medication details |
Prescription painkillers | Your healthcare provider will decide whether these are necessary for ear pain management. |
Antibiotics for middle ear infections | Amoxicillin, co-amoxiclav, ceftriaxone: recommended for those who are not allergic to penicillin Azithromycin or clarithromycin: safe alternatives for those with penicillin allergies |
Antibiotics for swimmer’s ear | Ciprofloxacin, ofloxacin, polymyxin B: administered as ear drops, often combined with anti-inflammatory medications to reduce swelling and pain |
Steroid nasal sprays | These can be effective in treating Eustachian tube dysfunction by decreasing swelling in the tube. |
Targeted treatments | Consult your doctor to identify and treat the specific cause of your earache, whether it's primary or secondary otalgia, to ensure effective relief. |
Where Can I Learn More About Managing Ear Pain?
Whether you’re struggling with mild ear discomfort or severe pain, LifeMD can help you get the treatment you need.
Reach out to a board-certified doctor or nurse practitioner for guidance on managing ear pain. They can also assist you with a prescription to get the right medication and feel better.
Make your appointment today to take control of your health — all from the comfort of your own home.
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