Earache

Overview

Earache is pain or discomfort in or around the ear. It is not a single condition. It can come from the ear itself, or from nearby areas such as the throat, jaw, or sinuses. Most earache is caused by a mild infection or pressure change and gets better with time and simple care.

Yes. Earache is one of the most common reasons people, especially children, seek medical advice.

Anyone can get earache, but young children get it most often. It is also more common in people who have colds, allergies, or ongoing ear or sinus problems.

Symptoms

Common symptoms

• Pain, throbbing, or a dull ache in one or both ears
• A feeling of fullness or pressure in the ear
• Muffled hearing or sounds seeming quieter
• Itching or irritation in the ear canal
• Fluid or discharge coming from the ear
• Fever or feeling generally unwell
• Ringing or buzzing in the ear

Symptoms in children

• Pulling, rubbing, or tugging at the ear
• Crying more than usual or being hard to comfort
• Poor sleep because of pain
• Irritability or clinginess
• Poor feeding or drinking less
• Fever
• Not responding to sounds as usual
• Problems with balance or clumsiness

Symptoms in older adults

• Ear pain or pressure that may come on slowly
• Hearing changes or muffled sound
• Discharge or itching in the ear canal
• Pain that may be felt in the jaw or throat instead of the ear
• Wax buildup or skin problems in the ear canal
• Fewer obvious signs such as fever, so discomfort may be the main clue

Causes

Main causes

• Middle ear infection, often after a cold
• Infection of the ear canal, sometimes called swimmer's ear
• Blocked or poorly working eustachian tube, the small passage that connects the middle ear to the back of the throat
• Wax buildup or a foreign object in the ear
• Pressure changes from flying, diving, or altitude
• Throat infection, sinus infection, or jaw joint problems causing referred pain
• Injury to the ear or ear canal

Risk factors

• Recent cold, flu, or other respiratory infection
• Allergies that cause swelling or congestion
• Smoking or exposure to secondhand smoke
• Being a young child, especially in group childcare
• Bottle-feeding while lying flat
• Using cotton swabs or inserting objects into the ear
• Swimming or moisture trapped in the ear canal
• Ongoing sinus or jaw problems

When to see a doctor

See a doctor urgently if:

• You have severe pain or pain that is getting worse quickly
• There is swelling, redness, or tenderness behind the ear
• A baby under 3 months has a fever
• There is sudden hearing loss or severe dizziness
• There is ear discharge with fever or severe pain
• You have diabetes, a weakened immune system, or have had recent ear surgery
• A child is very unwell, difficult to wake, or not drinking

Book a routine appointment if:

• Earache lasts more than a few days or keeps coming back
• Hearing stays muffled after the pain improves
• You are worried about your or your child's symptoms
• There is itching, discharge, or a feeling of blockage that does not settle
• Your child seems to have trouble hearing or speech is delayed

Diagnosis

A doctor or nurse will ask about symptoms, recent colds, allergies, swimming, and any ear problems in the past. They will look inside the ear with a small light and camera called an otoscope. They may also check the throat, nose, and neck.

Tests that may be done

• Otoscopy, which means looking inside the ear with a small light
• Tympanometry, a gentle test that checks how the eardrum moves
• Hearing tests if hearing problems continue
• A swab of discharge if the ear canal is infected
• Blood tests or scans only if a serious problem is suspected

What to expect at your appointment

The exam is usually quick and not painful. The doctor will explain what they can see and whether you need treatment, follow-up, or simple self-care.

Treatment

Treatment depends on the cause. Many earaches get better with rest, fluids, and pain relief. Some infections need antibiotics, but not all do. Your clinician will decide what is right for you or your child.

Self-care at home

• Use pain relief medicine if suitable for you or your child; ask a pharmacist for advice
• Rest and drink plenty of fluids
• Hold a warm compress against the outside of the ear if it feels soothing
• Keep the ear dry and clean on the outside only
• Do not put cotton swabs, oil, or objects into the ear
• For children, offer comfort and small sips of fluid often
• Avoid smoking and keep the person away from secondhand smoke

Medical treatments

A clinician may recommend watching and waiting for a short time, especially for mild middle ear infections. If a bacterial infection is likely, antibiotics may be prescribed. Ear drops may be used for some ear canal infections or wax problems. Your clinician will explain the options, benefits, and risks, and will advise on follow-up.

When is surgery considered?

Surgery is not common for earache. If a child has repeated middle ear infections or ongoing fluid that affects hearing, a specialist may discuss small ear tubes, sometimes called grommets. This is usually considered only after other options have been tried.

Living with this condition

Earache can make it hard to sleep, concentrate, or hear clearly. For children, it can disrupt feeding and sleep for the whole family. Most people feel better within a few days, but muffled hearing can linger for a short while.

Lifestyle tips

• Avoid smoking and secondhand smoke
• Treat allergies and colds early if they often trigger ear problems
• Keep ears dry after swimming or bathing
• Avoid inserting anything into the ear canal
• Feed babies upright rather than lying flat
• Wash hands often to reduce colds and flu

Diet and exercise

There is no special diet for earache. Drinking fluids and eating normally as comfort allows is fine. Rest is helpful, and gentle activity is okay if you feel well enough.

Mental health and emotional wellbeing

Earache can be distressing, especially for children and parents who are worried or losing sleep. This is normal. If you feel overwhelmed, talk to a clinician, health visitor, or someone you trust. If you or someone you care about is in crisis, contact your local emergency services or a local crisis support service.

Prevention

Not all earache can be prevented, but you can lower the risk by reducing colds, avoiding smoke, treating allergies, and keeping ears dry and free from objects.

Vaccines

Keeping up to date with routine childhood vaccinations and seasonal flu vaccination can help prevent some infections that lead to earache. Ask your clinician what is recommended for you or your child.

Screening programmes

There is no routine screening for earache. Hearing checks may be offered if there are ongoing concerns.

Complications

If left untreated

• A hole or rupture in the eardrum
• Ongoing fluid behind the eardrum and muffled hearing
• Spread of infection to the bone behind the ear, which is serious and needs urgent care
• Long-term ear infection or repeated infections
• Speech or learning delays in children if hearing is affected for a long time

Long-term outlook

Most people with earache recover fully. Pain often improves within a few days, and hearing usually returns to normal. If symptoms continue or hearing does not come back, follow-up can help find the cause and treat it.

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