When you think about pain or ache, ear pain is probably the last thing that crosses your mind. While ear pain might not be as common as other body pains such as back, neck, or shoulder pain, it can also cause debilitating pain and require medical attention if the symptoms are severe.
Introduction to Ear Pain
Your ears are the organs of hearing and are also responsible for controlling position sense and balance. Each of your ears is divided into 3 sections:
a) The outer ear, external ear, or Auris externa is the external part of the ear, which consists of the auricle (also called pinna) and the ear canal. The purpose of the pinna is to catch sound waves, amplify them and move them further to the ear canal.
b) The middle ear, also known as the tympanic cavity, is an air-filled, membranous open space between the outer ear and the inner ear. The main function of your middle ear is to transfer the sound waves effectively to the inner ear and protect the inner ear.
c) The inner ear, also called the labyrinth, contains the sensory organs of hearing and of maintaining equilibrium. Your inner ear is responsible for converting sound waves into electrical signals to send them to the brain.
Pain in the ear can originate from either inside the ear, known as primary ear pain, or can be a result or symptom of infections such as the common cold, flu, or sinusitis (an infection of your sinuses - 4 air-filled sacs located behind your forehead, nose, cheekbones, and in between the eyes).
Ear infections are also a common cause of ear pain or earache. Although ear pain is more common in children, it can affect anyone at any age.
Causes of Ear Pain
Ear pain is most often seen as a result of other illnesses or due to various external causes.
Bacterial/Virus Infections. Ear infections caused by bacteria or viruses can lead to severe ear pain. Ear infections cause inflammation which can produce mild pain or discomfort in your ear. Streptococcal infections (caused by the Streptococcus group of bacteria) can cause inflammation and pain in the throat. This infection can sometimes travel up to your middle ear, causing middle ear infection, also called acute otitis media, leading to ear pain.
Sinus infection. Also called sinusitis, is an inflammation of your sinuses. Sinusitis can affect the pressure in your ears, thus, leading to ear pain.
Skin infections. These occur in and around your ear and can result in ear pain. Eczema is one such common condition, characterized by dry, itchy, and flaky skin in and around your ears.
Changes in air pressure. Pressure changes can cause ear pain. There is a tube in each ear that connects the middle of your ear to your throat and nose which helps regulate ear pressure. Changes in altitude can affect the pressure in your ears. A condition called ear barotrauma can alter the pressure in your ears and cause discomfort or pain.
Wax. Ear wax build-up can happen if your ears make more wax than needed. Earwax is a yellowish, waxy material that is produced by the sebaceous glands located inside your ear canal. Unremoved earwax can lead to infections and cause severe pain.
Other causes. These include wearing tight headgear and poorly fitting headphones, sleeping on a hard surface, ear piercings, grinding teeth, or removing an object stuck in the ear by a sharp instrument.
Symptoms of Ear Pain
The most common symptoms of ear pain include:
Irritability
Difficulty sleeping
Fever
Nausea
Diarrhoea
Discharge from your ears
Loss of balance
Problems in hearing
Nasal congestion, also known as ‘stuffy nose’ or ‘blocked nose’
Loss of balance
Decreased appetite
Diagnosis and Treatment of Ear Pain
Your ENT (Ear, nose, and throat) specialist will take a detailed medical history. He/she will conduct a physical exam using an otoscope (a lighted instrument) to check for earwax build-up, swelling, fluid discharge, or for other signs of an infection. Your doctor will examine your middle ear and the ear canal to check the ear pressure.
Depending on the diagnosis, your doctor will prescribe medications to reduce pain and fever.
Home Remedies for Treating Ear Pain
You can use various remedies at home to relieve mild to moderate ear pain.
1. Cold or warm compresses. Heat or cold therapy can reduce inflammation and pain in the ear. Use a heating pad or wrap a few ice cubes in a towel and your compress is ready. You can also soak a clean washcloth in either cool or warm water, squeeze it out, and then put it over the ear where you have pain, for instant relief.
2. Ear drops. Use over-the-counter (OTC) ear drops for ear pain relief. You can use these only if your eardrum does not have a hole or a tear to avoid further complications. Consult your ENT specialist before resorting to this remedy. Topical (medications applied to a particular body part) drops are also available that can be applied into your ear canal to reduce inflammation and pain.
3. Chewing gum can be helpful. If your ear pain is due to a change in your ear pressure when you are at high altitudes and in an airplane, then chewing some gum can help lower that pressure and ease your symptoms.
