If you have pain inside your ears, it will be difficult to think about anything other than this pain. In this article, we will help you understand the cause of ear pain and how to treat it.
Ear pain may be triggered by a problem inside the ear, such as an outer or middle ear infection, or from a problem outside (however near) the ear, such as sinusitis, temporomandibular joint syndrome, or an oral infection. How ear pain feels (hurting, sharp, dull, and so on), its strength, its area, and other symptoms you are experiencing (e.g., fever, lightheadedness) can provide your doctor a place to start when working to make a diagnosis.
Most often, your doctor can accomplish this without any testing, though some cases might require imaging and blood tests in order to eliminate more serious causes of ear pain, like mastoiditis or an ear tumor.
The treatment strategy your physician produces for your ear pain will depend upon your underlying medical diagnosis and may involve a combination of therapies.
Causes of Pain Inside Ear
Due to the multiple possible causes of ear pain, it’s most convenient to consider primary medical diagnoses (those that originate within the ear) versus secondary medical diagnoses (those that come from outside the ear) independently.
Conditions that often trigger ear pain and come from within the ear consist of the following.
Otitis Media
Otitis media explains a middle ear infection in which fluid and inflamed tissue develops in the center ear area — the area in between your eardrum (tympanic membrane) and the oval window of your inner ear.
Besides a moderate to extreme hurting pain felt deep in the ear, an individual with otitis media may report numerous days of nasal blockage and/or a cough preceding the pain in ears. Often, a fever might take place.
If the eardrum ruptures as a result of the pressure buildup, purulent (including pus) ear drainage might result.
Otitis Media With Effusion
Otitis media with effusion (OME) explains the presence of middle ear fluid without signs of infection. To put it simply, there is fluid buildup without tissue inflammation. Overall, the ear pain of OME is typically mild and connected with a sensation of ear fullness and/or reduced hearing.
Usually, OME follows acute otitis media, but it may also occur as a result of barotrauma (injury brought on by air or water pressure) or allergy. Rarely, OME happens as a result of growth clog of the eustachian tube — a tunnel that links the middle ear to the upper throat and back of the nose.
External Otitis (Swimmer’s Ear)
External otitis — an infection of the ear canal — causes a feeling of ear fullness, itchiness, and significant ear pain when the earlobe is pulled. Yellowish or clear-colored ear discharge may likewise occur, together with reduced hearing and swelling of the ear canal.
The factor external otitis is frequently called “swimmer’s ear” is due to the fact that it often develops when water gets caught in the ear canal. Another common perpetrator behind external otitis involves the regular use of cotton bud. Placing them into the ear can create little cuts in the ear canal that act as a breeding ground for bacteria.
An extreme issue of external otitis is necrotizing (malignant) external otitis in which the ear canal infection infects the base of the skull. This condition is more common in older people with diabetes mellitus.
Earwax Blockage
The purpose of earwax (cerumen) is to protect your ear canal from water, bacteria, and injury. In some cases though, excessive earwax is produced or the wax gets pushed back too deep into the ear canal (why physicians advise not using cotton swabs to clean out your ears).
If an earwax blockage takes place, ear discomfort — typically reported as a full or overloaded experience — might take place. Issues hearing and ringing in the ear might likewise arise from earwax clog.
Eustachian Tube Blockage
The eustachian tube is a narrow tunnel that connects your upper throat to your middle ear. It manages the atmospheric pressure in and drains pipes excess fluid from your middle ear. If the eustachian tube ends up being blocked, typically as a result of allergy, infection, or a rapid elevation change, the following symptoms might occur:
- Ear pain.
- Ringing or popping in the ears.
- Lightheadedness.
- Hearing loss.
Ear Skin Problems
In some cases ear pain stems from the skin of the ear.
3 associated conditions consist of:
- Dermatitis of the ear, which triggers itching, flaking, and swelling of the skin of the ear canal, might arise from an allergy (contact dermatitis) or as a result of an underlying skin issue (i.e., seborrheic dermatitis or psoriasis).
- Periauricular cellulitis (infected skin on the ear) results in a red, hot, and extremely tender ear. A fever may likewise be present.
- Herpes zoster oticus (” shingles of the ear”) causes severe ear pain along with a vesicular rash (tense, fluid-filled sacs). In unusual circumstances, facial paralysis might occur together with the rash and ear pain in what’s known as Ramsay Hunt syndrome.
Perichondritis
Perichondritis emerges from an infection of your ear cartilage, leading to pain, swelling, and soreness over the skin. Fever may also exist and often an abscess (collection of pus) kinds. Without treatment, perichondritis can result in ear defect (called cauliflower ear) as the infection cuts off blood supply to the cartilage, consequently ruining it.
