Earache

Earache, or otalgia, is pain in or around the ear. The discomfort may arise from the ear itself or be referred from nearby structures such as the throat, teeth, or jaw. Earache is common in children but can affect people of all ages.

Causes include infections such as acute otitis media (middle ear infection) and otitis externa (ear canal infection). Other factors are cerumen (earwax) blockage, trauma or perforation of the eardrum, barotrauma, sinus or throat infections, dental problems, temporomandibular joint disorders, and, less often, tumors. In some cases the pain is referred rather than from the ear itself.

Symptoms vary but often include ear pain, a sensation of fullness, itching, or discharge from the ear, hearing loss, and sometimes fever, vertigo, or malaise. The presentation can be unilateral or bilateral.

Diagnosis is based on history and physical examination. An otoscopic exam assesses the ear canal and tympanic membrane. Additional tests, such as audiometry or tympanometry, may be used if there is suspected hearing loss or recurrent infections.

Treatment focuses on pain relief and addressing the underlying cause. Analgesics such as acetaminophen or ibuprofen are commonly recommended. Many cases of acute otitis media improve without antibiotics, but antibiotics may be indicated by age, severity, or suspected bacterial infection. Otitis externa is typically treated with topical antibiotic ear drops, sometimes with steroids; care is taken to avoid drops if the eardrum is perforated unless advised by a clinician. Avoid inserting objects into the ear.

Prevention includes vaccination, avoiding tobacco smoke exposure, breastfeeding, and good ear hygiene. Seek medical care for severe or persistent pain, fever, hearing loss, swelling around the ear, discharge, head trauma, or symptoms in newborns.