Earaches

Earaches are not an uncommon condition among both children and adults. The exact symptoms can vary from individual to individual, episode to episode. There are a variety of reasons for earaches, ranging from something as simple as water trapped in the ear to more complex causes such as referred pain from another area.

Symptoms of Earaches

The pain and discomfort associated with an earache can be sharp or dull, and occur on one side only or in both ears. People suffering from earaches will also find their pain can either be constant or come and go.

Other than pain in the ear, symptoms of earaches will depend on the underlying cause. Symptoms can include:

• Difficulty hearing
• A full sensation in the ear
• Dizziness and balance difficulties
• Nausea and vomiting
• Discharge from the ear
• Fever

For babies or young children who aren’t yet able to articulate their symptoms, you should also look out for:

• Unusually disrupted sleep
• Tugging at one or both ears
• Increased irritability
• Loss of appetite
• Balance difficulties
• Difficulty responding to sounds or speech

Causes of Earaches

Otitis media

One of the most common causes of earaches in children is a middle ear infection, also known as acute otitis media. Blockage of the eustachian tube connecting the eardrum space (middle ear) and back of the throat can result in an accumulation of fluid and bacteria in the middle ear. This can lead to otitis media ear infection, which may be recurrent in some children.

Otitis media should be treated promptly as the infection may spread to other structures in the head. It also has the potential to cause hearing loss, and in children, this can lead to developmental delays in speech and learning.

Otitis externa

Also known as swimmer’s ear, otitis externa is an infection of the ear canal (outer ear) and is one of the more common reasons of earache in adults. Swimmer’s ear is so named due to the association with swimming in contaminated water; it may also be caused by using cotton swabs or other objects in the ear canal that irritate the sensitive skin.

Temporomandibular joint (TMJ) dysfunction

TMJ is another frequent cause of earache in adults. Though the TMJ is part of the jaw and not within the ear, it can cause referred pain that is felt around the ears. Issues with this jaw joint is often due to teeth grinding during sleep.

Other causes of earache include:

• Inflammation of the outer ear (chondritis)
• Referred pain from throat infection
• Referred pain from throat cancer
• Change in environmental pressure, such as during ascent or descent on an airplane
• Earwax accumulation (cerumen impaction)
• Perforated eardrum
• Arthritis in the jaw
• An infected tooth
• Eczema in the ear canal
• Trigeminal neuralgia (pain of the facial nerve)
• Trauma and injury to the ear

Treatment for Earache

The treatment for earache ultimately depends on the underlying cause. Ear pain should be first investigated by your family physician or your child’s pediatrician, who can then refer you onward to a specialist, such as an ENT (ear, nose, throat) doctor, if necessary.

Earache caused by infection must be treated with antibiotic ear drops and, in some cases, also oral antibiotics. You may also consider taking over-the-counter pain-relieving medication or your doctor may prescribe anesthetic ear drops to alleviate the discomfort.

If an accumulation of pressure in the middle ear is involved in causing the pain, this pressure can sometimes be relieved through sitting in an upright posture, chewing gum, or drinking fluids. Breast- or formula-feeding infants can be useful to alleviate ear pressure and the associated discomfort. Antihistamine or decongestant medications can also help to address the fluid build-up and pressure in the ear, but always check with your doctor first whether this will be useful for you.

It’s important to seek medical attention promptly if:

• An infant has a fever over 101°F
• Your ear pain suddenly disappears, as this may be a sign of a ruptured eardrum
• Your earache is severe
• Your earache is associated with a severe headache
• You have other symptoms such as swelling around the ear, blood or pus discharge from the ear, or drooping facial muscles
• Your earache worsens or fails to improve within 48 hours

Children with chronic or recurrent ear infections may be suitable for ear tubes, also known as pressure equalization tubes. These tiny shunts are surgically inserted into the eardrum to aid drainage of fluid from the middle ear, bypassing the eustachian tubes.

Some causes of earache are preventable while others can only be managed as they arise. Avoid inserting objects into the ear, even if to clean out wax. Cleaning the ear canal of earwax can be more safely performed using cerumen-softening ear drops or seeing a doctor to perform a lavage. After swimming or bathing, ensure ears are properly dried. Remember that symptoms of an ear infection should not be ignored due to the risk of hearing loss in children or the infection spreading to nearby structures of the head.

If you believe you are suffering from a severe earache, please contact us to schedule an appointment to be seen in our office.