What should you know about unbearable ear pain?

Ear pain may involve the ear canal, eardrum, or middle ear. A middle-ear infection can present with intense pain, while earwax buildup can cause pressure, muffled hearing, or irritation. A cold or sinusitis can create pressure around the ear, and tonsillitis can send pain toward the ear even when the ear is not the main source. Pain after swimming, inserting an object, or a change in pressure gives a clinician useful context.

Keep the ear dry and do not put cotton buds, oil, or drops into it unless a clinician has advised them. A warm cloth held gently against the outside may be soothing. Use a pain medicine only if it is suitable for you and follow its package directions; check with a pharmacist if you take other medicines or have a long-term condition. Do not start leftover antibiotics. Treatment depends on the cause, and earwax removal may be appropriate only after the eardrum has been checked.

Arrange urgent medical advice for unbearable pain, pain that is worsening, or pain that prevents sleep or normal activity. Seek emergency help for severe dizziness, new facial weakness, confusion, breathing difficulty, or swelling spreading behind the ear. Prompt assessment is also needed for fluid, pus, or blood from the ear, sudden hearing loss, or a high temperature, particularly in a young child or someone with reduced immunity.

Ask whether the pain is coming from the ear canal, middle ear, teeth, throat, or sinuses; whether the eardrum can be seen clearly; which pain relief is safe with your medicines; and what changes should prompt a same-day review.