Ear ache and sore throat: what to know

A cold, influenza, COVID-19, tonsillitis, or strep throat can inflame nearby tissues and make pain seem to travel towards the ear. Allergic rhinitis may block the passage that equalises pressure between the middle ear and throat. Acid reflux can irritate the throat and cause referred discomfort without an ear infection. Glandular fever is another possibility when marked tiredness or swollen glands accompany the throat pain. The pattern, duration, fever, cough, nasal symptoms, and ability to swallow help a clinician narrow the cause.

Rest, drink fluids, and choose soft foods if swallowing hurts. Warm drinks or a salt-water gargle may soothe the throat. Keep smoke and other irritants away. A pharmacist can advise whether an appropriate pain reliever suits your age, health conditions, and other medicines; follow the product directions. Do not put objects, drops, or leftover antibiotics into the ear unless a clinician recommends them. If congestion is present, ask a pharmacist about suitable measures rather than combining several cold remedies.

Arrange medical advice if pain is severe, worsening, lasts beyond a few days, or keeps returning. Seek urgent help for trouble breathing, inability to swallow fluids, drooling, a muffled voice, swelling around the ear, pus or blood from the ear, severe dizziness, or sudden hearing change. A child who is unusually sleepy, difficult to settle, or drinking poorly should be assessed promptly. A clinician may examine the ear and throat and decide whether a swab or other test is useful.

Could the pain be coming from my throat rather than the ear? Do I need an examination or a throat test? Which pain-relief options fit my medicines and medical history? What changes should prompt urgent review?