Earache

Is this your symptom?

  • Pain in or around the ear
  • Not caused by an ear injury

Causes of Earaches

  • Ear Infection. An infection of the middle ear is the most common cause of earache. Can happen at any age, but more common in kids. Bacterial ear infections need antibiotics. Viral ear infections get better on their own. Both need pain medicine.
  • Infection in the Ear Canal can cause pain and leak fluid from the ear. Common in people with small or blocked ear canals. Also common in people who wear hearing aids. Can be treated with medicine and ear cleaning by a health provider.
  • Swimmer's Ear is an infection or raw feeling of the ear canal lining. It often happens to swimmers in the summer. Main symptom is an itchy ear canal. Can hurt if the ear canal gets infected. May happen over and over again.
  • Shingles can cause pain in the face and/or ear. It may feel like ear pain before the rash appears.
  • Mastoiditis. An infection of the mastoid bone that connects the part of the skull behind the ear to the middle part of the ear.
  • Ear Canal Injury. A cotton swab or fingernail can scratch the ear canal and cause infection and pain.
  • Pus Pocket in Ear Canal. A painful infection of a hair follicle in the ear canal. It looks like a small red bump. Sometimes turns into a pimple and needs to be drained.
  • Earwax. A piece of hard earwax can cause mild ear pain. If the wax has been pushed in by a cotton swab, the ear canal can become blocked. This pain will be worse.
  • Ear Canal Object. Objects put in the ear canal will hurt if they are sharp or left in for a long time. Bugs can also crawl into the ear and cause ear pain.
  • Airplane Ear. Quick changes in air pressure can cause ear pain. Often starts when coming down for a landing or taking off. Can also happen during mountain driving.
  • Pierced Ear Infections are very common and should be treated right away. Symptoms are redness, pain and swelling of the outside part of the ear.
  • Referred Pain. Ear pain can be referred from problems that are not in the ear. Tonsil infections, tooth problems and mumps can cause ear pain. Jaw pain (TMJ) can also be felt as ear pain.

When to Call for Earache

When to Call for Earache

Call Doctor or Seek Care Now

  • Severe earache and not improved 2 hours after taking ibuprofen
  • Pink or red swelling behind the ear
  • Outer ear is red, swollen and painful
  • Stiff neck (can't touch chin to the chest)
  • Walking is not steady
  • Pointed object was put into the ear canal (such as a pencil, stick, or wire)
  • Fever or chills; feeling hot or shivery
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Weak immune system. Examples are: diabetes, sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
  • Earache, but none of the symptoms above. Reason: could be an ear infection.
  • Blood, pus or cloudy discharge from ear canal
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Mild earache that started after or during a flight
  • Mild earache with a cold (gets better with over the counter pain meds)

Call Doctor or Seek Care Now

  • Severe earache and not improved 2 hours after taking ibuprofen
  • Pink or red swelling behind the ear
  • Outer ear is red, swollen and painful
  • Stiff neck (can't touch chin to the chest)
  • Walking is not steady
  • Pointed object was put into the ear canal (such as a pencil, stick, or wire)
  • Fever or chills; feeling hot or shivery
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Weak immune system. Examples are: diabetes, sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
  • Earache, but none of the symptoms above. Reason: could be an ear infection.
  • Blood, pus or cloudy discharge from ear canal
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Mild earache that started after or during a flight
  • Mild earache with a cold (gets better with over the counter pain meds)

Care Advice for Earache

  1. What You Should Know About Earaches:
    • Earaches are a common problem. Many cases get better without treatment.
    • Ear pain can often be controlled with pain meds.
    • Other treatment will depend on the cause of the ear pain.
    • Many earaches are caused by a virus and don't need an antibiotic.
    • Here is some care advice that should help until you talk with your doctor.
  2. Pain and Fever Medicine:
    • To help with the pain or fever, take an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil). Ibuprofen works well for this type of pain.
    • Use as needed, but do not take more than the maximum recommended dosage stated on the package.
    • If you are not sure what to take, ask a pharmacist.
  3. Cold or Warm Pack for Pain:
    • Put a cold or warm wet washcloth on the outer ear for 20 minutes. This should help the pain until the pain medicine starts to work.
    • Caution: avoid using heat or cold for too long. It could cause a burn or frostbite.
  4. Ear Infection Discharge (Pus):
    • Pus draining from the ear often means there is an ear infection. This might be in the ear canal or the eardrum. Pus can also happen if you have ear tubes in place.
    • The pus may be blood-tinged.
    • Wipe the pus away from the outer part of the ear, but do not insert cotton swabs or other objects into the ear canal.
  5. Return to Work and Other Activities:
    • Ear infections cannot be spread to others.
    • You can return to your normal activities when the fever is gone, if you feel better.
  6. Call Your Doctor If:
    • Pain becomes severe
    • You think you need to be seen
    • Your symptoms get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2023 Schmitt Decision Logic LLC.

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