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Earache

An earache is a sharp, dull, or burning pain in one or both ears. The pain may last a short time or be ongoing. Related conditions include:

Medical findings based on ear anatomyEar anatomy

Alternative Names

Otalgia; Pain - ear; Ear pain

Considerations

The symptoms of an ear infection may include:

  • Ear pain
  • Fussiness
  • Increased crying
  • Irritability

Many children will have minor hearing loss during or right after an ear infection. Most of the time the problem goes away. Lasting hearing loss is rare, but the risk increases with the number of infections.

Common Causes

The eustachian tube runs from the middle part of each ear to the back of the throat. This tube drains fluid that is 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. Pain that you feel in the ear may be coming from another place such as, your teeth, joint in the jaw (temporomandibular joint ) or throat. This is called "referred" pain.

Causes of ear pain may include:

Ear pain in a child or infant may be due to infection. Other causes may include:

  • Ear canal irritation from cotton-tipped swabs
  • Soap or shampoo staying in the ear

Home Care

The following steps may help an earache:

  • Place a cold pack or cold wet wash cloth on the outer ear for 20 minutes to reduce pain.
  • Chewing may help relieve the pain and pressure of an ear infection. (Gum can be a choking hazard for young children.)
  • Resting in an upright position instead of lying down can reduce pressure in the middle ear.
  • Over-the-counter ear drops can be used to relieve pain 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.)

For ear pain caused by change of altitude such as on an airplane:

  • Swallowing or chewing gum as the plane descends.
  • Allowing infants to suck on a bottle or breastfeed.

Call your health care provider if

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 such as:
    • Dizziness
    • 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 to 48 hours.

What to expect at your health care provider's office

The doctor will do a physical exam , and look at 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.

Prevention

The following steps can help prevent earaches:

  • Avoid smoking near children. Second-hand smoke is a major cause of ear infections in children.
  • Prevent outer ear infections by not putting objects in the ear.
  • Dry the ears well after bathing or swimming.
  • Take steps to control allergies. Try to avoid allergy triggers.
  • Steroid nasal spray may help reduce ear infections. However, over-the-counter antihistamines and decongestants do NOT prevent ear infections.

References

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.

Updated: 5/10/2013

Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.


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