Causes of Ear Pain and Treatment Options

Earwax-softening drops may be recommended by your healthcare provider if you have earwax buildup.

What You Need to Know About Earaches

Earaches usually occur in children, but they can occur in adults as well. An earache may affect one or both ears, but the majority of the time it’s in one ear. It may be constant or come and go, and the pain may be dull, sharp, or burning.

If you have an ear infection, fever and temporary hearing loss may occur. Young children who have ear infections tend to be fussy and irritable. They may also tug or rub their ears.

Read on for other symptoms, causes, treatments, and more.

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:

Preventable medical errors kill about 22,000 patients a year, according to research from the Yale School of Medicine. That’s much less than a previously reported number of 250,000 deaths a year where medical error is to blame.

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

Injury, infection, irritation in the ear, or referred pain may cause earaches. Referred pain is pain felt somewhere other than the infection or injured site. For example, pain that originates in the jaw or teeth may be felt in the ear. Causes of earaches can include:

Ear infections

Ear infections are a common cause of earaches or ear pain. Ear infections can occur in the outer, middle, and inner ear.

Outer ear infection can be caused by swimming, wearing hearing aids or headphones that damage the skin inside the ear canal, or putting cotton swabs or fingers in the ear canal.

Skin in the ear canal that gets scratched or irritated can lead to infection. Water softens the skin in the ear canal, which can create a breeding ground for bacteria.

Middle ear infection can be caused by infections that stem from a respiratory tract infection. Fluid buildup behind the ear drums caused by these infections can breed bacteria.

Labyrinthitis is an inner ear disorder that’s sometimes caused by viral or bacterial infections from respiratory illnesses.

Other common causes of earaches

change in pressure, such as when flying on a plane
earwax buildup
a foreign object in the ear
strep throat
sinus infection
shampoo or water trapped in the ear
use of cotton swabs in the ear

Less common causes of earaches

temporomandibular joint (TMJ) syndrome
perforated eardrum
arthritis affecting the jaw
infected tooth
impacted tooth
eczema in the ear canal
trigeminal neuralgia (chronic facial nerve pain)

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.

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.

Your doctor will treat TMJ, sinus infections, and other causes of earaches directly to improve your ear pain.

If you or your child has a persistent fever of 104ºF (40 ºC) or higher, seek medical attention. For an infant, seek medical help immediately for a fever higher than 101ºF (38ºC). The Healthline FindCare tool can provide options in your area if you don’t already have a doctor.

You should also seek immediate medical attention if you have severe pain that stops suddenly. This could be a sign of the eardrum rupturing.

You should also watch for other symptoms. If any of the following symptoms appear, make an appointment with your doctor:

severe ear pain
dizziness
bad headache
swelling around the ear
drooping of the facial muscles
blood or pus draining from the ear

You should also make an appointment with your doctor if an earache gets worse or doesn’t improve in 24 to 48 hours.

You can book an appointment with a primary care doctor in your area using our Healthline FindCare tool.

Some earaches may be preventable. Try these preventive measures:

Avoid smoking and exposure to secondhand smoke.
Keep foreign objects out of the ear.
Dry the ears after swimming or bathing.

Avoid allergy triggers, such as dust and pollen.

Last medically reviewed on July 5, 2019

Causes of Ear Pain and Treatment Options

Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.

Updated on April 05, 2022

John Carew, MD, is board-certified in otolaryngology and is an adjunct assistant professor at New York University Medical Center.

Table of Contents
Table of Contents

Ear pain, or earache, can originate from any of the three parts of the ear. Among the three sections in the ear, a person could have outer ear pain, middle ear pain, or inner ear pain. Ear pain can also originate from a problem close to the ear, such as from sinusitis, temporomandibular joint syndrome, or a dental infection.

How ear pain feels (aching, sharp, dull, etc.), its intensity, its location, and other symptoms you are experiencing (e.g., fever, dizziness) can give your healthcare provider a place to begin when working to make a diagnosis.

Most often, your healthcare provider can achieve this without any testing, though some cases may call for imaging and blood tests in order to rule out more serious causes of ear pain, such as mastoiditis or an ear tumor.

The treatment plan your healthcare provider creates for your ear pain will depend on your underlying diagnosis and may entail a combination of therapies.

Causes

Due to the multiple possible causes of ear pain, it’s easiest to consider primary diagnoses (which originate within the ear) versus secondary diagnoses (which originate outside the ear) separately.

