12 Main Causes of Ear Pain (& What to Do)

Medical review: Dr. Clarisse Bezerra
Family Doctor
March 2022

Ear pain typically emerges after the introduction of water or objects like ear swabs into the ear canal. These can cause an ear infection or a rupture of the eardrum. Problems in the jaw or throat and even tooth growth are also common causes of ear pain.

You can relieve ear pain at home by applying a warm compress to the external ear, or by resting in a seated position versus a lying position, as sitting can reduce pressure in the ear. Home treatments should only be used to help with pain relief until you seek medical attention, either from a general physician or otolaryngologist (for adults) or pediatrician (for children).

Common causes of ear pain include:

1. Ear infection

An ear infection, also known as otitis media, is characterized by ear pain, itchiness, fever and the presence of fluid or crust within the ear canal. In some cases, the bacteria responsible for an ear infection can originate from the throat following a throat infection. A throat infection can present with pain, discomfort or difficulty swallowing.

What to do: To help with pain, you can take over-the-counter analgesics like acetaminophen or anti-inflammatories like ibuprofen. However, if the infection does not resolve on its own or if the symptoms are very uncomfortable, you should seek the advice of a medical professional. He or she can assess your ear and initiate treatment as indicated, typically with prescribed antibiotics.

2. Trapped water

Ear pain caused by water trapped in the ear canal is very common in swimmers, but it can also occur after a bath or shower, after the use of a hot tub or pool or after swimming in ocean or lake water. This type of ear pain can be accompanied by discharge from the ear and even mild hearing loss.

What to do: To relieve ear pain caused by trapped water, apply a warm compress directly to the external ear for 15 minutes and take over-the-counter anti-inflammatories or analgesics, like ibuprofen or acetaminophen. You can also try tipping your head toward the side with trapped water to aid with the removal of water from the ear.

3. Pressure changes

Pressure changes from altitude, like when a plane is taking off or landing, can be painful and can cause a sensation that the ear is blocked.

What to do: One way to prevent or relieve ear pain from pressure changes during plane travel is to chew gum or yawn. With babies, breastfeeding or offering a bottle or pacifier are great ways to relieve pain.

4. Joint problems

Some health concerns involving the joints, like arthritis or a jaw dislocation, can cause pain in both the problem area and the ear. Problems in the jaw joint (also known as the temporomandibular joint, or "TMJ") can additionally cause pain with yawning or chewing and can sometimes cause headaches.

What to do: One way to relieve pain is to apply a warm compress directly on the affected joint and ear. Seeking medical attention in this case is highly recommended so that specific testing and treatment can be initiated.

5. Tonsillitis

Tonsillitis is a type of throat infection that occurs due to bacteria, virus or fungus in the tonsils. It can cause pain or discomfort in the throat, which can radiate to the ear due to its close proximity.

What to do: In these cases, a medical consult is recommended to initiate treatment with analgesics or anti-inflammatories. Antibiotics like amoxicillin may be indicated for treatment of a bacterial infection.

6. Wisdom tooth rupture

The rupture of a wisdom tooth can cause inflammation and infection close to the jaw joint. This tooth pain can radiate to the ear as well.

What to do: Ear pain caused by the growth of a wisdom tooth does not need any specific treatment and will resolve once the wisdom tooth is taken care of. In the meantime, to relieve pain, you can apply a warm compress directly over the jaw and external ear for 15-20 minutes per day, three times a day. You can also take anti-inflammatories like ibuprofen or analgesics like acetaminophen. In the presence of a wisdom tooth infection, the dentist may prescribe antibiotics and may recommend extraction by a dental surgeon. 

7. Other dental problems

In addition to wisdom tooth ruptures, other dental problems like gingival abscesses, cavities or teeth grinding can cause ear pain. This is because the nerves that are found in the teeth are in close proximity to the ear. 

What to do: To relieve ear pain, apply a warm water compress to the affected ear and take analgesics like acetaminophen. In the meantime, you should consult a dentist to treat the underlying dental problem. A cavity filling, antibiotics for a possible abscess or a mouth guard for grinding may be indicated.

8. Ruptured eardrum

Causes of ruptured eardrums include serious ear infections, trauma from foreign objects in the ear (e.g. a cotton swab or pen cap) or strong pressure changes (e.g. jumping into a pool).

