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Earache - Treatment

Alternative Names

Otalgia; Pain - 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.
  • Olive oil or over-the-counter ear drops are gentle and effective, as long as the eardrum has not ruptured. Prescription drops, such as Auralgan, are also effective for pain relief.
  • 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, which may include examination of the:

  • Ear
  • Mastoid (bony part behind the ear)
  • Nose
  • Throat

Pain, tenderness, or redness of the mastoid often indicates a serious infection.

During the examination, the doctor will ask questions about the ear pain, such as:

  • When did it begin?
  • Is it getting better, worse, or staying the same?
  • Is the pain constant?
  • What other symptoms are present?
  • Is there ear pressure?
  • Is there drainage from the ear?
  • Are there unusual ear noises?
  • Is there a fever?
  • Is there pain in the bone behind the ear?
  • Is there hearing loss?

Because most ear infections improve within 24 hours of receiving medical care, health care providers are less likely to prescribe antibiotics immediately. Your doctor will often wait to see if symptoms continue or worsen.

If antibiotics are prescribed, it is important to take all of the prescribed antibiotics on schedule.

Children with persistent or recurring ear infections may need ear tubes inserted to help the middle ear begin working properly again. Inserting ear tubes is a simple and effective surgical procedure.

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.
  • Reviewed last on: 5/12/2009
  • Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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.

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