Primary Causes

Conditions that often cause ear pain and originate within the ear include the following:

Otitis Media

Otitis media describes a middle ear infection in which fluid and inflamed tissue builds up in the middle ear space—the area between your eardrum (tympanic membrane) and the oval window of your inner ear.

Besides moderate to severe aching pain felt deep in the ear, you may experience several days of nasal congestion and/or a cough preceding the ear pain. Sometimes, a fever may occur.

If the eardrum ruptures as a result of the pressure buildup, purulent (containing pus) ear drainage may result.

Otitis Media With Effusion

Otitis media with effusion (OME) describes the presence of middle ear fluid without signs of infection. In other words, there is fluid buildup without tissue inflammation. Overall, the ear pain of OME is generally mild and associated with a feeling of ear fullness and/or decreased hearing.

Typically, OME follows acute otitis media, but it may also occur as a result of barotrauma (injury caused by air or water pressure) or allergy. Rarely, OME occurs as a result of tumor blockage of the eustachian tube—a tunnel that connects the middle ear to the upper throat and back of the nose.

External Otitis (Swimmer’s Ear)

External otitis—an infection of the ear canal—causes a feeling of ear fullness, itchiness, and significant ear pain when the earlobe is pulled. Yellowish or clear-colored ear discharge may also occur, along with decreased hearing and swelling of the ear canal.

Remember

Removing earwax with cotton swabs, fingers, or other objects can make your ear blockage worse and damage the eardrum.

Eustachian Tube Blockage

The eustachian tube is a narrow tunnel that connects your upper throat to your middle ear. It regulates the air pressure in and drains excess fluid from your middle ear. If the eustachian tube becomes blocked, often as a result of allergy, infection, or a rapid altitude change, the following symptoms may occur:

Ear pain
Ringing or popping in the ears
Dizziness
Hearing loss

Ear Skin Problems

Sometimes ear pain originates from the skin of the ear.

Three related conditions include:

Dermatitis of the ear, which causes itching, flaking, and swelling of the skin of the ear canal, may result from an allergic reaction (contact dermatitis) or as a result of an underlying skin problem (i.e., seborrheic dermatitis or psoriasis).
Periauricular cellulitis (infected skin on the ear) results in a red, hot, and extremely tender ear. A fever may also be present.
Herpes zoster oticus (“shingles of the ear”) causes severe ear pain along with a vesicular rash (tense, fluid-filled sacs). In rare instances, facial paralysis may occur along with the rash and ear pain in what’s known as Ramsay Hunt syndrome.

Perichondritis

Perichondritis arises from an infection of your ear cartilage, resulting in pain, swelling, and redness over the skin. Fever may also be present and sometimes an abscess (collection of pus) forms. Without treatment, perichondritis can lead to ear deformity (called cauliflower ear) as the infection cuts off blood supply to the cartilage, thereby destroying it.

Perichronditis is most likely to occur in people with certain autoimmune conditions, such as granulomatosis with polyangiitis, and those who experience trauma to the ear cartilage (e.g., upper ear piercing, a burn, or harsh contact from sports).

Labyrinthitis

Labyrinthitis is inflammation of a structure in the inner ear called the labyrinth. The labyrinth normally helps you to keep your balance. Labyrinthitis can also involve problems with the cranial nerve, or auditory nerve, within the inner ear.

People with labyrinthitis may experience dizziness, nausea, vomiting, or ringing in the ear. It can involve ear pain, but is rarely painful.

Meniere’s Disease

Meniere’s disease is caused by excess fluid buildup in the inner ear, although the precise “why” behind this fluid retention is unknown. In addition to the classic triad of symptoms—vertigo, ringing in the ears, and hearing loss—some people with Meniere’s disease report ear pain or pressure.

Tumor

Although not common, a cancerous or noncancerous tumor may be the source behind a person’s ear pain. For example, nasopharyngeal cancer (a type of head and neck cancer) may cause ear fullness, along with hearing loss, ringing in the ears, and recurrent ear infections.

Two examples of noncancerous tumors or growths that may develop in the ear and cause pain include:

Cholesteatoma: A benign skin growth that forms in the middle ear
Acoustic neuroma: A benign inner ear tumor that develops on the vestibular nerve (eighth cranial nerve).

Secondary Causes

These conditions may cause ear pain, though they originate outside of the ear.

Sinusitis

Sinusitis refers to infection or inflammation of the sinuses, which are hollow spaces located behind your nose, between your eyes, and within your cheekbones and lower forehead. Sinusitis may cause a variety of symptoms, such as:

Ear pressure, discomfort, or fullness
Fever
Nasal congestion and discharge
Tooth pain
Headache

Most cases of sinusitis are caused by a viral illness or allergy; only a small percentage of cases are due to a bacterial infection.

