Editor’s note: This article has been reprinted. First published September 21, 2016.
Ear pain can be caused by a variety of causes. Although it can be potentially painful and frustrating, most are not dangerous. Like most symptoms you experience, this indicates a problem. It is important to not only treat the symptoms but also pinpoint the cause of the pain.
More children than adults suffer from ear pain. Your child’s pediatrician will likely give you antibiotics or painkillers for ear pain. However, studies have shown that most otitis media cases resolve spontaneously, although uncomfortable, within a week.1
So does the U.S. Centers for Disease Control and Prevention (CDC).2 So does the American Academy of Pediatrics (AAP).3 To treat an ear infection, it is recommended that you use antibiotics right away. But ear infections aren’t the only reason you or your child experiences ear pain.
Before we look at the causes of ear pain and more effective ways to treat it at home, it is helpful to have an overview of the structure of the ear and where the pain comes from.
inside the ear
The ears are complex structures designed to collect sound waves from the surrounding environment, transmit them through delicate bone structures, and send signals to the brain that are interpreted as sound and language.
Each part of the ear has a specific function. This short video examines the structures of the outer ear that are essential for the early stages of hearing.
The way your ears are structured on the side of your head helps sound waves travel through the tubes. The outer ear ends when the sound travels through the external auditory canal and reaches the eardrum, also called the tympanic membrane. When sound hits this membrane, it begins to vibrate.4
The vibrations next enter the middle ear, which is made up of three small bones and the entrance to the Eustachian tube. This tube travels between the middle ear and the nasopharynx, behind the nose and mouth, to maintain pressure in the ear.
From there, sound enters the inner ear and the fluid-filled cochlea. Tiny hairs in the cochlea capture sound waves and transmit the information to the auditory nerve, which then relays this data to the brain. The process from sound generation to brain interpretation occurs in milliseconds.
Leave the wax and the cotton swab
You likely swab your outer ear after a shower as part of your daily hygiene, but you might want to reconsider removing earwax as it provides protection, lubrication and has some antibacterial properties to protect the outer ear.
According to a BBC report, earwax contains at least 10 antibacterial peptides that prevent bacteria and fungi from growing.5
Typically, earwax forms in the outer third of the external ear canal and naturally moves outward, carrying dirt and debris with it. Progression will also slow or stop if you consistently wear earplugs, headphones, or hearing aids.
If you have wax in your eardrum, you most likely applied too much force to your ear canal with a cotton swab, rolled-up napkin, or other object. Unless there are signs of earwax buildup or blockage, it is best to leave the wax alone. These symptoms include:
- earache
- Itching, odor, or discharge from the ears
- Partial or progressive hearing loss
- Tinnitus, ringing or noise in the ears
- Fullness of the ear canal
Dr. Otolaryngology Resident at Wayne State University, Michigan. Peter Svider talked about using ear swabs in Time Magazine. He said it is the leading cause of ear-related emergency room visits among adults in the United States, adding:6
“Cotton swab accidents are a common clinical phenomenon we see. The way swabs are designed, they’re not really a good tool for removing wax. They tend to push in more than they pull out.”
Why do my ears hurt?
There are many reasons why you may experience ear pain, including earwax buildup in the eardrum. Common causes of ear pain include:7
|
Temporomandibular arthritis |
short-term ear infection |
|
long-term ear infections |
Ear injuries due to pressure changes |
|
Foreign object stuck in ear |
There was a hole in my eardrum |
|
sinus infection |
sore throat |
|
Temporomandibular joint syndrome |
tooth infection |
There are a number of treatments available to relieve the discomfort of ear pain, but it is important to understand why your ears hurt, so seek medical attention for the underlying cause if necessary. Start by assessing your symptoms and history of ear discomfort. If you can’t find a reasonable cause or the problem persists, it’s time to see a doctor.
Assess your symptoms
Although many cases of otitis media are treated without antibiotics, you or your child may develop otitis media that requires treatment. Other known causes of ear pain can be addressed at home or require attention from an orthodontist, dentist, or primary care physician. Ask yourself some of the following questions about your symptoms to help you evaluate whether treatment is needed.
