Extreme ear pain and pressure: what to know

Pressure or fullness often reflects poor movement of air through the Eustachian tube, the passage between the middle ear and the back of the nose. A cold or sinus inflammation can narrow that passage. A middle-ear infection may add throbbing pain, fever or reduced hearing. Earwax buildup can block the canal and create fullness, muffled sound or tenderness. Throat inflammation, including tonsillitis, can sometimes send pain toward the ear even when the ear itself is healthy.

Rest, drink fluids and keep the ear dry. A warm compress held against the outer ear may be soothing. Use pain relief only as directed on its label and check with a pharmacist if you are pregnant, have kidney disease, stomach ulcers or take regular medicines. Do not put cotton buds, oil or unprescribed drops into the ear, and do not try to remove a deep blockage yourself. Antibiotic treatment is useful only when a clinician identifies a condition that needs it; it does not treat every earache. Ear Wax Removal may be considered when wax is confirmed.

Arrange prompt medical assessment for severe pain, new hearing loss, fluid or blood from the ear, marked dizziness, swelling around the ear, or fever with worsening symptoms. Seek urgent help for severe headache, facial weakness, confusion or difficulty walking. A clinician can examine the ear canal and eardrum, check hearing and decide whether treatment is needed.

Ask whether the eardrum looks inflamed or injured, whether wax or fluid is blocking sound, and whether nasal or throat symptoms are contributing. Tell the clinician when the pain began, whether it is on one side, what changes your hearing, and which medicines or drops you have already used.