Ear Pain

What is it?

Ear pain (otalgia) can arise from the ear itself (primary otalgia) or be referred from nearby structures (secondary otalgia). In children, acute otitis media (middle ear infection) is the most common cause. In adults, referred pain is more frequent — from the temporomandibular joint (TMJ), throat, teeth, or cervical spine. Otitis externa (swimmer's ear) causes sharp pain triggered by pulling the ear or pressing the tragus. Referred otalgia is important to recognize: a persistent ear pain without visible ear pathology should prompt evaluation of the throat and TMJ, especially in smokers — it can be an early sign of oropharyngeal cancer.

Common causes

When to see a doctor

• 1Ear pain in a child under 2 with fever — high risk for acute otitis media
• 2Ear pain with sudden hearing loss or a sensation of fullness with vertigo
• 3Facial paralysis, rash around the ear, or blistering (Ramsay Hunt syndrome)
• 4Pus or fluid draining from the ear canal
• 5Persistent unilateral ear pain without visible ear disease in a smoker or drinker over 40
• 6Severe pain with swelling and redness behind the ear (possible mastoiditis)

What you can do

• ✓Apply a warm compress over the ear to relieve pain from otitis media
• ✓Avoid getting water in the ears during active otitis externa — use a cotton ball with petroleum jelly
• ✓Yawn, chew gum, or try the Valsalva maneuver to clear eustachian tube pressure on flights
• ✓Do not insert cotton swabs or objects into the ear canal — they push wax deeper and risk injury
• ✓For TMJ-related ear pain: soft diet, avoid wide jaw opening, jaw stretching exercises
• ✓OTC analgesics (ibuprofen, acetaminophen) effectively manage ear pain while awaiting evaluation

Conditions that cause this symptom

Medications that may help

Treatment depends on the underlying cause. Always consult your provider before starting any medication.

Frequently asked questions