|
Is your pain related to a cold or flu? |
This pain is likely to gradually appear as a stuffy nose when you have a cold. It usually goes away once the cold is gone. |
|
Is there pus on the outside of your ear? |
This may be due to fluid buildup in the middle ear, causing the eardrum to rupture. When the eardrum ruptures, the pain almost disappears. |
|
Have you ever flown an airplane or scuba dived? |
You are experiencing barotrauma due to changes in altitude. If you experience any other physical symptoms after scuba diving, seek immediate medical attention. If confined to the ear, most cases are resolved by chewing gum, sucking hard candy, or yawning frequently to equalize the pressure.8 |
|
Do you grind your teeth at night? |
This increases muscle tension in the jaw and can translate into ear pain. Seek the attention of your dentist or orthodontist about overnight braces to stop grinding and prevent permanent damage to your teeth. |
|
Is your earache related to tooth pain or discomfort near the back of your mouth? |
This is caused by impacted wisdom teeth or cavities. If your dentist does not pay attention to cavities or wisdom teeth, your pain will not be resolved. |
|
Does pulling on the outer ear make ear pain worse? |
This may represent swimmer’s ear. You may also experience fever, drainage, and pain that spreads to your face and neck.9 If you do not experience rapid relief with home treatments, seek medical care to reduce the chance of hearing loss or cartilage damage. |
Delay taking antibiotics and painkillers until needed
Here, massage techniques are demonstrated to help drain the Eustachian tube and reduce pressure on the middle ear due to fluid buildup. Infections can occur in all three parts of the ear, but infections inside are most dangerous to hearing. Common otitis media rarely requires drug treatment, except in severe cases in young infants.10
If possible, avoid using antibiotics or painkillers. Antibiotics wreak havoc on your intestinal system, destroying your microbiome and increasing your risk of developing other health problems.
The American Academy of Pediatrics recommends administering antibiotics cautiously for ear infections because antibiotics do not always completely kill the bacteria present, making the bacteria left behind more resilient to antibiotics and more likely to cause chronic ear infections. I recommend doing this.11
Painkillers create another list of problems for you and your child. Although seemingly harmless and often sold over the counter, taking just a little too much acetaminophen can have serious and even fatal consequences. Listed below are several at-home options that can help reduce pain and discomfort without the added risks of painkillers.
Earwax buildup and reduced pressure in the middle ear
When considering these options for treatment at home, avoid putting anything into your ear canal if you think your eardrum has ruptured or if you know you have a small hole in your eardrum. Fluid or oil can escape through the hole and damage the delicate bone behind the eardrum, resulting in permanent hearing loss.
When earwax builds up near the eardrum, it causes pain and fullness in the ear. You can easily fix the situation at home by using liquid to soften the wax so it moves out, or by using an ear cleaning tool to wash the wax away.
Acceptable fluids are saline solution, coconut oil, hydrogen peroxide, carbamide peroxide, or olive oil. Removal requires cleaning the ear canal with a syringe. However, if done incorrectly, it can damage your eardrums. Do not clean your ears if you have diabetes, have a tube in your eardrum, have a perforation in your eardrum, or have a weakened immune system. Removal in this situation requires consultation with an otolaryngologist.
When ear pain is associated with a middle ear infection, there is an increase in fluid behind the eardrum that causes pain. There are several ways to reduce pain by reducing pressure. Massage techniques help open the Eustachian tubes and increase the flow of fluid in the middle ear.
In the same way, yawning or sucking on a hard candy causes thick liquid to flow down the Eustachian tube. Sleeping sitting up also helps reduce pressure on the eardrums, which can cause pain due to increased fluid.
Gargling with salt water can help loosen thick fluid in the Eustachian tubes and kill viruses in the back of the throat, shortening the duration of a viral infection.12 If you have a fungal infection, gargling with apple cider vinegar can also help.13 If you bottle feed your baby, it is important for your baby to eat in a more upright position to reduce the amount of formula entering the Eustachian tubes.
Reduce Ear Pain and Infections at Home
Use heat and cold compresses to reduce pain.14 Applying a cold, wet washcloth to the area for 20 minutes can help numb and reduce pain, while applying a warm, wet washcloth for 20 minutes can help relieve muscle tension and improve blood flow around the ear. Another alternative is to make a hot pack by adding a cup of salt or rice, heating it in the microwave or on the stove, and putting it in a sock. If it touches your skin, place it on your ear for 5 to 10 minutes.15
Garlic has natural antibacterial and pain-relieving properties.16 Eat 2-3 cloves of raw garlic every day, boil 2 cloves in 2 tablespoons of sesame oil or mustard oil until it turns dark to make this medicine, then strain it through a sieve. Once the oil has cooled enough that it doesn’t get too hot on the inside of your wrist, apply 1-2 drops to the affected ear.
The same goes for onion juice. Chop a small onion and cook in olive oil for 1-2 minutes. Once cooled, strain the liquid and place 1-2 drops in your ear. Leave it on for a few minutes, then turn your head to drain.
Breast milk contains natural antibodies that speed healing and reduce swelling, making it effective for both adults and children. Use 2 to 3 drops in the affected ear every 3 to 4 hours as needed. When cold or earache symptoms begin, place a few drops of 3% hydrogen peroxide in each ear and symptoms will improve within 24 hours.
Chiropractic adjustments are effective if your ear pain is caused by neck and shoulder muscle tension or if you have middle ear fluid. In the first case, the chiropractor will evaluate your posture and provide exercises to reduce potential problems caused by uneven muscle development in the shoulders and back that cause tension. Adjustments can also help open the Eustachian tube, allowing fluid to flow more freely in the middle ear and reducing pain.
