Ear pain arises with ear disease itself and for other, more remote causes. An example is a concurrent headache or referred pain from the cervical spine.
The basis can be inflammation and often arises from drafts.
In young children, it is a fairly frequent complication of the common cold. It is a symptom of the inflammation of the middle ear, i.e. otitis media. However, the latter also occurs in adulthood.
Alternatively, ear pain is accompanied by several difficulties. It is aggravated by touching the ear or position in sleep on the affected side, chewing, swallowing, sneezing, coughing. It also occurs in the course of pain and inflammation of the throat.
The medical term for ear pain = otalgia.
ICD-10 code H92.0
In young children, the presence of pain in the ear is complicated by the inability to say what it is. They are unable to describe their discomfort, cry and are restless. However, when the ear is touched and pressed, both their restlessness and crying are adequately accentuated.
The symptoms include:
- ear pain - dull, pressing or sharp - intense, stinging, stabbing, throbbing, burning
- itching in the ear, popping
- constant or fluctuating pain
- swelling of the outer and visible parts of the ear or ear canal
- redness of the skin of the ear or ear canal
- rash, eczema
- discharge from the ear (yellow-green to brown, dark)
- bleeding from the ear
- pressure in the ear and
- a reduction in the ability to receive a sound signal, i.e. hearing impairment
- humming, whistling, ringing and other unpleasant, unnatural sounds
Only one ear may be affected, or both.
Not only in children, but also in adulthood, pain is associated with other problems, such as:
- increase in body temperature to fever
- dizziness
- nausea
- sensation of retching to vomiting
- radiation of pain to the surroundings
- enlarged corresponding lymph nodes
Just as ear pain can be transmitted to other places, the opposite situation can also occur. It can radiate to the ear from another location.
Often there is radiating pain into the ear caused by:
- cervical spine
- headaches
- inflammation of the salivary gland
- from the teeth, for tooth decay or gingivitis, even after tooth extraction
- sore throat, tonsillitis
- tempormandibular joint
Why does my ear hurt?
Is it for inflammation or a cold, do I have a draft?
Could there be a more serious problem?
What should I do now?
Interesting information in the article.
What's behind the pain in your ear, you ask?
Often there are inflammatory causes, with viruses, bacteria or fungi (yeasts) causing the inflammation.
Outside of the inflammatory basis, these include, for example, an injury, a foreign body in the ear, or barotrauma, i.e. an injury caused by high pressure.
Damage to the eardrum occurs and ear pain occurs after cleaning and therefore with careless handling of cotton buds.
The most common causes of ear pain include:
- inflammation
- draught
- injury
- fluid accumulation
- excess ear wax and sebum blockage
- injury and foreign body in the ear
- excessive noise
What is most often behind ear pain?
This problem occurs quite frequently and across every age group, from newborns, young children, to older children, adolescents, adults and seniors.
Otalgia, or ear pain, can be primary when the cause is directly in the ear. Pathological findings in the ear and nearby anatomical structures are present.
The second group consists of secondary otalgia. In its case, the problem is outside the ear and anatomical structures outside the ear, and thus without pathological findings on examination.
Secondary otalgia is diagnosed in approximately 30-50% of cases.
These can be common colds and draughts, but also more serious, even life-threatening illnesses and conditions.
Table: the most common causes of ear pain
| External ear | Middle ear | Remote cause |
| External otitis - inflammation of the outer ear, also called swimmer's ear, inflammation of the skin of the outer ear, auricle, ear canal, most often bacterial inflammation. It is also divided into moist or dry form | Acute inflammation of the middle ear - in children around 3 years of age, as a complication of upper respiratory tract inflammation, influenza or rhinitis | Pain originating from the teeth - dentogenic pain, especially in the elderly in the absence of teeth, especially molars, in young children the cause is often breastfeeding, when it is seen that the child is grasping the ear. |
| Myringitis - inflammation of the tympanic membrane, most commonly due to a bacterial cause | Chronic inflammation of the middle ear - recurrent and chronic inflammation | Temporomandibular joint dysfunction (Costen's syndrome), malfunction of the joint between the skull and the temple, but also in the case of muscle disorders, which can be caused by a joint disorder, but also by inflammation or trauma, and may also be due to arthritis (inflammation of the joint). |
| Herpes zoster, also called shingles, herpes zoster oticus, caused by involvement of the nerves innervating the ear
| Mastoiditis - inflammation of the tympanic membrane, as a complication of bacterial otitis media, in case of neglect of treatment there is a risk of meningitis - the pain has a throbbing character. | Diseases of the pharynx, oesophagus and sinuses or diseases of the salivary glands (parotitis, or more commonly known mumps), often due to an infectious basis, inflammation in the area or tumours. |
| Perichondritis - infection of the skin and cartilage envelope up to the risk of cartilage inflammation, also frequent infection with bacteria. | Barotrauma - the action of excessive atmospheric pressure, the difference between the external pressure and the middle-ear pressure, at high altitudes, often in an airplane, when diving. | Eagle syndrome - arises due to prolonged processus styloideus (hooded process), the process presses on soft structures, nerves, blood vessels, it is accompanied by swallowing disorder, pain when swallowing, chewing, yawning, or when talking for a long time. |
| Erysipelas - also called Ignis sacer, holy fire, St. Anthony's fire, i.e. bacterial inflammation caused by streptococcus. | Dysfunction of the auditory tube - a change in the structure of the tube can stand up to a feeling of fullness in the ear or crackling in the ear. | Headache, migraine |
| Furunculosis of the ear - furunculus adn abscess (ulcer) - inflammation due to bacterial infection of the tiny hair roots - hair follicles, often due to a minor injury to the skin of the ear. | Perforation of the tympanic membrane - frequent, even with head trauma, and with a rapid change in pressure, but also by carelessly cleaning the ear with a cotton swab. | Psychological causes |
| Burn and frostbite - exposure to excessive heat or cold, also due to weather conditions and inadequate clothing, clothing protection + scalding. | Tumour of the middle ear - extremely rare
| Other diseases affecting mucous membranes, muscles, nerves or bones that are closely related.
