Definition of Earache:

An earache can be a sharp, dull, or burning pain in one or both ears. The pain may be temporary or constant.

See also:

• Otitis media
• Swimmer's ear
• Malignant otitis externa

Considerations:

The symptoms of an ear infection may include:

• Ear pain
• Fever
• Fussiness
• Increased crying
• Irritability

Many children will have temporary and minor hearing loss during, and right after, an ear infection. Permanent 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 normally 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. What you think is ear pain may actually be coming from another location, such as your temporomandibular joint, your teeth, throat, or other location. This is called "referred" pain.

Causes of ear pain may include:

• Arthritis of the jaw
• Acute ear infection
• Chronic ear infection
• Ear injury from pressure changes (from high altitudes and other causes)
• Object stuck in the ear or severely impacted ear wax
• Ruptured or perforated eardrum
• Sinus infection
• Sore throat with referred pain to the ears
• Temporomandibular joint syndrome (TMJ)
• Tooth infection

Ear pain in a child or infant may be due to infection, or the following causes:

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

Home Care:

The following steps may help an earache:

• A cold pack or cold wet wash cloth applied to the outer ear for 20 minutes may reduce pain.
• For children old enough to safely chew gum, chewing may help relieve the pain and pressure of an ear infection.
• If a child is uncomfortable lying down, resting in an upright position can help reduce pressure in the middle ear.
• Over-the-counter ear drops are gentle and effective, 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.)

You can relieve ear pain caused by rapidly descending from high altitudes by swallowing or chewing gum. Allowing infants to suck on a bottle while the plane is descending can help.

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, especially:
  • 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 - 48 hours

What to expect at your health care provider's office:

The doctor will do a physical examination, and examine 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. Smoking has been shown to cause millions of ear infections each year in children.
• Prevent outer ear infections by not putting objects in the ear, and drying the ear after bathing or swimming.
• Take steps to control allergies. In particular, avoid allergy triggers. Steroid nasal spray may help reduce ear infections. However, over-the-counter sedating antihistamines and decongestants do NOT prevent ear infections.

See: Traveling with children