Otalgia

The most common reason for this in children is an infection of the middle ear. Pain from the middle ear is usually caused by a build-up of fluid and pressure behind the eardrum. Pain from an earache can be sharp, dull, or burning. The pain may be temporary or constant. The middle ear is connected to the nasal passages by a short narrow tube called the Eustachian tube. The Eustachian tube allows fluid to drain out of the middle ear, and helps keep the pressure in your ear equalized.

CAUSES

A cold or allergy can block the Eustachian tube with inflammation and the build-up of secretions. This is especially likely in small children, because their Eustachian tube is shorter and more horizontal. When the Eustachian tube closes, the normal flow of fluid from the middle ear is stopped. Fluid can accumulate and cause stuffiness, pain, hearing loss, and an ear infection if germs start growing in this area.

SYMPTOMS

The symptoms of an ear infection may include fever, ear pain, fussiness, increased crying, and irritability. Many children will have temporary and minor hearing loss during and right after an ear infection. Permanent hearing loss is rare, but the risk increases the more infections a child has. Other causes of ear pain include retained water in the outer ear canal from swimming and bathing.

Ear pain in adults is less likely to be from an ear infection. Ear pain may be referred from other locations. Referred pain may be from the joint between your jaw and the skull. It may also come from a tooth problem or problems in the neck. Other causes of ear pain include:

  • A foreign body in the ear.

  • Outer ear infection.

  • Sinus infections.

  • Impacted ear wax.

  • Ear injury.

  • Arthritis of the jaw or TMJ problems.

  • Middle ear infection.

  • Tooth infections.

  • Sore throat with pain to the ears.

DIAGNOSIS

Your caregiver can usually make the diagnosis by examining you. Sometimes other special studies, including x-rays and lab work may be necessary.

TREATMENT

  • If antibiotics were prescribed, use them as directed and finish them even if you or your child's symptoms seem to be improved.

  • Sometimes PE tubes are needed in children. These are little plastic tubes which are put into the eardrum during a simple surgical procedure. They allow fluid to drain easier and allow the pressure in the middle ear to equalize. This helps relieve the ear pain caused by pressure changes.

HOME CARE INSTRUCTIONS

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver. DO NOT GIVE CHILDREN ASPIRIN because of the association of Reye's Syndrome in children taking aspirin.

  • Use a cold pack applied to the outer ear for 15 to 20 minutes, 3 to 4 times per day or as needed may reduce pain. Do not apply ice directly to the skin. You may cause frost bite.

  • Over-the-counter ear drops used as directed may be effective. Your caregiver may sometimes prescribe ear drops.

  • Resting in an upright position may help reduce pressure in the middle ear and relieve pain.

  • Ear pain caused by rapidly descending from high altitudes can be relieved by swallowing or chewing gum. Allowing infants to suck on a bottle during airplane travel can help.

  • Do not smoke in the house or near children. If you are unable to quit smoking, smoke outside.

  • Control allergies.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You or your child are becoming sicker.

  • Pain or fever relief is not obtained with medicine.

  • You or your child's symptoms (pain, fever, or irritability) do not improve within 24 to 48 hours or as instructed.

  • Severe pain suddenly stops hurting. This may indicate a ruptured eardrum.

  • You or your children develop new problems such as severe headaches, stiff neck, difficulty swallowing, or swelling of the face or around the ear.