Including issues that affect areas:
- of the jaw, maxillary sinuses and lower jaw
- nasopharynx
- teeth and gums
- the tongue and the root of the tongue
- palatine and cervical tonsils
- pharynx, oral part and lower
- larynx
- cheek or temporomandibular joint
- salivary glands
- lymph nodes of the neck
- nerves
- neck and spine - pressure on nerve roots, muscle spasms
- but also the chest and upper abdomen, respiratory or cardiovascular organs and the digestive system
- arteritis temporalis - inflammation of the temporal artery, a rare disease, especially in old people, pain in and around the ear up to the back of the head
- and various local infections in the aforementioned areas
|
Foreign body and ear injury
especially in young children
|
Earwax blockage
(cerumen, i.e. earwax, builds up and clogs your ear) |
| Tumour of the external ear, a less common cause, often skin tumour, (non-melanoma tumours, spinalioma, basalioma) but also malignant oncological forms. |
Ear pain due to a neurological cause - neuralgiform otalgia
Innervation of the ear by cranial nerves V, VII, IX, X
- nervus V trigeminus - trigeminal nerve, infections in the ear and other parts of the face, soft structures in the oral cavity, larynx, nasopharynx, tongue - often due to irritation by cold, draughts - air currents
- nervus VII facialis - facial nerve, infection or tumour, often due to irritation by cold, draughts - air currents
- nervus IX glossopharyngeus - glossopharyngeal nerve, diseases in the pharynx, but also in tonsillitis, sore throats and tongue injuries
- nervus X vagus - vagus nerve, disorders of the pharynx, oesophagus or thyroid gland, after coughing, when swallowing, yawning
Other nerves from the cervical spine at the level of the sensory nerve bundle from C2 and C3.
|
Table: characteristic difference between otitis externa and otitis media
| Inflammation of the outer ear | Inflammation of the middle ear |
- itching of the ear
- sensation of pressure in the ear
- intense pain around the ear canal
- swelling of the ear canal
- purulent discharge from the ear
- pain when pulling on the ear and when touching the ear
- swelling of lymph nodes in the area
| - severe pain
- pricking in the ear intensified by coughing or swallowing
- pain is aggravated especially at night
- increased body temperature
- lack of appetite
- pus in the ear behind the eardrum, if not relieved, worsens causing pain
- in addition to inflammation of the upper respiratory tract
|
Draught and swallowing
People often experience a pinching in the ear, which can be accompanied by an unpleasant feeling of pressure. This happens if the pressure between the external environment and the middle ear is not sufficiently equalised.
We can feel this pressure in the ears, for example, when driving a car and there is a sudden change in altitude.
This also happens in an elevator.
So, how can you relieve this pressure?
You should chew a gum or swallow a few times,
try to yawn or open your mouth as much as possible.
This should help to equalise this pressure imbalance.
As you can see in the table, a gentle breeze, a draught, or a flow of cold air from the air conditioner can be a trigger. The cause is a cold on an unprotected body surface. Which affects the muscles and therefore the blood vessels but also the nerves.
The cervical spine, the neck, but also the face and cheeks or temples are sensitive. It is, therefore, not recommended to let those body parts be directly exposed to cold air. The pain can worsen when chewing or swallowing.
This happens not only in the cold season, when we are poorly protected by clothing, but also in the summer or in periods of transitional weather.
This type of problem is acute and uncomfortable, but usually does not last more than two or three days. If it persists, it is best to have a specialist examination by a general practitioner or specialist, i.e. an ENT doctor.
The problem usually affects only one ear, but it can affect both ears.
An example is also pain in osteochondrosis of the cervical spine. Osteochondrosis is a disease that affects the intervertebral discs. It is a chronic and progressive problem that can become apparent after the age of 40.
Learn more: Diseases of the spine.