Dental Problems

Dental problems, such as a cracked tooth, decayed tooth, or tooth abscess, may refer pain to the ear. Usually, the pain is worsened by hot or cold stimuli or biting or eating.

Temporomandibular Joint (TMJ) Disorder

Your temporomandibular joint (TMJ) connects your lower jaw to the temporal bone of your skull. Arthritis or erosion of the joint or stress/overuse of the surrounding muscles may cause TMJ disorder.

The pain of TMJ disorder is often described as a constant and dull jaw joint pain that worsens with opening or closing the mouth. Headaches and tenderness around the ear canal are also common.

Giant Cell Arteritis

Giant cell arteritis (GCA) refers to inflammation of the branches of the external carotid artery, a large artery located in your neck. This inflammation may cause pain in the ear canal or outer ear, along with temple and/or forehead pain, fever, fatigue, and a loss of appetite. Vision changes and pain with chewing may also be present.

Mastoiditis

If a middle ear infection remains untreated, the infection may spread to the mastoid bone—a spongy, air-filled bone that is part of your skull. A mastoid bone infection (mastoiditis) causes pain, redness, and swelling behind the ear.

If mastoiditis is not recognized and treated promptly, it can lead to complications like a brain or skull bone abscess, meningitis, facial nerve paralysis, or hearing loss.

When to See a Healthcare Provider

If you are experiencing ear pain that is worsening, severe, or persisting for two or more days, be sure seek medical attention.

Other examples of situations that warrant a healthcare provider’s attention include:

Ear pain accompanied by a fever and/or a sore throat
Pain when tugging on your earlobe
Ear discharge
Ringing in the ears, dizziness, or hearing loss
Swelling or rash of the ear canal or earlobe

Diagnosis

Diagnosing ear pain often only requires a medical history and physical examination by a primary care provider or an ear, nose, and throat (ENT) specialist. Imaging and blood tests are less commonly needed.

Medical History

When you see your healthcare provider for ear pain, you can expect him to ask several questions related to the details of your pain:

What does the pain feel like?
Does the pain come and go or is it constant?
Are there any associated symptoms present, such as fever, hearing loss, balance problems or dizziness, ear drainage, or tinnitus (ringing in the ears)?
Have you recently been ill or experienced any trauma to the face or ear?

Physical Examination

During your physical exam, your healthcare provider will inspect the outer ear, ear canal, and tympanic membrane (eardrum) with an otoscope. Your healthcare provider will also inspect your nose, mouth, and sinuses. He may also press on your TMJ, look at your back molars to check for signs of grinding or frequent clenching of the teeth, and examine your neck to look for enlarged lymph nodes or other masses.

Keep in mind, as part of your exam, your ENT may perform a nonsurgical procedure called nasal endoscopy to better examine your nose and sinuses. The endoscope—a thin tube with a camera and light—allows your healthcare provider to better examine your nose, sinuses, and the top of your throat (where the opening of your eustachian tube lies).

Lastly, if you are experiencing hearing loss and/or dizziness (balance problems), your ENT may refer you for a hearing and/or a vestibular function test.

Imaging

Imaging is sometimes needed to sort out an ear pain diagnosis. For example, an X-ray may be ordered to evaluate a dental problem or to examine the jaw in TMJ disorder.

A computed tomography (CT) scan may be necessary if mastoiditis is suspected, especially if a person is experiencing worrisome complications of mastoiditis, like cranial nerve deficits or signs of meningitis.

A CT scan or magnetic resonance imaging (MRI) may also be ordered if your healthcare provider suspects a possible tumor, such as nasopharyngeal cancer or cholesteatoma, as the source of your ear pain.

An MRI to examine your brain may be used to evaluate for a diagnosis of Meniere’s disease, as central nervous system conditions, like a brain tumor or multiple sclerosis, may mimic the symptoms of Meniere’s disease.

Blood Tests

Blood tests may be used to help diagnose various ear pain conditions. For instance, if your healthcare provider suspects a severe infection, especially mastoiditis, he may order a white blood cell count and inflammatory marker tests, namely erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).

Blood tests may also be used to rule out concerns like thyroid disease, diabetes, and syphilis, all of which may have symptoms similar to those of Meniere’s.

Treatment

As there are many different causes of ear pain, there are similarly many possible treatments. The treatment of choice will specifically depend on the root cause of your ear pain.

