An earache is a very common condition with many different symptoms. Regardless of the problem, earaches can be annoying and painful. Earaches can affect the areas which surround the ear, as well as the ear itself.
Common Causes of Earache
Earaches can be caused by an infection in the middle ear, fluid in the ear, swimmer’s ear, barotrauma, perichondritis, and a ruptured eardrum.
Infection of the Middle Ear
Middle ear infections are very common in both adults and children. However, small children are most frequently affected. Improper draining of the Eustachian tube is often the cause of a middle ear infection. When the auditory tube cannot drain properly, debris and mucus become trapped, blocking air flow. This provides the ideal conditions for germs to thrive.1
Often, it is a common cold or respiratory infection which precedes a middle ear infection. This painful condition can have several symptoms, including:
- A feeling of pressure in one or both ears
- Pain in the ear
A middle ear infection is diagnosed by looking inside the ear with an otoscope. Any drainage, redness or swelling indicates infection. There are several options for treating an infection of the middle ear, including natural and pharmaceutical methods, or your primary care physician may suggest waiting to see if the infection resolves itself.
Fluid in the Ear
Serous otitis media, or fluid in the ear, occurs as the result of the Eustachian tube being impaired. The job of the Eustachian tube is to drain fluid from the ear to the back of the throat. This particular condition often has no symptoms, which can make it difficult to diagnose. Many things can cause fluid in the ear, including:
- Exposure to second-hand smoke or other chemical irritants
- Cleft palate and other oral abnormalities
- Growths which block the Eustachian tube, such as nasal polyps and enlarged sinus tissue
Adults may feel subtle symptoms or those which are more severe and debilitating. Tinnitus is a common symptom of fluid in the ear, as is a plugged feeling in one or both ears. Sufferers may also experience pain during altitude changes, as well as an inability to “pop” the ears.2
In order to properly diagnose fluid in the ear, much skill is required. This is because fluid in the ear can be very difficult to confirm. Once diagnosed, a hearing test may be ordered, as well as antibiotics and observation. Typically, fluid that remains after four or more weeks will result in a recommendation of the insertion of ear tubes.
Swimmer’s ear occurs when germ-containing water becomes trapped in the outer ear. The moist, warm conditions in the ear make it a good environment for bacteria to grow, resulting in the need for urgent care. Swimmer’s ear often has visible symptoms, the most common which is redness and flaking of the skin. Other symptoms of swimmer’s ear include:
- Pain when the ear is touched or the head is moved
- Drainage from the ear
- Itchiness inside the ear
Typically, this condition is easily diagnosed, especially if you have recently had contact with water and are experiencing the common symptoms above. Once diagnosed, the treatment of swimmer’s ear via steroidal or antibiotic ear drops will usually be recommended, or both may be prescribed to be used together.3
When air pressure changes drastically as the result of a sudden atmospheric change, barotrauma can often be the result. This particular condition will occur when the tympanic membrane or Eustachian tube does not function properly when exposed to a change in pressure, ultimately causing a mismatch between the pressure inside the ear and that outside of the ear.
The regulation of pressure inside the ear is governed by both the Eustachian tube and the eardrum. The Eustachian tube’s job is to allow air to enter the inside of the ear. When we yawn or swallow, the normally closed tube opens. However, when barotrauma occurs, the Eustachian tube remains closed.4
The eardrum regulates pressure in the ear by receiving sound, and then transporting those vibrations to the bones of the inner ear. However, when it doesn’t respond normally to a change in pressure, the eardrum can also be the cause of unequal pressure inside the ear, which can be treated with concierge medicine.
You may have experienced barotrauma if you have:
- Fluid buildup in the inner ear
- Ear pain
- Hearing loss
In order to properly diagnose barotrauma, a physical examination of the ear will be necessary. If it’s determined that damage to the eardrum has occurred, the most likely prescription will be to let time pass to allow for healing. If you also experience discomfort or pain, these can be treated with analgesics or decongestants.
If you know you will be experiencing rapid changes in air pressure due to flying or other changes in altitude, you can take preventative measures. These include sucking on candy, chewing gum, and eating. All of these will cause the frequent swallowing necessary to allow the Eustachian tube to open.
The infection of ear tissue can also cause earaches. The condition is known as perichondritis and can occur as the result of the improper treatment of swimmer’s ear, sports injuries, cuts, burns, and even ear piercing. Perichondritis is also used to describe an autoimmune condition which attacks ear tissue.
There are many visible symptoms of perichondritis, including:
If the condition is severe, you may also experience deformation of the ear structure, fluid discharge, or fever. The history of trauma experienced to the ear, as well as the appearance of the infected ear, will make it easy for a doctor to obtain a diagnosis of perichondritis.
Antibiotics are usually involved in the treatment of perichondritis via retainer medicine unless it is the autoimmune variety. In the latter case, steroid treatment is typically chosen.
Some forms of perichondritis can be prevented. For example, since cartilage piercing can increase the risk of developing perichondritis, it’s recommended that this activity is avoided.
When the eardrum is torn or there is a small hole in it, a ruptured eardrum is often the diagnosis. A ruptured eardrum can occur as the result of an ear infection. This is because an ear infection can cause fluid to build up and pressure to increase enough to tear the eardrum.
Another cause of eardrum rupture is the drastic change in atmospheric pressure when diving, flying, or traveling at high altitudes.
Injury to the ear from some kind of impact can also cause the eardrum to rupture. Impact can include anything from being hit in the ear to the insertion of a foreign object like a cotton swab.
The main symptom of a ruptured eardrum is pain. Ranging from mild to severe, it can be present at the same intensity through the day or vary in intensity. Pain will typically subside once the ear begins to drain a pus-filled, bloody, or watery fluid.
Diagnosis of a ruptured eardrum may need to be obtained via several means, including an audiology examination, the obtaining of a fluid sample from the ear, and examination by otoscope.
Other Causes of Earache
In addition to the above causes, earache can also require same day service care for other reasons. These include an excess of earwax pushed too far into the ear canal, as well as a foreign object being stuck in the ear. Earaches can also be caused by temporomandibular joint disorders (TMJ) and teeth grinding or bruxism.5
Examination Should Be Your First Step
If you are experiencing ear pain, and this condition is not within the norm for you, your first step should be to seek primary care. The primary care physicians at Direct Care offer extended hours as well prompt access to care.
Direct Care, located in Park Cities, is a membership practice that treats each patient as an individual. We strive to optimize health through increased communication focused on individual patient needs.
Contact Direct Care today to discover the benefits of membership.