4. Correct your sleeping position. Sleeping with your affected ear on a pillow could aggravate your pain even more. Try sleeping with that ear in which you experience pain, facing the ceiling.
Additionally, try to sleep with an elevated head or sleep sitting up to encourage fluid in your ear to drain. This could ease ear pressure and pain in your middle ear. Use pillows to raise your head or rest for a while on an armchair.
5. Acupuncture for ear pain. Acupuncture is a Chinese healing technique in which thin needles are placed at specific points in your body to relieve pain and treat certain health conditions.
Acupuncture increases the flow of blood to that particular body part and helps decrease inflammation. Acupuncture can also decrease or heal any infection in your ear.
Acupuncture can be done only by trained specialists. It can be done at home but should be done only by a certified practitioner.
6. Saltwater gargles. Your sore or strep throat can sometimes cause ear pain. Gargling with warm salt water can help soothe your sore throat and ease your symptoms. Mix a tablespoon of salt in a glass of warm water, gargle, spit out, and repeat.
Similarly, warm soups or vegetable broths can also help relieve sore throat and decreased associated ear pain.
7. Use garlic or garlic oil. Garlic’s antimicrobial, antiviral, and antifungal properties are well-known for fighting viral and bacterial infections. Apply a few drops of garlic oil to your ear canal to help kill bacteria or viruses that might be causing an ear infection and place a piece of cotton over the opening of the ear to stop the oil from seeping out. You should remain in the same position for around 10 to 15 minutes after applying the garlic oil.
8. Neck exercises to get rid of ear pain. Simple neck exercises can help relieve pressure in your ear canal and reduce associated pain. You can do 5 to 10 rounds of neck-rotation exercises (rotate your neck and shoulders, in both the anti-clockwise and clockwise direction) until your muscles feel a bit relaxed.
Neck rotation exercises can be done while standing or sitting. Just make sure your posture is erect and your shoulders are relaxed.
9. Ginger and onions are effective home remedies. Ginger’s anti inflammatory properties can give relief from ear pain. Do not put ginger directly into your ear. It is advisable to apply ginger mixed with warm oil to your outer ear canal.
Like garlic and ginger, onions too can help fight infection and reduce pain. Strain the liquid from 1 or 2 onions and apply several drops to the ear. You can lie down for some minutes after applying either of the juices to relieve the earache.
10. Gently massage your ears. A gentle massage can help with ear pain that radiates upwards to cause a headache. Massage the area around your ears with gentle hands and see if it hurts any further. A massage will help increase blood flow to the inflamed area and reduce pain. It may also help with your ear infection.
Apply downward pressure, just behind your ears and down the neck. Slowly, start massaging forward to the front of your ears. This may help drain excess fluid from your ears and prevent the pain from getting worse.
If you do not have any relief after trying the above remedies, visit your doctor immediately.
One last and very important point to discuss when it comes to ear pain is the pain from headphones or earbuds.
Ear Pain From Earphones and Earbuds
Excessive use of earphones and earbuds, over a prolonged period of time, can result in ear pain. Wearing poorly-fitted or too tight earphones around your head can put excess pressure on your outer ear, and cause itchiness, swelling, bleeding, and discomfort.
Another possible reason for ear pain can be high volumes of sound or music streaming right into your ears. Earphones and earbuds can also cause hearing loss and infections, both of which can result in ear pain.
To avoid pain from earphones and earbuds use, make sure to use correctly fitting devices that sit comfortably in your outer ear. Do not use them for prolonged hours and listen to music on low or moderate volume. Keep your earphones or earbuds clean; disinfect with a sanitizing solution regularly.
Ear pain is usually treated with home remedies but consulting your ENT specialist is recommended if your ear pain is unbearable.
To summarize, being careful and taking the right precautions can prevent ear pain and ear infections. Schedule a visit with your ENT specialist and get your ears checked regularly to detect underlying issues and treat them on time. Do not ignore recurrent ear pains and consult your doctor immediately.
Seek doctor's advice if you have dizziness, swelling around your ears, a bad headache or a high fever.
References:
1. Earwood, J., Rogers, T. and Rathjen, N., 2021. Ear Pain: Diagnosing Common and Uncommon Causes. [online] Aafp.org. Available at: <https://www.aafp.org/afp/2018/0101/p20.html> [Accessed 9 February 2021].
2. Worrall G. Acute earache. Can Fam Physician. 2011;57(9):1019-e322.
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