Shooting Pain in the Ears, Pressure in the Ears due to Headache

Pain shooting into the ears and earache is a fairly common problem with which a person seeks professional help. Primarily it may be a disease of the ear, however, pain in the ear can also originate from more distant tissues, structures, organs, systems or areas.

The most common cause of these pains is inflammation, which can also have a basis in draughts. And an example is also the pain that shoots into the ear from the cervical spine.

In young children, earaches occur quite frequently along with rhinitis. However, in this case, it is already a complication of an upper respiratory tract infection.

Pain as an unpleasant sensation warns that something is not right in the body. Therefore, when acute, but also prolonged or too intense pain occurs, it is necessary to find the cause. It can also be a serious health or life-threatening condition. 

Ear pain is professionally referred to as otalgia.

In addition to ear pain, other ailments such as:

• ear pain, may be dull, pressing or sharp, intense, stabbing, stinging, throbbing, burning
• itching or cracking in the ear
• has a steady or fluctuating character 
• 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 and this can be yellow-green to brown, dark
• bleeding from the ear
• hearing impairment or pressure in the ear and reduced ability to receive a sound signal
• sound like whistling, ringing and other unpleasant, unnatural sound stimuli - tinnitus
• increase in body temperature, fever
• dizziness
• nausea
• gagging, vomiting
• enlargement of lymph nodes

From which parts does the pain shoot into the ears?
Is it a symptom of the disease?
Or is it just a benign manifestation?
Read on.

Where ear pain comes from

It is important to realize that even with an earache, it is possible that we will have a headache in the vicinity, in the head. It is important to notice how the trouble started and in what way it is getting worse.

Did the pain start in the ear?
Or is the earache just referred pain or a complication? 

Pain in the ear may be caused by:

• inflammation
• draught
• injury
• fluid build-up
• excess earwax and blockage of the ear canal by sebum
• injury and foreign body in the ear
• excessive noise or pressure
• tumour

Examples:

In children, and especially in small babies, newborns or infants, pain in the ears occurs quite often. However, in this case it is usually a complication of upper respiratory tract inflammation. 

And these can be of viral (more common) or bacterial origin, for example influenza or cold. 

This is done because of anatomical conditions. The Eustachian tube, or the connection between the nasopharynx and the middle ear, is shorter. The inflammation is compounded by swelling of the mucous membrane and transmission of infection.

The result is middle ear infection.

Young children cannot describe their difficulties, so when there is a change in behaviour or incessant crying, it is necessary to look for other signs, for example:

• 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

Especially due to rhinitis, increased mucus production (snot) and upper respiratory tract infections. In this case, coughing due to a stuffed nose is also often encountered.

Ear pain is called primary when the cause is directly in the ear.

Secondary otalgia, on the other hand, is caused by something else at another site in the body.

The cause of referred ear pain

Secondary otalgia, i.e. pain referred pain to the ear, represents 30-50% of ear pain cases. It stems from a variety of problems. It occurs frequently and affects any age.

We sometimes also observe pain radiating from the teeth. This may happen due to a decayed tooth (tooth decay), an extracted tooth or gingivitis (inflammation of the gums). 

Especially in the elderly, pain occurs due to lost teeth. Most often, pain radiates to the ear if a person does not have back teeth, that is, molars. 

Young breastfed babies (of infant age) are often seen to grab their ears during breastfeeding. This is exactly type of pain that may be the cause.

Dentogenic pain = pain originating from the teeth.

Pain due to temporomandibular joint issues

Another cause might be the temporomandibular joint (TMJ), i.e. the temporal bone and the mandible (lower jaw, jawbone).

Opening the mouth, yawning, chewing, popping, squeaking or cracking sounds during jaw movements (causing aggravation) and:

1. headache
2. pain radiating to the ear
3. pain in the face
4. pain radiating to the shoulders or neck
5. ringing in the ear
6. pressure in the ear
7. morning stiffness of the chewing muscles
8. head spinning
9. pain in the teeth
10. difficulty opening the mouth

It may be a case of the temporomandibular joint pain-dysfunction syndrome.

