What should you know about excruciating ear pain?

Pain can come from the ear canal, eardrum or middle ear, but nearby structures can refer pain into the ear. A middle-ear infection may follow a cold and cause pressure, fever or reduced hearing. Earwax buildup can block sound and create discomfort. Sinusitis and a common cold may cause pressure around the ear, while tonsillitis can make swallowing painful with pain felt near the ear.

The pattern matters: discharge, tenderness when the outer ear is moved, sudden hearing loss, dizziness, dental pain or jaw symptoms each change what a clinician looks for. Ear pain alone does not identify one cause.

Use a suitable pain reliever only according to its label and your clinician’s advice, considering allergies, pregnancy, stomach or kidney problems and other medicines. A warm cloth over the outer ear may be soothing. Rest, drink fluids and avoid smoke.

Do not insert cotton buds, fingers or objects into the ear, and do not use leftover drops when the eardrum may be damaged. Keep the ear dry if there is discharge. Antibiotic treatment is not appropriate for every earache; a clinician decides after examining the ear.

Get urgent help for sudden hearing loss, severe dizziness, facial weakness, confusion, a stiff neck, swelling behind the ear, a high fever, severe headache, blood or pus from the ear, or pain after a significant injury. Emergency assessment is needed if severe pain accompanies collapse or difficulty breathing.

Arrange prompt review when pain is excruciating, lasts beyond a short period, keeps returning, or is paired with reduced hearing or discharge. Children, people with diabetes and anyone with a weakened immune system may need earlier assessment.

Ask which part of the ear appears affected, whether wax or infection is present, whether hearing should be checked, and which pain relief is safe for you. Mention recent colds, swimming, flying, injuries, discharge, dental symptoms and medicines already tried.