Ear pain (otalgia) commonly occurs in children, but it can also happen in adults. Pain that begins inside the ear is known as primary otalgia, whereas pain that originates outside the ear is known as secondary otalgia.

Ear pain can arise gradually or all of a sudden. The pain can feel dull, sharp, or burning, and can be temporary or ongoing. Usually, the pain arises in only one ear, but sometimes it can appear in both ears.

Signs and Symptoms of Ear Pain

Symptoms that can accompany ear pain include:

  • Fever
  • Drainage from the ear
  • Hearing loss
  • Headache
  • Difficulty chewing
  • Jaw pain
  • Clicking or popping
  • Fussiness and irritability (in children)
  • Increased crying (in children)
  • Loss of appetite (in children)

Causes and Risk Factors of Ear Pain

Ear pain is often caused by a blockage in the eustachian tube, the passageway that extends from the middle ear to the back of the nasal cavity and the throat. When the eustachian tube is blocked, air and fluid can’t flow through the passageway, causing a buildup of pressure and pain.
Ear infections are a common cause of ear pain, especially in children. Middle ear infections, called otitis media, occur when fluids build up in the tubes inside the middle ear.This fluid can then become infected by a bacteria or virus.
Children are more likely to get ear infections than adults, in part because their eustachian tubes are smaller and straighter, which makes it harder for fluid to drain out. Their immune systems are also still developing, which makes them more susceptible to infections.
Swimmer’s ear — also known as otitis externa (infection of the outer ear and ear canal) — can be caused by unclean water that gets stuck in the outer ear canal after swimming, creating an ideal environment for infection-causing bacteria.
Ear pain can be caused by scratching the inside of the ear with a finger, cotton swab, or other object.
Other possible causes of ear pain include:
  • Allergies
  • Sinus infection
  • Sore throat
  • Tooth infection
  • Buildup of earwax
  • Ruptured eardrum
  • Altitude pressure changes (barotrauma)
  • Temporomandibular joint syndrome (TMJ, or problems with the joint that connects your jaw to the side of your head)
  • Arthritis of the jaw
Ear infections usually aren’t the main cause of ear pain in adults. Rather, the pain may stem from a problem such as TMJ.

How Is Ear Pain Diagnosed?

A doctor can diagnose ear pain based on your symptoms and medical history. They will also likely examine your ears, nose, and throat with an otoscope (an instrument with a light) to check for redness and other symptoms in order to find the cause of your ear pain.
To diagnose an ear infection, a doctor can also use the otoscope to blow a puff of air against the eardrum to see if it’s moving normally.

Prognosis of Ear Pain

The prognosis of ear pain depends on the cause. Ear infections, for example, tend to clear up on their own within a week or two.
A ruptured eardrum also tends to heal by itself within a few months. The prognosis tends to be good; rarely, long-term hearing loss and symptoms like dizziness and vertigo can occur.

Treatment and Medication Options for Ear Pain

The treatment for ear pain often depends on what’s causing the problem. Common treatments include medication, surgery, and home remedies.

Medication Options

To reduce ear pain, your doctor may recommend over-the-counter (OTC) drugs such as Tylenol (acetaminophen) or ibuprofen (Advil, Motrin). Your doctor may also recommend OTC ear drops to relieve the pain, but these should never be used if there’s a chance the eardrum has ruptured.
Antibiotics are sometimes prescribed for ear infections, but in many cases, they aren’t necessary. In children, antibiotics such as amoxicillin may be used to treat ear infections that are severe or last for more than a few days.

A buildup of earwax in the ear canal can cause an earache. Still, never stick anything into your ear — including a cotton swab, which will just push the wax deeper into the ear instead of removing it. Excessive earwax should be diagnosed and treated by a healthcare professional.

