Otalgia (patient information)
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-in-Chief: Alexandra M. Palmer
Overview
Otalgia, or earache, can be a sharp, dull, or burning pain in one or both ears. The pain may be temporary or constant.
What are the symptoms of Otalgia?
The symptoms of an ear infection may include:
- Ear pain
- Fever
- Fussiness
- Increased crying
- Irritability
Many children will have temporary and minor hearing loss during, and right after, an ear infection. Permanent hearing loss is rare, but the risk increases with the number of infections.
What causes Otalgia?
Ear pain in children is often caused by a buildup of fluid and pressure behind the eardrum, in the area called the middle ear. The middle ear is connected to the nasal passages by a short narrow tube, the Eustachian tube. The Eustachian tube allows normal fluids to drain out of the middle ear, and helps keep the pressure in your ear equalized.
A cold or allergy can block the Eustachian tube due to inflammation and the buildup of secretions. This is especially likely in small children, because their Eustachian tube is shorter and more horizontal. Closing of the Eustachian tube prevents the normal flow of fluid from the middle ear. The fluid begins to build up, which can cause stuffiness, pain, hearing loss, and an ear infection.
Ear pain in adults is less likely to be from an ear infection. What you perceive as ear pain may actually be coming from another location, such as your temporomandibular joint, your teeth, throat, or other location. This is called "referred" pain.
Causes of earache:
- Arthritis of the jaw
- Ear infection
- Middle ear infection - acute (short and severe episode)
- Middle ear infection - chronic (does not go away or recurs)
- Outer ear (canal) infection - acute
- Outer ear (canal) infection - chronic
- Outer ear (canal) infection - malignant
- Ear injury from pressure changes (from high altitudes and other causes)
- Object stuck in the ear or severely impacted ear wax
- Ruptured or perforated eardrum
- Sinus infection
- Sore throat with referred pain to the ears
- Temporomandibular joint syndrome (TMJ)
- Tooth infection
Ear pain in a child or infant is not always from infection, however. Other causes include:
- Ear canal irritation from cotton-tipped swabs
- Soap or shampoo staying in the ear
- Water from bathing
Who is at risk for Otalgia?
Children are more at risk for Otalgia than adults. Children are especially at risk if they:
- Are around smokers
- Go to day care where they are exposed to many more germs and viruses
- Have a cold or allergy. This blocks the Eustachian tube and prevents the normal flow of fluid from the middle ear.
- Have had previous ear infections or have a family history of ear infections
- Were premature at birth or had a low birth weight
In general, males tend to show a higher incidence of ear infections than females.
How do I know if I have Otalgia?
The doctor will do a physical examination, which may include examination of the:
Pain, tenderness, or redness of the mastoid often indicates a serious infection.
During the examination, the doctor will ask questions about the ear pain, such as:
When did it begin? Is it getting better, worse, or staying the same? Is the pain constant? What other symptoms are present? Is there ear pressure? Is there drainage from the ear? Are there unusual ear noises? Is there a fever? Is there pain in the bone behind the ear? Is there hearing loss?
When to seek urgent medical care
Call your doctor if:
Your child has a high fever or severe pain or seems sicker than is usual for an ear infection
- New symptoms appear, especially:
- 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 - 48 hours
Treatment options
Home care
The following steps may help an earache:
- A cold pack or cold wet wash cloth applied to the outer ear for 20 minutes may reduce pain.
- For children old enough to safely chew gum, chewing may help relieve the pain and pressure of an ear infection.
- If a child is uncomfortable lying down, resting in an upright position can help reduce pressure in the middle ear.
- Olive oil or over-the-counter ear drops are gentle and effective, as long as the eardrum has not ruptured. Prescription drops, such as Auralgan, are also effective for pain relief.
- 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.)
You can relieve ear pain caused by rapidly descending from high altitudes by swallowing or chewing gum. Allowing infants to suck on a bottle while the plane is descending can help.
Diseases with similar symptoms
- Swimmer's ear
- Malignant otitis externa
Where to find medical care for Otalgia
Directions to Hospitals Treating Otalgia
Prevention of Otalgia
The following steps can help prevent earaches:
- Avoid smoking near children. Smoking has been shown to cause millions of ear infections each year in children.
- Prevent outer ear infections by not putting objects in the ear, and drying the ear after bathing or swimming.
- Take steps to control allergies. In particular, avoid allergy triggers. Steroid nasal spray may help reduce ear infections. However, over-the-counter sedating antihistamines and decongestants do NOT prevent ear infections.
What to expect (Outlook/Prognosis)
Because most ear infections improve within 24 hours of receiving medical care, health care providers are less likely to prescribe antibiotics immediately. Your doctor will often wait to see if symptoms continue or worsen. If antibiotics are prescribed, it is important to take ALL of the prescribed antibiotics on schedule.
Children with persistent or recurring ear infections may need ear tubes inserted to help the middle ear begin working properly again. Inserting ear tubes is a simple and effective surgical procedure.
Sources
http://www.nlm.nih.gov/medlineplus/ency/article/003046.htm