Earache
Pain in or around one or both ears
Quick Facts
- Type: Ear (otologic) symptom
- Common causes: Ear infections, pressure, earwax, throat or jaw pain
- Most affected: Children, but all ages
- Seek care: Severe pain, fever, drainage, hearing loss
Overview
An earache is pain felt in or around the ear. It may be a sharp stab, a dull ache, or a burning, throbbing discomfort, and it can affect one or both ears. Earaches are extremely common in young children but happen at any age. The pain can come from the ear itself or be "referred" from a nearby area such as the throat, teeth, or jaw.
While an earache is often distressing, especially at night, most causes are not dangerous and improve on their own or with simple treatment. Understanding the likely source helps you decide whether home care is enough or whether you should see a clinician. Persistent, severe, or worsening ear pain, particularly with fever or drainage, always deserves medical attention. Knowing whether the pain comes from the ear itself or a nearby area, and how severe it is, helps you judge whether simple home care will be enough or whether a clinician should take a closer look at what is causing it.
Common Causes
Earache has many possible sources, both inside and outside the ear:
- Middle ear infection: Otitis media, often after a cold, is the classic cause in children.
- Outer ear infection: Swimmer's ear inflames the ear canal, causing pain when the ear is tugged.
- Earwax buildup: Impacted wax (cerumen impaction) can press and ache.
- Pressure changes: Flying or diving (barotrauma) can hurt the eardrum.
- Referred pain: Sore throat, dental problems, or a jaw-joint disorder (TMJ disorder) can be felt as ear pain.
- Sinus problems: Sinusitis can radiate to the ears.
Associated Symptoms
The symptoms accompanying an earache help point to the cause:
- A feeling of ear pressure or fullness
- Muffled hearing or temporary hearing loss
- Fluid or pus draining from the ear (ear discharge)
- Fever, especially in children
- Sore throat, congestion, or jaw pain
- Ringing in the ear (tinnitus) or dizziness
In young children who cannot describe pain, tugging at the ear, extra fussiness, and trouble sleeping may be the only clues.
Diagnosis & Evaluation
A clinician usually finds the cause quickly with a focused exam:
- Otoscopy: Looking in the ear canal and at the eardrum for redness, bulging, fluid, wax, or infection.
- Throat, nose, and jaw exam: Checking nearby areas that can refer pain to the ear.
- Hearing assessment: If hearing seems affected or the problem keeps returning.
Most earaches need no imaging or blood tests. Recurrent or complicated cases may be referred to an ear, nose, and throat specialist.
Treatment & Management
Treatment targets the cause, and home care often eases the pain in the meantime:
- Pain relief: Over-the-counter acetaminophen or ibuprofen reduces pain and fever (follow dosing for age and weight).
- Warm compress: A warm cloth held to the ear can soothe discomfort.
- Antibiotics: Prescribed for some bacterial ear infections, though many middle-ear infections clear on their own.
- Ear drops: Used for swimmer's ear; keep water out of the canal while it heals.
- Earwax removal: Softening drops or professional cleaning for impacted wax.
Avoid putting cotton swabs or objects into the ear canal, which can worsen pain or cause injury.
Self-Care & Prevention
Several steps can lower the chance of ear pain, especially in children:
- Prevent infections with good hand washing and keeping up to date with recommended vaccines.
- Avoid secondhand smoke, which raises the risk of ear infections in children.
- Dry ears gently after swimming or bathing to discourage swimmer's ear, and avoid inserting cotton swabs.
- Manage allergies and colds to reduce fluid buildup behind the eardrum.
- Equalize pressure when flying by swallowing or chewing during descent.
For babies, breastfeeding and keeping bottle-feeding upright (not lying flat) may help reduce ear infections.
When to See a Doctor
See a doctor if an earache is severe, lasts more than a day or two, or keeps returning. Seek prompt care for:
- High fever, severe pain, or pain with a stiff neck
- Fluid, pus, or blood draining from the ear
- Sudden hearing loss, severe dizziness, or facial weakness
- Swelling, redness, or tenderness of the bone behind the ear
- An earache in an infant under 6 months
Swelling and tenderness behind the ear or a high fever with a stiff neck can signal a serious infection and need urgent evaluation.
Frequently Asked Questions
How can I relieve an earache at home?
Over-the-counter pain relievers such as acetaminophen or ibuprofen and a warm compress held to the ear often ease the pain. Keep the ear dry and avoid inserting cotton swabs. If pain is severe, lasts more than a couple of days, or comes with fever or drainage, see a doctor.
Do all ear infections need antibiotics?
No. Many middle-ear infections, especially mild ones in older children and adults, clear on their own within a few days. Doctors often recommend pain relief and watchful waiting first, reserving antibiotics for severe, persistent, or high-risk cases.
Why does my ear hurt when I have a cold or sore throat?
Congestion can block the Eustachian tube and trap fluid that causes ear pain, and a sore throat can refer pain to the ear because they share nerves. The earache usually improves as the cold or throat infection resolves.
When is an earache an emergency?
Seek urgent care for an earache with high fever, a stiff neck, severe pain, fluid or blood draining from the ear, sudden hearing loss, facial weakness, or swelling and redness of the bone behind the ear.
Should I worry about ear pain in my baby?
Any earache in an infant under 6 months, or one with high fever, persistent crying, poor feeding, or ear drainage, should be checked by a doctor promptly, since young children cannot describe their pain and need careful evaluation.
References
- American Academy of Pediatrics. Ear Infection Information.
- Mayo Clinic. Earache — Symptoms and causes.
- MedlinePlus, U.S. National Library of Medicine. Earache.
- National Institute on Deafness and Other Communication Disorders (NIDCD).