When to worry about earache with sinusitis

Inflammation and mucus around the nose and sinuses can affect the pressure-equalising passage between the back of the nose and the middle ear. This may create fullness, popping, muffled hearing, or aching without an ear infection. Pressure can be more noticeable when you bend forward or during changes in altitude.

Earache can also come from the ear itself, the throat, jaw, or teeth. A clinician may need to look inside the ear and examine your nose and throat to separate these causes. The symptom alone cannot identify the cause.

Rest, drink fluids, and use saline nasal rinsing if it is suitable for you. Follow the product instructions and use sterile, distilled, or previously boiled and cooled water for a rinse. A warm compress over the painful area may feel soothing.

Use only pain relief that is safe for you and follow the label. Do not put cotton buds, oil, or unprescribed drops into the ear. Avoid flying or diving while pressure and pain are prominent, and arrange a review if symptoms are not settling or are interfering with sleep, eating, or hearing.

Seek urgent medical help for severe pain, new facial or ear swelling, pus or blood from the ear, a marked change in hearing, severe dizziness, weakness around the face, or a severe headache with neck stiffness, confusion, or unusual drowsiness. Get prompt advice if you feel very unwell, have a high fever, or symptoms are rapidly worsening.

Arrange a medical appointment when earache persists, returns repeatedly, or remains after sinus symptoms improve. Children, people with reduced immunity, and people with significant medical conditions should seek advice earlier when pain or fever develops.

Ask whether the pain appears to come from pressure around the sinuses or from the ear, whether the eardrum looks inflamed, and what treatment is appropriate. Mention when the pain began, any fever or discharge, changes in hearing, recent swimming or flying, and every medicine or nasal product you have used.