Symptoms:

• tooth loss on one side
• deep or crossed bite
• incorrect position of teeth
• tooth replacement
• elevated tooth filling
• injury
• joint inflammation - arthritis
• stress, depression, anxiety
• grinding of teeth during sleep or during the day

Temporomandibular joint pain dysfunction syndrome is also referred to as Costen's syndrome.

Cervical spine + headache and earache?

Ear pain may also come from the cervical spine. There are two conditions.

One is a functional problem and the other radiculopathy with an organic underlying base.

Functional pain not severe, although unpleasant. They arise quickly, however, and subside quickly. This is the case with a spinal block, in this case in the cervical spine. The pain radiates from the neck to the head, even to the ear or upper limbs.

Cervicocranial syndrome, or Craniocervical Junction Syndrome: CCJ syndrome, is characterized by symptoms such as:

• headache
• painful throat
• aggravation on changing position and movement
• the pain is localised more in the upper cervical spine
• block - impaired mobility
• muscle stiffness

The organic source of pain may be from a damaged intervertebral disc or other structural defect and damage to the spine.

Learn more:

• Vertebrogenic pain syndrome
• Radiculopathy
• Pseudoradiculopathy
• Disc herniation - slipped disc
• Spinal stenosis
• and other spinal disorders

Earache and headache

Headaches are also a fairly common problem. The range of causes is rich. However, it is common to experience ear pain with migraine or migraine-related pain.

Migraine has a typical episodic paroxysmal throbbing pain, occurs on one side, around the eye, forehead to the ear, is moderate to severe. The pain is accompanied by increased sensitivity to light and noise.

That is why a person with migraine prefers darkness and silence and may seek silence under the covers.

Learn more: Headache: sometimes it is harmless, other times it indicates a serious problem.

The neurological basis means irritation of the nerves that run around the ear and provide its innervation. In this case, there are 4 main cranial nerves, which are additionally responsible for the transmission of nerve signals from several areas of the human body.

The cause has a different basis, such as inflammation, injury mechanism or pressure caused by another factor, even a tumor, tumor.

Ear pain for a neurological cause - neuralgiform otalgia.

Innervation of the ear by the cranial nerves V, VII, IX, X:

1. nervus V trigeminus - trigemial nerve, infections in the ear and other parts of the face, soft structures in the oral cavity, larynx, nasopharynx, tongue - often due to irritation from cold, draughts and air currents
2. nervus VII facialis - facial nerve, for infection or tumour, often due to irritation by cold, draughts and air currents
3. nervus IX glossopharyngeus - glossopharyngeal nerve, diseases in the pharynx, but also in tonsillitis, sore throats and tongue injuries
4. nervus X vagus - vagus nerve, pharyngeal, oesophageal or thyroid disorder, pain after coughing, when swallowing, yawning

Other nerves mainly from the cervical spine, which are at the level of the sensory nerve bundle from C2 and C3 (as mentioned above). 

A simple blowing in a draught and a blast of cool air from the air conditioner tends to trigger colds on unprotected body surfaces. This affects the muscles, blood vessels or nerves. The cervical spine and the backside of the neck, the face and cheeks or temples are particularly sensitive.

It is not recommended to set the air conditioner or fan so that the cold airflow is directed directly on exposed parts of the body.

Learn more:

• How does air conditioning affect our health? Can it be harmful?
• How to use, or set up, the air conditioning correctly and so that it does not harm us?

Other causes

Of course, there may be more. Most often these are the above conditions but that's not all.

An example is Eagle syndrome, which arises because of an elongated processus styloideus (hooded process). The protrusion then presses on soft structures, nerves, blood vessels, and is accompanied by swallowing disorder and pain when swallowing, chewing, yawning, or when speaking for a long time.

The problem may stem from the following areas: 

• jaw and maxillary sinuses
• nasopharynx
• teeth, gums
• of the tongue, the root of the tongue
• palatine and pharyngeal tonsils, such as in tonsillitis
• pharynx and from the oral part and below
• larynx
• salivary glands
• lymph nodes of the neck
• nerves
• neck, backside of the neck, and spine, muscle spasms
• the chest area and from organs of the respiratory or cardiovascular system
• from the upper abdomen and digestive system
• arteritis temporalis, i.e. temporal artery inflammation, is a rare disease, especially in the elderly
• various local infections in the above areas

More info in: Ear pain due to inflammation, draughts or cervical spine