Home Remedies and Alternative and Complementary Therapies

Many people experience ear pain and mild hearing loss or muffling due to sudden changes in air pressure, such as when they’re traveling on an airplane, taking an elevator, or diving to the bottom of a swimming pool. When this occurs, swallowing repeatedly — for example, by chewing gum or sucking on hard candy — can help clear your ears.(This kind of ear pain is usually temporary and rarely leads to lasting problems.)
A cold compress can help relieve ear pain. Place a cold pack or wet washcloth on the affected ear for about 20 minutes.Both hot and cold packs can be used to ease the symptoms of TMJ (as can stress-reduction techniques or mouth guards).
Instead of lying flat, try resting with your head propped up. This can help ease the pressure in the middle ear.
More on Ear Infections

What Are the Possible Complications of Ear Infections?

A review of studies published in February 2016 in the journal Medicine considered a number of complementary and alternative treatments for pediatric otitis media, including homeopathy, phytotherapy, xylitol (a sugar alcohol), vitamin D supplements, and probiotics. Researchers found that there may be some benefits to these therapies, but evidence is limited and more research is needed.

Surgery Options

Children who are prone to earaches from ear infections may need to have a surgical procedure in which a small tube is inserted into the eardrums to prevent fluid buildup. Short-term tubes usually last about 6 to 9 months before falling out on their own.
Long-term tubes are larger and secured in place.

Prevention of Ear Pain

Ear pain isn’t always preventable, but there are some things you can do to reduce your risk of ear injuries and ear infections.

Keep all foreign objects out of your ears, and always dry your ears after swimming, showering, or bathing. You can also wear a bathing cap, earplugs, or use custom-fitted swim molds when swimming.
If you smoke, quit; likewise, try to avoid secondhand smoke, which has been linked to ear infections in children.
One good step to stay healthy is to get a flu vaccine every year.Children should get the pneumococcal vaccine as well, since the bacteria Streptococcus pneumoniae can cause middle ear infections.

Research and Statistics: Who Has Ear Pain?

Pain from ear infections occurs more often in children than adults. About five out of six children will have at least one ear infection by their third birthday, according to the National Institute on Deafness and Other Communication Disorders. In fact, ear infections are the most common reason parents bring their child to the doctor’s office.
Each year, more than 500,000 ear tube surgeries are performed on children. Children who receive these surgeries are usually 3 years old or younger.

Resources We Love

National Institute on Deafness and Other Communication Disorders (NIDCD)

The NIDCD is a research institution and part of the National Institutes of Health (NIH). Since its founding in 1988, its funding and support has led to discoveries that have helped millions of people with hearing, speech, and language disorders.

ENT Health

This website, run by the American Academy of Otolaryngology–Head and Neck Surgery, offers information on a number of conditions affecting the ears; it also explains what ENT (ear, nose, and throat) specialists do and why you may need to see one about ear pain you're experiencing.

Editorial Sources and Fact-Checking

  • Ear Pain: Diagnosing Common and Uncommon Causes. American Academy of Family Physicians. January 1, 2018.
  • Ear Infections. MedlinePlus. November 6, 2020.
  • Ear Infections in Children. National Institute on Deafness and Other Communication Disorders. May 12, 2017.
  • Swimming and Ear Infections. Centers for Disease Control and Prevention. June 3, 2020.
  • Swimmer's Ear. Mayo Clinic. June 28, 2019.
  • Earache. MedlinePlus. January 1, 2020.
  • Ear Infection. Cleveland Clinic. April 16, 2020.
  • Ear Infection (Middle Ear). Mayo Clinic. May 14, 2019.
  • Ruptured Eardrum. MedlinePlus. November 23, 2020.
  • Ear Infection. Centers for Disease Control and Prevention. August 27, 2019.
  • Ears and Altitude. ENT Health. August 2018.
  • Marom T, Marchisio P, et al. Complementary and Alternative Medicine Treatment Options for Otitis Media. Medicine. February 2016.
  • TMJ Disorders. MedlinePlus. November 23, 2020.
  • Swimmer's Ear. MedlinePlus. August 5, 2018.
  • Ear Tubes. ENT Health.

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