Perichronditis is probably to take place in people with certain autoimmune conditions, such as granulomatosis with polyangiitis, and those who experience trauma to the ear cartilage (e.g., upper ear piercing, a burn, or harsh contact from sports).
Meniere’s Disease
Meniere’s disease is triggered by excess fluid buildup in the inner ear, although the precise “why” behind this fluid retention is unknown. In addition to the traditional triad of symptoms — vertigo, ringing in the ears, and hearing loss– some individuals with Meniere’s disease report ear pain or pressure.
Tumors
Although not common, a cancerous or noncancerous tumor may be the source behind a person’s ear pain.20 For example, nasopharyngeal cancer (a type of head and neck cancer) might trigger ear fullness, in addition to hearing loss, ringing in the ears, and reoccurring ear infections.
2 examples of noncancerous tumors or growths that may develop in the ear and cause pain include:
- Cholesteatoma: A benign skin growth that forms in the center ear.
- Acoustic neuroma: A benign inner ear tumor that establishes on the vestibular nerve (8th cranial nerve).
Following conditions may cause ear pain, thought they originate outside of the ear.
Sinus problems
Sinus problems refers to infection or inflammation of the sinuses, which are hollow spaces located behind your nose, in between your eyes, and within your cheekbones and lower forehead. Sinus problems might cause a range of symptoms, such as:
- Ear pressure, discomfort, or fullness.
- Fever.
- Nasal blockage and discharge.
- Tooth pain.
- Headache.
The majority of cases of sinusitis are caused by a viral disease or allergy; only a small percentage of cases are because of a bacterial infection.
Oral Problems
Dental problems, such as a broken tooth, decayed tooth, or tooth abscess, may refer pain to the ear. Usually, the pain is intensified by hot or cold stimuli or biting or consuming.
Temporomandibular Joint (TMJ) Disorder
Your temporomandibular joint (TMJ) links your lower jaw to the temporal bone of your skull. Arthritis or disintegration of the joint or stress/overuse of the surrounding muscles may trigger TMJ disorder.
The pain of TMJ disorder is typically described as a constant and dull jaw joint pain that gets worse with opening or closing the mouth. Headaches and inflammation around the ear canal are also typical.
Giant Cell Arteritis
Giant cell arteritis (GCA) refers to inflammation of the branches of the external carotid artery, a large artery located in your neck. This inflammation may trigger pain in the ear canal or external ear, along with temple and/or forehead pain, fever, tiredness, and an anorexia nervosa. Vision changes and pain with chewing might likewise be present.
Mastoiditis
If a middle ear infection stays unattended, the infection may spread to the mastoid bone — a spongy, air-filled bone that becomes part of your skull. A mastoid bone infection (mastoiditis) causes pain, soreness, and swelling behind the ear.
If mastoiditis is not acknowledged and treated immediately, it can result in issues like a brain or skull bone abscess, meningitis, facial nerve paralysis, or hearing loss.
When to See a Doctor
If you are experiencing ear pain that is worsening, serious, or persisting for 2 or more days, be sure seek medical attention.
Other examples of circumstances that require a physician’s attention include:
- Ear pain accompanied by a fever and/or a sore throat.
- Pain when pulling on your earlobe.
- Ear discharge.
- Ringing in the ears, dizziness, or hearing loss.
- Swelling or rash of the ear canal or earlobe.
Diagnosis
- Detecting ear pain typically just needs a case history and physical examination by a medical care physician or an ear, nose, and throat (ENT) expert.
- Imaging and blood tests are less commonly required.
Case history.
When you see your medical professional for ear pain, you can expect him to ask several questions connected to the information of your pain:
- What does the pain feel like?
- Does the pain come and go or is it continuous?
- Exist any associated symptoms present, such as fever, hearing loss, balance issues or dizziness, ear drainage, or tinnitus (ringing in the ears)?
- Have you recently been ill or skilled any trauma to the face or ear?
Physical Examination
Throughout your physical exam, your physician will check the external ear, ear canal, and tympanic membrane (eardrum) with an otoscope. Your doctor will likewise check your nose, mouth, and sinuses. He might likewise continue your TMJ, take a look at your back molars to check for signs of grinding or frequent clenching of the teeth, and examine your neck to search for enlarged lymph nodes or other masses.
Remember, as part of your examination, your ENT might perform a nonsurgical treatment called nasal endoscopy to much better examine your nose and sinuses. The endoscope — a thin tube with a camera and light — permits your doctor to better examine your nose, sinuses, and the top of your throat (where the opening of your eustachian tube lies).
