Otalgia, better known to most people as earache, is a broad term meaning any kind of earache due to almost any cause, and it's usually classified into two groups depending on types of causes. If a person has primary otalgia, they have aching directly caused by some part of the interior or exterior ear. Other people get a more complicated condition called referred otalgia, and in these cases they may have ear pain with no apparent dysfunction of the ear. The earache is referred or is caused by some other part of the body.
The human ear is divided into three parts, the external ear, middle ear and the inner ear canal. Each of these parts can suffer from earache due to various causes. Let us have a look at some of the common causes of earache.
Otitis Externa
The outer ear canal tends, mostly after swimming, to suffer from a skin infection. This is one of the common ear pain causes in children. The skin becomes red, dry, flaky and painful. Some complain of a ringing or buzzing sound in the ear and few experience a sensation of blocked ear. Many times, one suffers from a thick discharge from the ear canal.
Otitis Media
Another cause of earache in children and infants is otitis media. This is an infection of the middle ear as well as eardrum. Although common in children, it is also seen affecting adults. Symptoms of otitis media include loss of hearing, ringing sound in the ear, sensation fullness in ear, fever, ear discharge, vomiting, diarrhea, irritability and poor feeding and poor sleeping patterns in infants. The cause of otitis media is a bacterial or viral infection of the middle ear. This infection is almost always followed by a cold or upper respiratory tract infection. Many develop this middle ear infection due to allergies, bottle feeding an infant in supine position, etc.
Bullous Myringitis
One of the causes of earache in adults is an inflammation of the eardrum due to infection or trauma to the ear. The eardrum may also get injured when a foreign object pierces the ear. Bacteria and virus may infect the eardrum and lead to inflammation and blister formation. This condition is called bullous myringitis. The symptoms include extreme pain due to eardrum rupture, fever, hearing loss and bloody discharge from the ear.
Fluid in the Ear
An ear infection or blockage in the Eustachian tube may lead to fluid in the ear. This condition may lead to earache and needs surgical intervention for treatment.
Barotrauma
One of the ear pain causes in adults is barotrauma. In this condition, changes in the ear pressure causes earache. Flying in an airplane, diving deep into the sea, loud explosion or noise, etc leads to pressure in the ear. It may lead to ruptured eardrum at times.
Perichondritis
One of the common causes of an earache is perichondritis that occurs due to trauma to the ear. One such common trauma to the ear that leads to an earache is ear piercing.
Earwax
A build up of earwax is one of the intermittent causes of earache. It forms an ear plug-in the auditory canal that may cause intermittent pain and reduction in hearing. The treatment for earwax is removal of the 'plug' by dissolving the wax with the use of ear drops.
Less commonly, earache may be caused by any of the below conditions. See your doctor or dentist if you think you have any of these.
Problem with the Jaw Bone
You may have a problem with the joint of your jaw bone, where the jaw meets the skull. This is known as temperomandibular joint pain, and it may be caused by arthritis or teeth grinding.
Dental Abscess
A dental abscess is a collection of pus that can form in your teeth or gums as a result of a bacterial infection. It can cause earache, although the main symptom of a dental abscess is pain in your affected tooth, which can be intense and throbbing. Your dentist will need to remove the abscess and drain the pus.
Impacted Tooth
Earache can be caused by a wisdom tooth or molar (back tooth) that has not fully broken through the skin. Have a look inside your mouth if you think this is the cause of your earache – some of the tooth will still be below the gum line. Your dentist can advise you on whether it needs to be removed.
Facial Nerve Pain
Sometimes, ear pain can actually be trigeminal neuralgia, which is sudden, severe nerve pain in the face that is usually caused by pressure on the main nerve inside the skull. The pain is felt in the jaw, cheek or eye and can last from a few seconds to a couple of minutes. Prescription medicine can provide temporary relief from the pain.