Self-Care Strategies

Simple, at-home therapies can sometimes go a long way in easing your ear pain, especially if the pain is related to fluid build-up from a virus or allergies.

For instance, in order to ease the congestion of sinusitis, otitis media, or eustachian tube blockage, your healthcare provider may recommend taking an over-the-counter decongestant or using a nasal spray.

Other self-care strategies that may be helpful include:

Hold a warm compress against your ear or sinuses
Apply mineral oil or diluted hydrogen peroxide followed by a warm shower to loosen congestion
Yawn or chew gum in order to try “pop” your ears
Drink lots of water (six to eight glasses per day)

Self-care strategies also play an important role in managing TMJ syndrome. These strategies include:

Performing simple jaw exercises
Avoiding triggers of TMJ pain (e.g., chewing gum or grinding your teeth)
Using a bite guard when you sleep
Engaging in relaxation and stress management techniques

Ear Flushing

Ear flushing is performed by a healthcare professional to remove impacted wax. The procedure is also used to remove debris, infected material, and dead skin cells in the treatment of otitis externa.

Medications

Several different medications may be used to treat your ear pain:

Ear Drops

Earwax-softening drops may be recommended by your healthcare provider if you have earwax buildup.

Likewise, ear drops are the primary treatment for external otitis. There are many different types of ear drops available, including antibiotics, acidifying solutions, and steroids. Many of these ear drops work in combination to reduce inflammation, treat the infection, and ease pain.

Oral or Intravenous Antibiotics

Sometimes oral (by mouth) or intravenous (by vein) antibiotics are required to treat more serious causes of ear pain, such as:

Bacterial sinusitis
Severe cases of external otitis, including necrotizing (malignant) external otitis
Perichondritis
Mastoiditis
Periauricular cellulitis

Pain Relievers

To soothe your ear pain, your healthcare provider may recommend over-the-counter Tylenol (acetaminophen) or nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil or Motrin (ibuprofen). For the pain of TMJ syndrome, your healthcare provider may also prescribe a muscle relaxant or a tricyclic antidepressant.

Surgery

A surgical procedure called a myringotomy is sometimes needed to treat chronic middle ear infections or persistent eustachian tube dysfunction.

With a myringotomy, a small hole is made in your eardrum to ease pressure and let the fluid drain. An ear tube may then be placed in the eardrum to allow airflow into the middle ear and to prevent fluid from re-accumulating.

Surgery may also be indicated for other ear pain diagnoses like a tumor, severe mastoiditis, or abscess formation in perichondritis.

Prevention

Here are a few strategies that may help prevent certain ear pain diagnoses:

To prevent earwax buildup:

Avoid chronic use of cotton swabs or earwax softening agents, such as Debrox (carbamide peroxide)
If you suffer from frequent episodes of earwax buildup, consider regular use of topical emollients or a routine ear cleaning by a healthcare professional every six to 12 months

To prevent external otitis (“swimmer’s ear”):

After swimming, blow-dry your ears (using a low setting and holding the hairdryer about a foot away).
Consider wearing special earplugs for swimming.
Avoid sticking your finger or towel into your ears after swimming.

A Word From Verywell

Ear pain is not only unpleasant, but it’s oftentimes distracting and frustrating. The good news is that the majority of diagnoses are curable, especially if treated promptly. With that, be sure to see your healthcare provider if you develop ear pain, so you can get back to enjoying life.

Frequently Asked Questions

Is it possible to have ear pain without an ear infection?

Yes, you can feel ear pain and not have an ear infection. Other possible causes include trauma to the ear or surrounding area, improperly removing wax from the ear, a tumor, jaw pain, and changes in barometric pressure.

Are there any at-home remedies for ear pain?

There are some remedies you can try at home to relieve ear pain, but these remedies will not cure an infection and you should still seek medical attention if an infection is suspected. Some people find that a hot or cold compress helps relieve ear pain, but be mindful not to make it too hot or too cold, and use a towel to wrap the compress. Over-the-counter pain relievers like ibuprofen and acetaminophen can also be helpful, and some people believe that sleeping on the unaffected ear relieves pressure on the painful ear and reduces pain.

41 Sources

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Why Does My Ear Hurt?

Parents know how common earaches are in children, but adults can get frequent ear pain, too. You don’t have to have an infection, or even anything wrong with your ears, to have ear pain.

