Why Does My Ear Hurt?

Ear pain, otherwise known as otalgia, is a common presenting complaint. The ear is made up of three parts – the inner ear, middle ear, and outer ear. The nerves that supply the ear are extremely complicated, as it shares nerve with many other regions, including the face (Trigeminal nerve), tongue (Facial, glossopharyngeal nerve), and even heart (Vagus nerve). Otalgia is classified into primary and secondary. Primary otalgia is pain within the ear, while secondary otalgia is pain outside the ear. If you find that the ear pain is worrying, it is best to find a doctor

Symptoms to look for 

It is often difficult, even for healthcare providers, to determine the cause of otalgia. Severe things may be helpful, including: 

  • Pain location 
  • How is the pain like
  • How long has it been since the pain started 
  • Anything that makes the pain worse 
  • Anything that makes the pain better 
  • Associated symptoms such as vomiting, ear discharge, hearing loss, headache, toothache, fever, etc. 
  • Is this the first occurrence 

Primary Otalgia 

Primary otalgia occurs when the pain originates from either the inner, middle, or external ear. Common causes of primary otalgia include barotrauma, foreign objects including impacted cerumen (ear wax), and infection. 

If the pain starts while one is scuba diving, flying in an airplane, or after a strong explosion or blast, there is a high likelihood that one has acquired barotrauma. Barotrauma occurs when there is a disruption of pressure in the ear canal, often in the situations mentioned above. One might feel dizzy along with the ear pain, and there might also be hearing loss. It is important to get an assessment from your doctor to determine the treatment required. Although the damage is often transient, severe barotrauma might require a hearing test to determine hearing loss. 

Impaction of foreign objects in the ear is extremely common in children. While they might not be able to verbalize or describe the pain, it can be observed when they frequently touch, dig, or even hit their ears. This can also be caused by a build-up and hardening of ear wax. Your healthcare provider can help to remove the foreign body or flush out the impacted wax. It is not recommended to attempt removal at home due to the risk of pushing the foreign object deeper into the ear. 

Otitis externa and otitis media is the infection of the outer and middle ear, respectively. Otitis externa is often due to the introduction of infection during swimming, and it commonly presents with ear discharge along with pain in the ear. On the contrary, otitis media is often related to an upper respiratory tract infection, including flu or sore throat. To differentiate between otitis externa and otitis media, your doctor will use an otoscope to look into your ear. These infections commonly require antibiotics.

Secondary Otalgia 

When pain from another region of the face gets referred to the ear, it is known as referred pain. As the ear shares many nerves with other regions including the head, neck, chest, and even abdomen, referred pain is a common cause of secondary otalgia. One of the common causes of secondary otalgia is dental caries or abscesses. If you find that you have a toothache along with otalgia, visit your dentist to get an evaluation, 

Another common cause is temporomandibular disorder (TMD). This is a problem with the joint that connects the bone of the jaw to the skull, known as the temporomandibular joint (TMJ). One may experience clicking or popping of the jaw, or even “locking” of the joint, making it difficult to open the mouth. This condition is usually not serious and might self-resolve over time. If you are still concerned after some time, it is better to seek an assessment. 

The above-mentioned causes of otalgia are often not serious, and prompt treatment can resolve the symptoms.

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