Eczema in the Ear Canal
A type of eczema called seborrhoeic dermatitis can sometimes cause earache. It affects any area of skin that is naturally greasy, such as the ears, and will cause the skin to become irritated and inflamed, with red, scaly patches. Your doctor will be able to prescribe eardrops containing corticosteroids to clear it.
Inflammation of any type will cause pain, swelling, and reddness.
Otitis Externa
Otitis externa symptoms include:
gradual development of an earache;
individuals with mild cases may describe an itch instead of pain;
touching or pulling on the ear helix (upper rim) worsens the pain;
hearing loss;
ringing or buzzing sounds in the ear;
blocked or full sensation in the ear;
swelling of the ear; and
thick drainage from the ear canal and helix.
Otitis Media
Pain in the ear (most common symptom), although infants and young children may not be able to localize the pain and may have be fussy and irritable.
Other symptoms of otitis media include:
hearing loss;
ringing or buzzing sounds in the ear;
full or plugged sensation in the ear;
fever; and
occasionally, discharge from the ear (eardrum ruptures and the infected fluid drains out);
Other symptoms of otitis media in infants include:
vomiting or diarrhea;
irritability;
poor feeding; and
poor sleeping.
Bullous Myringitis
Symptoms of bullous myringitis include pain in the ear. The pain may be extreme but also may suddenly resolve if the bulla spontaneously ruptures, decreasing the pressure in the blister.
Other symptoms include:
fever;
hearing loss; and
bloody drainage from the ear canal.
Most of the earache causes and remedies involve use of ear drops or placing one or two drops of warm vegetable oil, olive oil, baby oil drops, etc in the ear. Many times, chewing a wad of chewing gum also helps in relieving the pain. Placing a few drops of garlic oil in the ear canal also helps relieve ear infections due to bacteria, virus and fungal agents. For severe pain with fever, discharge and other symptoms, seek medical help for treatment of an earache.
Otitis Externa
Most cases are treated with eardrops for 7-10 days.
These drops contain an antibiotic to fight the infection, and often a steroid to reduce swelling.
The drops are placed in the affected ear with the individual laying on their side. After the drops are placed, the patient should remain in this position for about 5 minutes to prevent the drops from running out.
If the ear canal is very swollen, a wick or small piece of gauze material may be placed into the canal to allow the ear drops to reach the appropriate location.
Occasionally, the health care practitioner may prescribe an oral antibiotic as well as the eardrops. Pain medication is often needed for a few days until the infection is under control.
The ear canal should be kept dry during treatment. An earplug or small cotton ball coated with Vaseline can be used during bathing to keep water out.
In some cases the drainage in the ear builds up, and the infection won't clear until it is removed. Referral to an otolaryngologist (an ear, nose, and throat specialist) may be required.
Otitis Media
There are different ways of approaching the treatment of otitis media. Depending upon the situation, the health care practitioner may prescribe antibiotics immediately. This is most often used for adults who develop otitis media.
Alternatively, in children, observation and comfort care may be appropriate, and if symptoms resolve in 2-3 days, no antibiotics may be necessary. The American Academy of Pediatrics recommends this two-step approach depending upon the age of the child, the certainty of the diagnosis, the severity of illness, and the ability of the child and family to have access to follow-up care.
The decision about which course of treatment to use will depend upon the discussion between parent and health care practitioner.
Symptomatic treatment may include pain control with over-the-counter or prescription pain medications, drinking plenty of fluids, and humidifying the air.
Bullous Myringitis
Treatment for infections of the eardrum may include oral antibiotics, antibiotic ear drops, and pain medications.
Earaches should be evaluated by a health care practitioner, but symptomatic treatment for pain and fever may be provided at home prior to the visit. Usually, acetaminophen or ibuprofen are appropriate to use, depending upon past medical history (for example, acetaminophen should not be used in people with liver disease and ibuprofen should be used with caution in those with kidney disease or who are taking anticoagulation medications). Remember that dosing for infants and children is based upon weight.
