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Earache

  • Definition
    • An earache is a sharp, dull, or burning pain in one or both ears. The pain may last a short time or be ongoing. Related conditions include:

      Medical findings based on ear anatomyEar anatomy
  • Alternative Names
    • Otalgia; Pain - ear; Ear pain

  • Considerations
    • The symptoms of an ear infection may include:

      • Ear pain
      • Fever
      • Fussiness
      • Increased crying
      • Irritability

      Many children will have minor hearing loss during or right after an ear infection. Most of the time the problem goes away. Lasting hearing loss is rare, but the risk increases with the number of infections.

  • Causes
  • Home Care
    • The following steps may help an earache:

      • Place a cold pack or cold wet washcloth on the outer ear for 20 minutes to reduce pain.
      • Chewing may help relieve the pain and pressure of an ear infection. (Gum can be a choking hazard for young children.)
      • Resting in an upright position instead of lying down can reduce pressure in the middle ear.
      • Over-the-counter ear drops can be used to relieve pain, as long as the eardrum has not ruptured.
      • Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can provide relief for children and adults with an earache. (DO NOT give aspirin to children.)

      For ear pain caused by a change of altitude, such as on an airplane:

      • Swallow or chew gum as the plane descends.
      • Allow infants to suck on a bottle or breastfeed.

      The following steps can help prevent earaches:

      • Avoid smoking near children. Secondhand smoke is a major cause of ear infections in children.
      • Prevent outer ear infections by not putting objects in the ear.
      • Dry the ears well after bathing or swimming.
      • Take steps to control allergies. Try to avoid allergy triggers.
      • Try a steroid nasal spray to help reduce ear infections. (However, over-the-counter antihistamines and decongestants DO NOT prevent ear infections.)
  • When to Contact a Medical Professional
    • Call your health care provider if:

      • Your child has a high fever, severe pain, or seems sicker than is usual for an ear infection.
      • Your child has new symptoms such as dizziness, headache, swelling around the ear, or weakness in the face muscles.
      • Severe pain suddenly stops (this may be a sign of a ruptured eardrum).
      • Symptoms (pain, fever, or irritability) get worse or do not improve within 24 to 48 hours.
  • What to Expect at Your Office Visit
    • The provider will do a physical exam and look at the ear, nose, and throat areas.

      Pain, tenderness, or redness of the mastoid bone behind the ear on the skull is often a sign of a serious infection.

  • References
    • Bauer CA, Jenkins HA. Otologic symptoms and syndromes. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 156.

      Coker TR, Chan LS, Newberry SJ, et al. Diagnosis, microbial epidemiology, and antibiotic treatment of acute otitis media in children: a systematic review. JAMA. 2010;304(19):2161-2169. PMID: 21081729 www.ncbi.nlm.nih.gov/pubmed/21081729.

      Lieberthal AS, Carroll AE, Chonmaitree T, et al. The diagnosis and management of acute otitis media. Pediatrics. 2013;131(3): e964-e999. PMID: 23439909 www.ncbi.nlm.nih.gov/pubmed/23439909.

      O'Handley JG, Tobin EJ, Shah AR. Otorhinolaryngology In: Rakel RE, Rakel DP eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 18.