Evaluation of Hearing (Audiology)

Earache: causes, symptoms and management

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Earache

Earache is a common problem, particularly in children. It can be worrying, but it’s usually only caused by a minor infection and will often get better in a few days without treatment.

Earache can be a sharp, dull or burning ear pain that comes and goes or is constant. One or both ears may be affected.

Earache can be caused by a variety of otologic problems, but external otitis and acute otitis media are the most common. Differentiation of the two should be apparent by pneumatic otoscopy.

Pain out of proportion to the physical findings may be due to herpes zoster oticus, especially when vesicles appear in the ear canal or concha. Persistent pain and discharge from the ear suggest osteomyelitis of the skull base or cancer, and patients with these complaints should be referred for specialty evaluation.

Nonotologic causes of otalgia are numerous. The sensory innervation of the ear is derived from the trigeminal, facial, glossopharyngeal, vagal, and upper cervical nerves. Because of this rich innervation, referred otalgia is quite frequent.

Temporomandibular joint dysfunction is a common cause of referred ear pain. Pain is exacerbated by chewing or psychogenic grinding of the teeth (bruxism) and may be associated with dental malocclusion.

Repeated episodes of severe lancinating otalgia may occur in glossopharyngeal neuralgia.

Infections and neoplasia that involve the oropharynx, hypopharynx, and larynx frequently cause otalgia.

Persistent earache demands specialty referral to exclude cancer of the upper aerodigestive tract.

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Earache symptoms

Earaches can develop from ear infections or injury. Symptoms in adults include:

  • ear pain
  • impaired hearing
  • fluid drainage from ear

Children can typically show additional symptoms, such as:

  • ear pain
  • muffled hearing or difficulty responding to sounds
  • fever
  • sense of fullness in the ear
  • difficulty sleeping
  • tugging or pulling at the ear
  • crying or acting irritable more than usual
  • headache
  • loss of appetite
  • loss of balance

Self-management of earache

You can take several steps at home to reduce earache pain. Try these options to ease the ear pain:

  • Apply a cold washcloth to the ear.
  • Avoid getting the ear wet.
  • Sit upright to help relieve ear pressure.
  • Use over-the-counter (OTC) ear drops.
  • Take OTC pain relievers.
  • Chew gum to help relieve pressure.
  • Feed an infant to help them relieve their pressure.

Medical treatment for earaches

If you have an ear infection, your doctor will prescribe oral antibiotics or eardrops. In some cases, they’ll prescribe both.

Don’t stop taking the medication once your symptoms improve. It’s important that you finish your entire prescription to ensure that the infection will clear up completely.

If a buildup of wax is causing your ear pain, you may be given wax-softening eardrops. They may cause the wax to fall out on its own. Your doctor may also flush out the wax using a process called ear lavage, or they may use a suction device to remove the wax.

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