What is ear pain like?
The ear is made up of outer, middle and inner sections, and pain is most often associated with the first two. With external otitis, it hurts when pressing on the tragus and pulling on the auricle. Otitis media gives a deep shooting or throbbing pain, which subsides if the membrane ruptures and discharge appears. In addition, the ear is innervated by branches of several nerves common to the teeth, jaw, pharynx, and larynx, so pain from these areas may be felt in the ear. This kind of pain is called referred pain.
- Primary - for diseases of the ear itself
- Reflected - from teeth, joint, pharynx, neck
- Acute shooting - most often otitis media
- Pain when touching the ear - often otitis externa
- Pressing pain during flight - barotrauma
- Burning pain with blisters - herpetic lesion
Possible reasons
In children, the leading cause is acute otitis media due to ARVI, since their auditory tube is short and wide. In adults, otitis externa often occurs, developing after swimming, trauma to the ear canal with sticks, and eczema. A boil in the ear canal causes sharp pain when chewing. Barotrauma occurs when landing an airplane with a stuffy nose. Among the extra-auricular causes, the leading ones are caries and inflammation of wisdom teeth, dysfunction of the temporomandibular joint due to teeth grinding, sore throat and pharyngitis. Persistent unilateral pain in a smoker requires examination of the pharynx and larynx.
- Acute otitis media
- Otitis externa and furuncle of the auditory canal
- Sulfur plug and foreign body
- Barotrauma of the ear
- Mastoiditis is a complication of otitis media
- Problems with teeth and temporomandibular joint
- Sore throat, pharyngitis, peritonsillar abscess
- Neuralgia and pharyngeal tumors - less often
Associated symptoms
With otitis media, pain is accompanied by congestion and hearing loss, fever, and in young children - crying, restlessness, refusal to eat and pulling on the ear. Discharge from the ear indicates a ruptured membrane or otitis externa. Itching, swelling of the ear canal and pain when chewing are characteristic of external otitis and boils. Clicking in the joint, pain when opening the mouth and morning fatigue of the masticatory muscles indicate a temporomandibular joint. Pain when swallowing, radiating to the ear, is typical of tonsillitis. Bubbles on the auricle with facial asymmetry are a sign of a dangerous herpetic lesion.
- Hearing loss and congestion
- Ear discharge
- Itching and swelling of the ear canal
- Temperature, restlessness of the child
- Clicking and pain in the jaw when chewing
- Pain when swallowing
- Rash on the ear
Diagnostics
The main method is to examine the ear using an otoscope or endoscope: the doctor evaluates the ear canal and eardrum, sees wax, foreign body, swelling, bulging membrane or perforation. If necessary, audiometry and tympanometry are performed. If the ear looks healthy, the ENT doctor examines the nose, pharynx and larynx, checks the temporomandibular joint and may refer you to a dentist or neurologist. If mastoiditis, cholesteatoma or complications are suspected, a CT scan of the temporal bones is prescribed. Taking a smear from the ear is necessary for a prolonged or recurrent course.
- Otoscopy or endoscopy of the ear
- Audiometry and tympanometry
- Endoscopy of the pharynx and larynx
- Culture of ear discharge
- CT scan of the temporal bones for complications
- Examination by a dentist for suspected teeth and joint problems
Treatment and what to do at home
Before the examination, you can take an anesthetic and antipyretic drug approved by age and sleep with your head elevated. Do not put alcohol, oils, plant juices into the ear or heat the ear until the doctor has ruled out perforation of the membrane and a purulent process. For acute otitis media in children older than 6 months with a mild course, the doctor sometimes suggests observation and pain relief, since many otitis media go away on their own; in other cases, antibiotics are prescribed. Otitis externa is treated with ear drops after toileting the ear canal. The doctor removes the wax and foreign bodies.
- Painkillers and antipyretics
- Antibiotics - only as prescribed by a doctor
- Ear drops for otitis externa
- Removing wax plug or foreign body
- Treatment of teeth and joints for referred pain
- Protecting the ear from water during otitis externa
- Avoiding cotton swabs
