Earache

Definition

An earache can be sharp, dull, or burning pain. The pain may be temporary or constant.

Alternative Names

Considerations

The symptoms of an ear infection may include:

• Ear pain
• Fever
• Fussiness
• Increased crying
• 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.

Causes

Ear pain in children is often caused by a buildup of fluid and pressure behind the eardrum, in the area called the middle ear. The middle ear is connected to the nasal passages by a short narrow tube, the Eustachian tube. The Eustachian tube allows normal fluids to drain out of the middle ear, and helps keep the pressure in your ear equalized.

A cold or allergy can block the Eustachian tube due to inflammation and the buildup of secretions. This is especially likely in small children, because their Eustachian tube is shorter and more horizontal. Closing of the Eustachian tube prevents the normal flow of fluid from the middle ear. The fluid begins to build up, which can cause stuffiness, pain, hearing loss, and an ear infection.

Ear pain in adults is less likely to be from an ear infection. What you perceive as ear pain may actually be coming from another location, such as your temporomandibular joint, your teeth, throat, or other location. This is called "referred" pain.

Causes of earache:

• Arthritis of the jaw
• Ear infection
  • Middle ear infection - acute (short and severe episode)
  • Middle ear infection - chronic (does not go away or recurs)
  • Outer ear (canal) infection - acute
  • Outer ear (canal) infection - chronic
  • Outer ear (canal) infection - malignant
• Ear injury from pressure changes (from high altitudes and other causes)
• Object stuck in the ear or severely impacted ear wax
• Ruptured or perforated eardrum
• Sinus infection
• Sore throat with referred pain to the ears
• Temporomandibular joint syndrome (TMJ)
• Tooth infection

Ear pain in a child or infant is not always from infection, however. Other causes include:

• Ear canal irritation from cotton-tipped swabs
• Soap or shampoo staying in the ear
• Water from bathing

References

American Academy of Pediatrics Subcommittee on Management of Acute Otitis Media. Diagnosis and management of acute otitis media. Pediatrics. 2004 May;113(5):1451-65. Review.