Last but not least, if you are experiencing hearing loss and/or dizziness (balance problems), your ENT may refer you for a hearing and/or a vestibular function test.
Imaging
Imaging is sometimes needed to sort out an ear pain diagnosis. For example, an X-ray may be ordered to assess an oral problem or to analyze the jaw in TMJ condition.
A computed tomography (CT) scan may be essential if mastoiditis is believed, especially if a person is experiencing uneasy problems of mastoiditis, like cranial nerve deficits or signs of meningitis.
A CT scan or magnetic resonance imaging (MRI) might also be purchased if your physician presumes a possible tumor, such as nasopharyngeal cancer or cholesteatoma, as the source of your ear pain. An MRI to analyze your brain might be used to examine for a diagnosis of Meniere’s disease, as central nerve system conditions, like a brain tumor or multiple sclerosis, may simulate the symptoms of Meniere’s disease.
Blood Tests
Blood tests might be used to assist diagnose various ear pain conditions. For instance, if your physician suspects a severe infection, especially mastoiditis, he might purchase a white blood cell count and inflammatory marker tests, particularly erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).
Blood tests may likewise be used to eliminate concerns like thyroid disease, diabetes, and syphilis, all of which might have symptoms similar to those of Meniere’s.
Treatment
As there are various causes of ear pain, there are likewise lots of possible treatments. The treatment of choice will particularly depend on the root cause of your ear pain.
Self-Care Strategies
Basic, at-home treatments can in some cases go a long way in reducing your ear pain, specifically if your ear pain is related to fluid build-up from a virus or allergies.
For example, in order to relieve the blockage of sinus problems, otitis media, or eustachian tube blockage, your medical professional may advise taking an over-the-counter decongestant or utilizing a nasal spray.
Other self-care methods that might be handy include:
- Hold a warm compress against your ear or sinuses.
- Take a hot bath or shower to loosen congestion.
- Yawn or chew gum in order to attempt “pop” your ears.
- Consume lots of water (six to 8 glasses per day).
Self-care techniques also play an important function in managing TMJ syndrome. These strategies consist of:
- Performing easy jaw workouts.
- Avoiding triggers of TMJ pain (e.g., chewing gum or grinding your teeth).
- Utilizing a bite guard when you sleep.
- Taking part in relaxation and stress management methods.
Ear Flushing
Ear flushing is carried out by a healthcare expert to eliminate affected wax. The treatment is also utilized to remove particles, infected material, and dead skin cells in the treatment of otitis externa.
Medications
Numerous different medications might be used to treat your ear pain:
Ear Drops
Earwax-softening drops might be recommended by your doctor if you have earwax buildup.
Also, ear drops are the primary treatment for external otitis. There are many different types of ear drops available, including antibiotics, acidifying services, and steroids. A lot of these ear drops operate in combination to decrease inflammation, treat the infection, and relieve pain.
Oral or Intravenous Antibiotics
Sometimes oral (by mouth) or intravenous (by vein) antibiotics are needed to treat more serious causes of ear pain, such as:
- Bacterial sinusitis.
- Serious cases of external otitis, including necrotizing (deadly) external otitis.
- Perichondritis.
- Mastoiditis.
- Periauricular cellulitis.
Painkiller
To relieve your ear pain, your medical professional might recommend over-the-counter Tylenol (acetaminophen) or nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil or Motrin (ibuprofen). For the pain of TMJ syndrome, your doctor may likewise recommend a muscle relaxant or a tricyclic antidepressant.
Surgery
A surgical procedure called a myringotomy is sometimes needed to deal with chronic middle ear infections or persistent eustachian tube dysfunction.
With a myringotomy, a small hole is made in your eardrum to alleviate pressure and let the fluid drain. An ear tube might then be positioned in the eardrum to enable airflow into the middle ear and to prevent fluid from re-accumulating.
Surgery may likewise be suggested for other ear pain diagnoses like a tumor, serious mastoiditis, or abscess development in perichondritis.
Prevention
Here are a few techniques that might help prevent certain ear pain identifies:
To prevent earwax buildup:
- Avoid chronic use of cotton bud or earwax softening agents, such as Debrox (carbamide peroxide).
- If you suffer from frequent episodes of earwax buildup, think about regular use of topical emollients or a regular ear cleaning by a health care expert every 6 to 12 months.
To prevent external otitis (“swimmer’s ear”):
- After swimming, blow-dry your ears (utilizing a low setting and holding the hairdryer about a foot away).
- Consider using special earplugs for swimming.
- Prevent sticking your finger or towel into your ears after swimming.
