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Why does it hurt? Earaches explained

At Indigo Health, earaches are among the most common conditions we treat. And while we most often see young children for these uncomfortable conditions, ear pain also happens in adults.

From infections to obstructions to discomfort prompted by underlying medical issues, there’s a range of reasons for the pain in your ears.

Here are some of the most common types of earaches.

  1. Middle ear infection

Inflammation of the middle ear, usually caused by bacteria, occurs when fluid builds up behind the eardrum. This is the most common ear infection and most commonly affects young children.

The tubes and spaces in children’s ears are much smaller and more horizontal. When they get a cold or other respiratory illness, their compact anatomy makes it difficult for fluid to drain out of the ear. According to the National Institutes of Health, five out of six children will have a middle ear infection by the time they reach their 3rd birthday. 

Symptoms of middle ear infections include:

  • Ear pain. Pain from a middle ear infection may be obvious in an adult or older child. Infants express ear pain by rubbing or tugging ears crying more than usual. They may also have difficulty sleeping.
  • Loss of appetite.
  • Irritability.
  • Poor sleep. (Pain can worsen when you lie flat.)
  • Fever from 100 to 104 degrees.
  • Ear drainage.
  • Trouble hearing.


  1. Inner ear infection

Inflammation deep inside the ear is often caused by some type of virus or bacteria. In addition to ear pain, additional signs of an inner ear infection or inflammation may include:

  • Spinning sensation (vertigo) and nausea or vomiting that can result from vertigo.
  • Trouble balancing or walking normally.
  • Hearing loss.
  • A feeling of fullness or blockage in the ear.
  • Ringing in your ears (tinnitus).
  • Headache.
  • Fluid or pus coming from the ear.


  1. Swimmer’s ear

This bacterial ear infection is typically caused by water that gets trapped in the outer ear canal. You don’t have to be in the pool to be at risk. Swimmer’s ear can be caused by shampoos and other hair products, heavy perspiration, humid environments and other factors.

Typical symptoms of swimmer’s ear include:

  • Itching in the ear canal.
  • Slight redness inside the ear.
  • Mild discomfort made worse by pulling on the outer ear or pushing in on the ear.
  • Drainage of clear, odorless fluid.


  1. Airplane ear

Quick changes in altitude can create an imbalance of pressure in the ear drum and cause blocked ears, muffled hearing, or discomfort or pain deep inside the ear canal. 

There are some simple ways to help equalize the pressure and ease discomfort while flying:

  • Swallow and yawn when ear discomfort begins to help open Eustachian tubes. When flying with babies, feed them or give them a drink or pacifier during takeoff or landing to encourage swallowing.
  • Chew gum during takeoff or landing.
  • Gently blow your nose or blow air through your nose while closing your mouth and pinching your nose.
  • Wear ear plugs.

Flying with a cold, nasal congestion or allergies can worsen ear pain. If you must fly, take a decongestant to help clear up your ears.


  1. Ear wax buildup

Ear wax acts as a natural cleanser to flush out dead skin cells, hair and dirt. But when too much of a good thing builds up, ear wax can become hard and form a plug that blocks the ear. That blockage can be painful and affect hearing.

Over-the-counter ear drops might help, or you can leave wax removal to the medical professionals at Indigo Health who have the right tools and expertise to do the job. Never DIY with a cotton swab. It will only push the wax deeper into the ear and cause even more impaction. Just placing a cotton swab in your ear can create enough pressure to rupture your eardrum and may cause sharp pain, drainage, ringing in the ears and hearing loss.


  1. Perforated eardrum

A perforated or burst eardrum is a hole or tear in the thin tissue that separates the ear canal from the middle ear.

Signs and symptoms of a ruptured eardrum may include:

  • Ear pain that may subside quickly
  • Mucus-like, pus-filled or bloody drainage from the ear
  • Hearing loss
  • Ringing in the ear (tinnitus)
  • Spinning sensation (vertigo) and nausea or vomiting that can result from vertigo


  1. Foreign objects

Unwanted items can go in the ear on purpose (cotton swabs) or by mistake (a small earring or insect). Curious children are notorious for testing the ear’s capacity with food, crayons and small toys. But what goes in the ear easily doesn’t often come out the same way.

Symptoms of a foreign body lodged in the ear may include a sensation of fullness, pain and decreased hearing. If an object is not removed, an infection may develop and produce more severe symptoms, including:

  • Intense pain.
  • Redness.
  • Swelling.
  • Discharge.

Anything stuck in the ear that doesn’t come out on its own should be removed by a medical provider.

  1. Ear eczema

This common skin condition that causes dry, itchy or inflamed skin can also find its way into your ears. Eczema can be triggered by contact with certain irritants, such as fragrances, soaps, shampoos, hair dyes and metal jewelry.

Symptoms of ear eczema include:

  • Dry, flaky skin around the outside of the ear or inside the ear canal.
  • Redness, itchiness or swelling inside or around the ear.
  • Clear discharge leaking from the affected ear.

Fortunately, ear eczema is highly treatable. If left untreated, however, it can lead to infection of the ear canal and cause:

  • Aching pain.
  • Excessive ear redness.
  • Green or yellow discharge.
  • Flu-like symptoms.

Other causes of ear pain

Earaches aren’t always caused by something in your ear. Pain can also be a symptom of something going on in another part of your body, including:

  • Dental issues, such as tooth abscesses, cavities and impacted molars.
  • Throat infections, including tonsillitis or pharyngitis.
  • TMJ (temporomandibular joint) disorders. Pain in the hinge of the jaw below your ears can be caused by teeth grinding or may be a symptom of arthritis.
  • Nonmedical factors. Ear pain can also be caused by tight headwear, poorly fitting headphones, sleeping on a hard surface and ear piercings.


How can I treat earaches at home?

If your ear pain is mild, there are some remedies you can try at home to relieve pain and pressure:

  • Apply cool or warm compresses (or heating pad set on “warm”) to the affected ear.
  • Try over-the-counter pain relievers, including acetaminophen (Tylenol), ibuprofen (Advil) or naproxen (Aleve).
  • Sleep upright to encourage fluid from the ear to drain.

Over-the-counter ear drops may help, but it’s best to check with a medical provider first. Drops of any kind should never be placed in the ear if an eardrum has a tear or hole.


Indigo Health can ease your ear pain

If you or a family member are dealing with ear pain and other symptoms that don’t improve within two or three days, it’s a good idea to seek medical care.

Indigo Health makes it easy to get the care you need. And with seamless scheduling and more than 35 convenient locations across Washington state, you can count on the same refreshing care, wherever you are.

Your Indigo medical provider will evaluate your symptoms and use an otoscope to examine inside your ear to help make a diagnosis. If needed, we’ll prescribe ear drops or antibiotics or provide other treatment to manage pain or other uncomfortable symptoms. We can also dislodge any objects and ensure there’s no infection or damage. If wax buildup is the culprit, your provider may remove the wax or prescribe wax-softening eardrops.

If you have symptoms with your earache that indicate something more serious is going on, we’ll refer you to a higher level of care.


When is an earache an emergency?

If you have any of the following symptoms along with your earache, it’s best to visit your nearest emergency department.

  • Swelling or a knot behind or under the ear
  • Difficulty moving parts of your face
  • Weakness or lethargy
  • Sudden high fever
  • Prolonged dizziness
  • Loss of balance
  • Extreme headaches
  • Seizures

Ear pain and ear infections are more serious in infants. If your child is under 6 months old and shows signs of ear pain, you should also seek immediate medical care.

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