Inflammation in children and adolescents
Inflammation of the outer and the middle ear occurs quite often in this period.
Otitis media is very common in newborns, babies and young children. This is a complication of rhinitis and upper respiratory tract infections.
The anatomical conditions typical of this period contribute to ear pain in children:
- shorter Eustachian tube - used to equalize the pressure in the ear
- easier transmission of inflammation
- swelling of the tube
- anatomy of the nasopharynx - more horizontal placement
- influence of the nasal tonsils
Ear pain in otitis media proceeds suddenly, the pain is more severe, it escalates at night. It is aggravated by sneezing, coughing, chewing and yawning or blowing (sniffling) the nose.
Increase in body temperature and fever can be associated symptoms, but it can manifest as an earache without temperature.
Young children do not know how to express their health problems. Therefore, it is important to note the symptoms according to the child's behavior, e.g.:
- the child is restless, crying, easily irritated and nervous
- the child grabs the ear and the surrounding area
- impaired responsiveness due to hearing impairment
- wakes from sleep more often and falls asleep less well
- refuses food
- has an elevated body temperature to fever
This is especially true for rhinitis, increased production of mucus (snot) and upper respiratory tract infections. In this case, coughing due to postnasal drip is also common.
Learn more: Middle ear infection.
Ear pain radiating from the teeth?
This is due to the close anatomical arrangement, but also to the common innervation. Tooth decay causes swelling of the gum in the area, which is accompanied by unpleasant pain. This spreads to the ear. Therefore, neglecting oral hygiene and tooth decay is irresponsible and risky.
This is due to common innervation by the trigeminal or facial nerve.
Do you know the condition when the area of your teeth, cheek, eye and ear hurts at the same time?
Read also:
Ear pain after swimming
During hot and summer days, this is a frequent health complication. The reason for this is inflammation of the outer ear. It is also referred to as swimmer's ear.
Causes are:
- skin maceration – soaking with liquid, in summer with water from swimming pools, water tanks, directly with inflammatory liquid
- mechanical damage to the skin by trauma
- chemical damage to the skin, chemical preparations
The action of external influences will cause a malfunction of the sebaceous glands.
Earwax serves as a protection - a barrier.
Lack of earway = easier penetration of infection.
The inflamed ear canal, and outer ear, is sensitive to touch, which aggravates the pain. Likewise, chewing or yawning can intensify the problem.
We can get water out of the outer ear in one of the following ways:
- lie down on the bed or floor with the affected ear down
- take advantage of the suction effect and put your palm to your ear and back away
- application of special drops containing acetic acid, vinegar
- drying the ear with a stream of warm air from the hairdryer, but be careful not to burn the ear
The risk is mainly thermal water, which contains chlorine and bacteria of the genus Pseudomonas aeruginosa. Read also: Inflammation of the ear in summer
In addition to exposure to pool water, frequent shampooing of the hair and a dusty environment pose a risk for ear infection.
Ear pain in pregnancy?
Pregnancy is a period of increased susceptibility to viruses or other and bacterial infections. Acute respiratory illnesses are not unavoidable for pregnant women, and these can be complicated by a middle ear infection.
It is generally advisable to protect yourself from colds, draughts or other risk factors during this period. Supporting immunity is also important.
Additionally, during this period, both the pregnant woman and the doctor have a limited choice of pain medications, fever reducers or antibiotics.
In addition, the musculoskeletal system is more stressed during the last weeks, which can cause pain in the spine or the cervical region.
How can ear pain be treated?
If the pain is acute and lasts no more than two or three days, painkillers will suffice.
However, if the condition becomes more complicated, persists or worsens, a specialist examination is necessary. In the first line is the general practitioner (GP), however, the specialist is the ENT doctor.
Additionally, for pain that has a neurological basis and neurologist or orthopedist.
In children, otitis media may be the preferred cause, but it is not the only cause. And even that can be complicated. That's why a specialist examination is in order.
Examples of treatment are pain and inflammation control, or local heat (warm compress), inhalation (burdock, chamomile or eucalyptus), which additionally helps with inflammation of the upper respiratory tract, as well as gargling.
Earache can be treated with certain home remedies:
- gargling salt water
- nasal rinses and steaming (natural healing thermal water, herbs) or aromatherapy, sea salt,
- elevated position, even during sleep
- lots of liquid
- no smoking, no alcohol consumption
- increase vitamin intake (fruit, vegetables)
- ginger - tea
- garlic (to eat, not to stick inside the ear)
- plantains (also called fleaworts)
- Breckland thyme (also called Breckland wild thyme, wild thyme, creeping thyme, or elfin thyme)
- zinc, selenium, vitamin C
Do not insert objects into the ear as this could worsen the overall condition.
Home treatment often includes garlic. However, garlic contains irritants that can irritate the skin of the outer ear. In this case, it should be stressed that if you do persist on using garlic, it should be wrapped in gauze only and certainly but do not leave it in the ear during the night and it should not be inside the ear for a longer period of time.
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