Earache: what lies behind the symptoms

Earache: what lies behind the symptoms

Earaches are not a disease in their own right but are merely a symptom of a specific disease. Earache can have many causes – a middle ear infection is particularly often behind the symptoms. But other triggers can also cause earaches. The following article provides help in interpreting earaches that occur on one side when swallowing or together with a sore throat or what can be behind a stabbing or severe earache. However, you should always seek medical advice if you experience persistent or severe ear pain.

Earaches have many causes.

Ear pain can be a sign of an ear condition, but it can also have other causes. If there is an ear disease, the auricle, auditory canal, eardrum, middle ear or inner ear are affected. A disease of one of these parts is called primary otalgia. Earaches are most commonly caused by inflammation in the middle ear and the external auditory canal. A middle ear infection usually occurs due to a cold: bacteria from the nose and throat reach the middle ear and cause inflammation there.

On the other hand, inflammation of the external auditory canal is an infection of the skin of the auditory canal caused by bacteria or fungi. Such an inflammation is often caused by excessive ear hygiene and injuries caused by cotton swabs or penetrating bath water.

There are also other possible causes of earache (secondary otalgia), for example:

  • Diseases of the teeth or the jaw joint ( wisdom teeth, malocclusions)
  • Diseases of the nasopharynx or the larynx
  • nerve inflammation in the face
  • problems in the cervical spine
  • Inflammation of the parotid gland
  • Changes in air pressure (for example, when diving and flying, but also in the event of an explosion or a blow to the ear)

 

Typical accompanying symptoms of earache

Ear pain can occur on one or both sides and can be oppressive or stabbing. They are usually relatively strong and often do not subside even at night.

Depending on the cause of the earache, it can be accompanied by different symptoms. This can lead to dizziness, ear ringing, a foreign body sensation, and hearing loss. In the following section, you will find more detailed information on the individual causes of earache and the associated symptoms.

Ear pain: unilateral or bilateral?

In many cases, earaches are perceived as bilateral. If there is unilateral ear pain, it can be caused by a middle ear infection. This can cause unilateral pain if only one ear is affected by the inflammation.

Other possible causes of unilateral ear pain are nerve pain from facial or cranial nerves. An example is the so-called trigeminal neuralgia. The pain often occurs very suddenly and in waves.

An abscess on the tissue surrounding the tonsils can also cause unilateral ear pain. Such a peritonsillar abscess is usually accompanied by other symptoms, such as fever or high temperature, a general feeling of illness and swelling in the throat.

 

Ear pain when swallowing

If an earache occurs when swallowing, it can also be caused by irritation of specific brain nerves. In this case, the swallowing movement triggers the (often unilateral) pain.

The previously mentioned peritonsillar abscess can also cause ear pain that worsens when swallowing. In addition, tonsillitis can cause ear pain when eating. In both diseases, in addition to the earache, there is usually a sore throat and fever.

Ear pain when chewing

If ear pain occurs more frequently when chewing, irritation of the glossopharyngeal nerve can be the cause. This is then referred to as glossopharyngeal neuralgia. The pain is usually severe and can also affect the face.

Problems with the jaw, such as arthrosis of the temporomandibular joint or tension in the facial and jaw muscles (oromandibular dysfunction), can also cause increased ear pain when chewing. This muscle tension can increase with stress. So stress can trigger earaches.

If the chewing muscles are tense from grinding your teeth at night, the muscles in the shoulder and neck area can also hurt. 

However, such symptoms can also indicate cervical spine problems. If this is the case, there is usually additional pain when moving the cervical spine. In such a case, you should consult an orthopaedist.

sore throat and earache

If an inflammation in the ear itself does not cause ear pain but inflammation in the pharynx or larynx, there are other symptoms besides ear pain. This includes:

Throat and ear pain can be triggered, among other things, by tonsillitis or pharyngitis. But mouth, throat or larynx cancer, mumps or glandular fever can also be a cause. If the earache occurs due to a feeling of pressure in the face, headache, and a blocked nose, a sinus infection can also be behind the symptoms.

 

Stinging ear pain

An inflammation of the middle ear can be behind stinging ear pain, which sets in suddenly, especially in the evening or at night. A middle ear infection usually accompanies fever and a general feeling of illness. In addition, nerve pain can be felt as stabbing. They typically occur in attacks and suddenly.

Even if the eardrum is injured, stabbing ear pain can occur. There is severe hearing loss, tinnitus, dizziness, and fluid or blood loss through the ears. The eardrum can be injured by internal inflammation and strong fluctuations in air pressure or noise exposure.

Although the eardrum is not permanently injured, a so-called blast trauma, i.e. damage to the inner ear by a solid sound pressure wave, can also be accompanied by stabbing ear pain. Tinnitus usually occurs at the same time.

Severe ear pain

Particularly severe ear pain can occur as part of an ear canal inflammation, a so-called otitis externa. The periosteum in the ear is inflamed. The pain typically increases with pressure on the auricle. It can also cause swelling, itching, and redness of the skin. Secretions can also escape from the ear.

Inflammation of the auricle and inflammation of the middle ear and the eardrum can also cause severe earache. Influenza viruses often trigger such an inflammation, which is then referred to as influenza otitis. In addition to earache, hearing loss and bloody blisters in the ear canal can be symptoms of this condition.

earache outside

If the auricle or earlobe is red and swollen, this indicates an injury and inflammation of the outer ear. Such an inflammation occurs when bacteria penetrate the tissue through wounds or irritated skin areas – for example, after a piercing. The ear often becomes tense and warm to the touch if such an inflammation is present.

 

foreign body in the ear

If there is severe hearing loss in addition to earache, this can be a sign that the ear canal is blocked by earwax or a foreign body in the ear. A foreign body often also causes pain in the ear.

earache in children

Children often suffer from earaches; tiny children usually struggle with earaches several times in the first few years of life. Boys are more likely to suffer from earache than girls.

Children’s earaches are particularly common due to a middle ear infection. This is because the connecting tube between the nasopharynx and the middle ear is shorter and more horizontal in children than adults. When you have a cold or flu, bacteria can quickly get into the middle ear and cause inflammation.

Toddlers often cry when they have an earache and often rub their ears. General symptoms such as fever, abdominal pain, diarrhoea or vomiting often occur. If your child has an earache, you should seek medical advice to determine the cause of the earache.

ear pain in pregnancy

Infections can occur more frequently during pregnancy, as the immune system is particularly challenged. The use of certain medications for ear pain, especially antibiotics, should always be clarified by a doctor. Some remedies are also suitable for use during pregnancy, whereby the month of pregnancy and weighing benefits and risks play a role.

 

Earache: When to see a doctor?

Slight earaches, for example, due to a cold, pressure changes when flying or little muscle tension, do not always have to be treated directly by a doctor. Depending on the cause, home remedies, muscle relaxation, or over-the-counter remedies from the pharmacy can be used first.

However, suppose the earache does not improve after a few days. In that case, if it is very severe or accompanied by symptoms such as fever, hearing loss or leaking blood, a doctor should always be consulted to determine the exact cause and to be able to treat it specifically.

 

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