Ear Pain During a Cold: What It Can Mean and What to Do

A cold can swell the lining of the nose and throat. This may stop the Eustachian tube from equalising pressure normally, causing a blocked feeling, aching, popping, or muffled hearing. Coughing, sneezing, and changes in pressure can make the discomfort more noticeable.

Ear pain may also have another cause, such as a middle-ear infection, sinusitis, tonsillitis, or earwax buildup. Ear pain alone cannot distinguish these conditions. Fluid behind the eardrum may remain after other cold symptoms start improving, so the ear can feel full for a while.

Rest, drink fluids, and use a warm—not hot—cloth against the outside of the ear for comfort. Saline nasal spray or drops may help loosen nasal congestion. Swallowing, yawning, or chewing gently can encourage pressure to equalise; do not forcefully blow your nose.

Pain relief may be appropriate for you when used according to the product instructions and your clinician's advice. Do not put cotton buds, oil, or unprescribed drops into the ear, and avoid getting water inside it if discharge is present. Antibiotics do not treat the cold itself and should only be used when a clinician identifies a bacterial infection.

Arrange a medical assessment if the pain is severe, is getting worse, lasts after the cold settles, or is accompanied by new hearing loss, fluid or pus from the ear, fever, dizziness, or repeated vomiting. A clinician can examine the ear and eardrum rather than relying on symptoms alone.

Seek urgent care for swelling or redness behind the ear, marked weakness, confusion, or a severe headache with neck stiffness. Babies and young children who are unusually sleepy, difficult to settle, or feeding poorly should be assessed promptly.

You could ask: Could congestion or fluid be affecting my middle ear? Is the eardrum intact? What signs would mean I need a follow-up visit? Which pain-relief options are suitable with my other medicines or health conditions?