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Earache

Earache is a very common symptom of an ear infection, and often clears up without any treatment. It can however be indicative of a potentially serious condition.

  • Very common in children
  • Usually clears up within a few days
  • Treatment varies from painkillers to antibiotics

If you have recently damaged your ear or are unsure about where the earache may have originated, you can speak to one of our GMC-registered clinicians via our online video consultation service, from 9.30am-4.30pm, five days a week.

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Possible causes

What causes earache?

Earache may be caused by numerous things, including an infection, a common cold or a foreign body.

Infection

There are two main types of infection which can affect the ear: otitis media and otitis externa. Otitis media is much more common in children, and is usually accompanied by a high fever.

Otitis externa is an infection in the outer part of the ear canal. It’s often associated with people who experience eczema or are repeatedly exposed to water. It causes the ear to feel sore and itchy, and can also produce pus as discharge from the ear.

Other causes

Sometimes a common cold can lead to earache if there is a buildup of mucus, which causes congestion in the middle part of the ear. It’s also possible to get earache from the presence of a foreign body, which could be anything small enough to fit in the ear canal. This is why it’s not recommended to use ear buds to clear wax from the ears, as the act of poking can damage several parts of the ear, or cause an infection.

The presence of wax is unavoidable in the ear canals, but usually it moves away from the ear without you having to clear it away. It can cause earache if a block is formed in the ear canal. A dramatic change in pressure due to flying in a plane, or deep sea diving, for example, can also cause earache.

Diagnosing the cause of earache

A doctor will usually be able to diagnose the cause of an earache in light of the symptoms you describe, and following an examination of your ear. 

They will ask about the location of the pain and whether there are any accompanying symptoms, which could be an indication of a systemic condition. The severity of the pain is not necessarily that relevant, as it does not always equate to the seriousness of the cause. This is evident in the case of tumours, where the pain may be mild, whereas an infection in the ear can be extremely painful.

For a physical examination, a doctor will use an otoscope to examine the ears, as well as the throat and nasal passage. Specifically, a pneumatic otoscope will be used for a suspected ear infection. It enables a doctor to see if there is fluid present behind the eardrum, by gently releasing air against it to see if it moves.

A doctor may also feel the outer part of the ear to see if there is any tenderness, and press against the tragus (the inner side of the external ear). This would indicate a problem with the auditory canal, which can usually be attributed to otitis externa.

If a doctor is still unsure having performed a physical examination, there are a few additional tests that they may recommend. A tympanometry test can measure the movement of the eardrum, and assess whether there is too much pressure within the middle ear. Rarely, a doctor can perform acoustic reflectometry to see how much sound is being reflected by the eardrum. Under normal circumstances, the eardrum absorbs the sound, but fluid in the middle ear may affect this.

If you feel pain in your ear, and you are concerned about it, you may want to speak to a doctor via our online video consultation service. Our GPhC-registered clinicians can issue advice regarding symptoms and treatment, and prescriptions and referrals to specialists, where suitable. They are available for consultation from 9.30am-4.30pm, Monday to Friday.

Page last reviewed:  11/06/2020
Types of Treatment

How is earache treated?

In most cases, you will not need any specific medication, as an earache will usually resolve itself. A doctor will advise taking some over-the-counter medications such as paracetamol and ibuprofen.

Treatment for earaches initially involves waiting to see whether symptoms develop or subside by themselves. During this period, a doctor will recommend taking some painkillers to alleviate the pain. It can also help to place a warm compress over the affected ear to try and relieve the pain.

For an otitis media infection, a doctor is unlikely to prescribe antibiotics, but they may do if a person has a severe pre-existing health condition which could make them vulnerable to future complications. Antibiotics may also be prescribed if the symptoms have not improved after three or four days. 

If required, the course of treatment is a medication called amoxicillin, for five days. However, antibiotics are not routinely recommended because they can often contribute to making bacteria more resistant over time, and in many cases do not speed up the healing process.

Otitis externa is treated slightly differently, as prescription ear drops are often needed. They can  consist of antibiotics if it’s a bacterial infection, corticosteroids if there is swelling, or antifungals for fungal infections. The drops are applied by gently removing any ear wax which may be in the canal, warming the drops slightly in your hands, and then lying on your side whilst applying them, with your ear facing upwards.

If any part of the inner ear has become damaged (from the presence of a foreign object, for example, which can perforate the eardrum) treatment usually involves allowing the ear to heal by itself. During the healing process, nothing should be put in the ear, as this can slow recovery down. Swimming is not advised, and you should be careful when washing your hair.

If pain in the ear is being caused by an earwax blockage, a doctor can suck out the wax with a syringe. They can also use a curved instrument called a curet, which can flush out the wax. 

If you are experiencing earache and are worried about the pain, one of our GMC-registered clinicians may be able to help. You can use our online video consultation service to speak with them between 9.30am and 4.30pm, five days a week. They can recommend measures you can take to alleviate the pain, and provide advice on allowing the ear to heal if it has been damaged.

Page last reviewed:  11/06/2020
Questions and Answers

How long is it normal to have earache for?

Infections in the middle ear will not normally last for more than a couple of days. Outer ear infections tend to last for up to a week, and inner ear infections longer still.

Severe trauma to the ear can cause pain for a few days, but it is very rare for chronic earache to be triggered.

Is earache serious?

Earache is usually due to a self-limiting condition which will clear up with basic treatment, but if it is accompanied by symptoms such as vomiting, hearing loss or severe swelling around the ear, you should contact a GP urgently.

Can I get treatment for earache?

Treatment for earache is available in the form of basic self-help measures, such as using a warm flannel against the ear, or using painkillers such as ibuprofen and paracetamol.

For an outer ear infection, there are prescription ear drops available for bacterial and fungal infections.

How can I prevent earache?

There are no vaccinations available to prevent an ear infection; some people are simply more predisposed to getting them than others.

However, there are a few tips you can follow to reduce your chances of getting earache. Avoiding environments of high pressure, not putting foreign objects in your ear and not getting the inside of the ear wet, can all help.

Can I speak to a doctor about earache?

If you are experiencing earache and would like to speak to a doctor about it online, you can do so using our online video consultation service. One of our registered clinicians will be able to issue input on symptoms and treatment, and provide prescriptions and referral to specialists, where appropriate. You can book an appointment with them between 9.30am and 4.30pm, Monday to Friday.

Page last reviewed:  11/06/2020

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