Ear pain from a ruptured eardrum can be accompanied by other symptoms like bleeding, hearing loss or ringing in the ear.

What to do: You should seek medical treatment from an otolaryngologist, who might indicated antibiotics. In more serious cases, or if the eardrum does not improve in 2 months, surgery may be necessary.

9. Otomycosis

A fungal infection in the ear, or otomycosis, can lead to symptoms like itchiness, redness and even decreased hearing in some cases.

This type of infection is more commonly seen in patients with uncontrolled diabetes and in swimmers (due to constantly moist ear canals).

What to do: Itching or picking with a cotton swab should be avoided to prevent ear pain. It is important to consult an otolaryngologist, who may perform an ear cleaning and prescribe antifungal ear drops or pills.

10. Sinus infection

A sinus infection can emerge from allergies or from a viral, bacterial or fungal infection. It usually results in inflammation of the nasal canals and can cause a build-up of discharge in the sinuses, which can affect the ears and cause pain.

What to do: Drinking plenty of fluids can help to drain built-up discharge, which may relieve facial pressure and ear pain. Nasal sprays with saline can also help to remove discharge. Anti-inflammatories like ibuprofen can help with both the ear pain and the sinus infection. Sinus infections caused by bacteria should be treated with antibiotics following a consult with an otolaryngologist.

11. Labyrinthitis

Labyrinthitis is a swelling of the inner ear that is typically caused by an infection. In addition to pain, symptoms can include buzzing in the ear, dizziness, nausea and loss of balance.

What to do: The underlying inner ear infection should be treated to resolve the ear pain. In the meantime, you should rest to prevent any injuries from loss of balance. Medications can be indicated to treat any associated symptoms, like dimenhydrinate for nausea or betahistine for balance issues and inflammation. When infection is present, antibiotics may be necessary and prescribed by a doctor.

12. Diabetes

Diabetes can cause on overall weakening of the immune system, and therefore diabetics are at a higher risk to develop ear infections. In general, ear pain from infection can be accompanied by other symptoms like hearing loss, discharge or foul odour from the ear.

What to do: In this case, the underlying ear infection should be treated first. In the longterm, however, it is important to control sugar levels to avoid complications from diabetes (e.g. infections, retinopathy, and neuropathy).

Ear pain in babies

Ear pain in babies is common in the first years of life, as there is a larger opening and greater permeability in the canal that connects the nose to the ear. This allows for discharges caused by cold and flu viruses to trickle into the ear and cause swelling and pain in the ear. Other reasons for ear pain in babies can include:

  • Water trapped in the ear from baths
  • Tooth growth
  • Allergies
  • Contagious infections picked up from other children (e.g. at daycare)

When infection is present, other symptoms like temperature over 38ºC (or 100.4ºF), fluid-like discharge from the ear canal or foul odour can emerge. In these cases, seeking medical attention to start treatment is recommended. Antibiotics may be prescribed. 

When to go to the doctor

You should see a doctor if you have any of the following symptoms:

  • Ear pain for more than 3 days
  • Ear pain that worsens over 48 hours
  • Fever, with temperatures over 38ºC (or 100.4ºF)
  • Dizziness
  • Headache
  • Ear swelling

In these cases, a consult with an otolaryngologist is recommended so that testing and diagnosis can be done promptly to initiate the most appropriate treatment.

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Atualizado por Tua Saude editing team, em March de 2022. Medical review por Dr. Clarisse Bezerra - Family Doctor, em July de 2021.

References

  • HARMES, Kathryn M.; et al . Otitis Media: Diagnosis and Treatment. American Family Physician. 88. 7; 435-440, 2013
  • SAVIG, Doron; et al. Traumatic Perforation of the Tympanic Membrane: A Review of 80 Cases. J Emerg Med. 54. 2; 186-190, 2018
Show more references
  • WANG, Mao-Che; et al. Ear Problems in Swimmers. J Chin Med Assoc. 68. 8; 347-352, 2005
  • PIGNATARI, Shirley S.N.; ANSELMO-LIMA, Wilma T. Tratado de Otorrinolaringologia da ABORL e CCF. 3.ed. Rio de Janeiro: Elsevier, 2018.
Medical review:
Dr. Clarisse Bezerra
Family Doctor
Dr. Bezerra possesses a medical degree and specializes in family medicine. She is licensed to practice under CRM-CE licence #16976.