Home remedies may include a warm compress to the ear to help with pain control. It is important to avoid burning the skin with the heat of the compress. Other home remedies include:
Add one clove of garlic to a teaspoon of sesame oil and heat it till it become mildly hot. Cool it, so that it does not hurt the tender skin, inside the ear. (However, ensure that it is not cold). Make the person suffering from earache lie down, and pour 4 drops of this liquid in one ear. After, 10 minutes put the same amount of the liquid in the other ear.
Make a paste of licorice in ghee (clarified butter) and apply it externally, to the ear to get relief from earache.
Another effective natural earache treatment can be obtained using mango leaves. Extract the juice of some tender mango leaves and heat it a little. Put 4 drops of this leaf extract in each ear. Ensure that the liquid remains in each ear for about 10 to 15 minutes.
Some people experience ear pain when flying which occurs due to change in air pressure. If a toddler experiences pain in ear due to this, provide him a feeding bottle or a pacifier. For earache treatment in adults due to change in altitude, chewing gum or sucking on a candy will help. The movements involved in chewing or swallowing, relieves pressure that builds behind the eardrum.
If it is the case of ear infection, then pouring a few drops of lukewarm mustard oil in each ear gives relief from pain.
Add two cloves of garlic in approximately, two teaspoons of mustard oil and heat till the garlic cloves become black and then add 2 to 3 drops in each ear. This is an effective home earache treatment.
Heat some salt in a microwave for 3 to 4 minutes and pack this salt in socks or a piece of cotton cloth and place it close to the ear. This home earache treatment cures pain and swelling due to infection.
Make the most of Bishop's weed oil for earache treatment. Mix 1 part of this oil with 4 parts of sesame oil. Heat it and then add 4 drops in each ear.
Here is another simple option for earache treatment at home. In case you have capsules of vitamin A or E at home, pierce these capsules and pour a few drops straight into each ear. While vitamin A is a powerful healing agent, vitamin E works wonders for any type of infection.
Put a few drops of 3% hydrogen peroxide in each ear. Let the liquid remain in the ear for a couple of minutes and then drain it out. This home remedy is very effective in curing earaches. One can also flush the ear with warm water. This treatment clears the ear of excess wax build up.
Another ready option for earache treatment at home is using ginger and sesame oil. Extract some ginger juice and mix it with an equal amount of sesame oil. Add 2 to 3 drops of this liquid in each ear and cover the ear with cotton and let the liquid do its work for 10 to 15 minutes. This home remedy for earache brings quick relief.
Try some peppermint juice for earache. First grind some peppermint and squeeze out as much juice as possible from it. Soak a clean cotton ball in the juice and add a few drops in each ear to attain much-needed earache relief.
These are some of the easy but effective home remedies for ear ache. However, these would work only, when the cause of earache is not a severe one, in which case it is best to see a doctor immediately. A medical practitioner will prescribe medicines which will mostly be antibiotics. It is best to take these medicines as per the doctor's instructions, as a health care professional is the one who judges the cause of earache accurately and then prescribes the most suitable earache treatment.
Call your doctor if:
you or your child has a fever (38ºC or above)
you or your child has other symptoms, such as dizziness, severe headache or swelling around the ear
the earache does not improve within 24-48 hours
Most otitis media will resolve with symptomatic care including pain control, good hydration, and humidity. Bullous myringitis and otitis externa almost always requires medical care. It may be difficult to distinguish between the different types of ear infection without seeking medical care.
Pain that lasts for a few hours or increases in intensity should be evaluated by a care provider. As well, earache associated with hearing loss, unexplained fever, and general malaise or feeling poorly should be clues that care is needed.
Infants under the age of 8 weeks who develop a fever should be taken for medical care immediately.
People with diabetes or those who are immunocompromised who develop earache, fever, and redness around the ear should seek medical care to make certain a condition called malignant otitis externa is not present.
Individuals who have symptoms of meningitis or encephalitis associated with an earache should seek immediately care. These symptoms may include fever, vomiting, headache, neck stiffness, and lethargy.