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 |  Earache What Is It? Pain in one or both ears can occur for many reasons, some not related to the ear at all. The most common cause of earache is pain in the middle ear that occurs when the passageway between the ear and the back of the throat (Eustachian tube) becomes blocked. The middle ear is the small, air-filled cavity just behind the paper-thin eardrum. Normally, air enters the middle ear through the Eustachian tube, equalizing the pressure between the middle ear and outer ear. The Eustachian tube also drains fluid out of the middle ear. When this tube becomes blocked, and air and fluid cannot flow freely, pressure builds in the ear, causing pain. If fluid behind the eardrum becomes infected with a virus or bacteria, it causes a middle ear infection that can lead to pain and fever. Other causes of pain related to the ear include:
Pain from a sore throat or a problem with the jaw joints called temporomandibular joint disorders (TMJ) may be felt in the ear. When too much wax blocks the ear, you may feel pressure, but this usually doesn't cause pain. Symptoms Earache is most commonly described as a feeling of pressure in the ear that causes ear pain. This feeling may begin gradually or suddenly, and it can be very severe. Other symptoms such as hearing loss, fever and feeling unwell usually indicate an ear infection. When the ear canal is inflamed or if the eardrum ruptures, there may be drainage from the ear. If the eardrum ruptures because of a middle ear infection, the pain is often relieved because the pressure is reduced. In young children, the only signs of an ear infection may be fever, irritability and pulling at the ear. Diagnosis Adults and older children with mild ear pain or pressure who do not have a fever or hearing loss usually do not need to see a doctor. This type of pain usually is caused by a blocked Eustachian tube. If the ear pain is more severe, or there are other symptoms, it's a good idea to see a health professional. Your doctor will examine your ears, nose and throat. He or she will use a device called an otoscope (a lighted instrument) to look inside the ears and check for redness and fluid buildup behind the eardrum. The doctor may blow a puff of air through the otoscope into your ear to see if the eardrum moves normally. Your doctor may test your hearing. One way is to check how well you can hear fingers rubbed together near your ear. Expected Duration An earache will continue until the problem causing it goes away or is treated. If the pain is due to a blocked Eustachian tube, an over-the-counter decongestant may help open it up. Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin and others) will decrease pain until the underlying condition is treated or goes away. Prevention Some people, particularly young children, are prone to recurring earaches. If a child continues to have frequent ear infections, the doctor may surgically insert a ventilation tube into the eardrum to prevent the ear from becoming blocked. Breastfed infants are less likely to develop ear infections because breast milk contains antibodies that help to protect the baby from infection. Also, when a baby sucks on a bottle, the fluid is more likely to get pulled into the Eustachian tube, particularly if the infant drinks from a bottle while lying on his or her back. For this reason, it is better to hold the baby at least semi-erect during feeding. Children are more prone to earaches if they:
Treatment Pain medications such as acetaminophen (Tylenol and others) treat earaches most effectively. Resting the infected ear on a warm heating pad can provide some relief. For a blocked Eustachian tube, drugs commonly used include decongestants, antihistamines and mucolytics (drugs that make the mucous thinner), but the effectiveness of these medications has not been proven. Children with earaches should not take aspirin without a doctor's approval because aspirin has been linked to Reye's syndrome, a potentially fatal illness that can occur in children who have certain viral infections. If you have an ear infection, your doctor may wait a few days before prescribing antibiotics to see if the ear infection will improve on its own. If the symptoms are severe or last beyond a couple of days, antibiotics are often prescribed for up to 14 days. When To Call a Professional Call your doctor if you or your child has a fever or hearing loss with an earache. See a doctor if you develop ear pressure that lasts for several days, even if you don't have other symptoms. Prognosis The outlook for most cases of earache is excellent. Ear pain often goes away on its own. Ear pain from infections usually goes away within a few days of starting antibiotics. Additional Info National Institute on Deafness and Other Communication Disorders American Academy of Otolaryngology — Head and Neck Surgery Last updated August 29, 2008 |