These are the most common causes:

Earwax

Your ear makes and gets rid of wax all the time. When the process doesn’t work well, the gunk builds up and hardens so your ear canal gets blocked. Your doctor will call this impacted wax. Sometimes, it causes pain.

Don’t use cotton swabs or other objects to try to get wax out. You’ll just push it farther into your ear canal and make it more likely to get impacted. Your ear might hurt, itch, discharge gunk, or get infected. You could even lose your hearing for a while.

You can treat mildly impacted ears at home with over-the-counter ear drops that soften the wax so it can naturally drain. Or go see your doctor if the wax has hardened. She can get the wax out without damaging the eardrum. Learn more about earwax.

Air Pressure

Most of the time, your ear does a great job of keeping pressure equal on both sides of your eardrum. That little pop you feel when you swallow is part of the process. But quick changes, like when you’re on an airplane or in an elevator, can throw off the balance. Your ear might hurt, and you could have trouble hearing. This is typically a eustachian tube dysfunction which can be a chronic in some people.

To avoid problems on a plane:

Chew gum, suck on hard candy, or yawn and swallow during takeoff and landing.
Stay awake while the plane descends.
Take a deep breath, pinch your nostrils shut, then gently try to blow air out of your nose.
Avoid air travel and diving when you have a cold, a sinus infection, or allergy symptoms.

Swimmer’s Ear

If your ear hurts when you pull on your earlobe or push on the tiny flap that closes it, you probably have this outer ear infection. You get it when water trapped in your ear canal begins to breed germs. Your ear might get red, swollen, or itch and leak pus. It isn’t contagious. To avoid it, keep your ears dry during and after swimming. Your doctor will probably prescribe antibiotic ear drops to clear it up. Learn more about swimmer’s ear.

Middle Ear Infection

A cold, allergies, or a sinus infection can block the tubes in your middle ear. When fluid builds up and gets infected, your doctor will call it otitis media. This is the most common cause of ear pain. If your doctor thinks the cause is a bacteria, she may prescribe antibiotics. If not, then she may recommend a decongestant allergy treatment with an antihistamine and a nasal steroid. Let her know if your pain doesn’t improve or returns. If it isn’t treated, a middle ear infection can spread or cause hearing loss. Learn more about ear infection treatments.

Other Causes

You may feel pain in your ears even when the source is somewhere else in your body, like a toothache. That’s because the nerves in your face and neck pass very close to your inner ear. Doctors call this type of pain that starts in one area but is felt in another “referred pain.”

If your earache comes with a severe sore throat, it could be an infection like tonsillitis or pharyngitis. In fact, ear pain is often the worst symptom of one of these conditions. Learn more about sore throat symptoms.

Tooth abscesses, cavities, and impacted molars also can cause ear pain. Your doctor will be able to tell if your teeth are to blame by tapping on a tooth or your gums to see if they feel sore. Learn more about toothaches.

The temporomandibular joint, or TMJ, is the “hinge” of your jaw that sits directly below your ears. You might get TMJ pain from grinding your teeth, or it could be a symptom of arthritis. The ache in your ears or face comes after you chew, talk, or yawn. To treat it, take over-the-counter pain medicine and put warm compresses on your jaw. Try not to clench your teeth. You may benefit from using a mouth guard when you sleep. This can help ease the tension that causes ear pain. Eating soft foods will help, too. Learn more about causes of jaw pain.

Some causes of ear pain can be serious such as tumors or infections, including cellulitis or shingles. If your ear pain is severe, doesn’t go away within a few days of home treatment, or comes with a high fever or sore throat, or you get a new rash, visit your doctor right away for treatment and to rule out something more serious.

Show Sources

Fairview Health Services Health Library: “Earache, No Infection (Adult).”

American Family Physician: “Diagnosis of Ear Pain.”

American Academy of Otolaryngology — Head and Neck Surgery: “AAO-HNSF Clinical Practice Guideline: Earwax Removal,” “Earaches and Otitis Media,” “Ears and Altitude,” “Earwax and Care,” “Experts Update Best Practices for Diagnosis and Treatment of Earwax (Cerumen Impaction) Important Patient Education on Healthy Ear Care.”

CDC: “Facts about Swimmer’s Ear.”

Mayo Clinic: TMJ Disorders: “Overview,” “Treatment.”

National Health Service: “Earache,” “What Are the Differential Diagnoses for Chronic Ear Pain?”

Nemours TeensHealth: “Cellulitis.”

Canadian Medical Association Journal: “Antibiotic treatment for acute otitis media: time to think again.”

Causes of Ear Pain and Treatment Options