Earache is cited as the most common reason for a parent to call a doctor out of hours for their child.
It will often be the result of an ear infection. Adults are less likely to experience earache and ear infections than children.
Earache can be a sharp, dull or burning ear pain that comes and goes or is constant. One or both ears may be affected.
When to call your GP
You should call your GP if:
(1) You or your child has a high temperature (fever) of 38ºC (100.4ºF) or above
(2) You or your child has other symptoms, such as dizziness, a severe headache, or swelling around the ear
(3) The earache does not improve within 24-48 hours
What you can do at home
You can use over-the-counter painkillers such as paracetamol or ibuprofen to treat the pain.
Children under 16 years of age should not take aspirin.
Placing a warm flannel against the affected ear may also help to relieve the pain.
Your pharmacist may be able to recommend over-the-counter eardrops for your earache, but let them know your symptoms and ask for their advice first.
Eardrops or olive oil drops should not be used if the eardrum has burst, and they will not help an ear infection.
If you or your child has an ear infection, you should avoid getting the affected ear wet.
Common causes of earache
The information below should not be used to self-diagnose your condition, but may give you an idea as to what is causing your earache.
It does not include every possible cause, but outlines the most common reasons for earache.
(1) Glue Ear – a build-up of fluid deep inside the ear (behind the eardrum), which mainly affects children
(2) An Infection in the Ear Canal (outer side of the eardrum)
(3) A Scrape or other Physical Damage to the inside of the ear caused by a cotton bud, stick or similar
(4) A Plug of Earwax or another object stuck inside the ear
(5) A Throat Infection, such as Tonsillitis or Quinsy, which can affect the ear
Earache caused by glue ear
Glue ear is a build-up of fluid deep inside the ear, which commonly causes some hearing loss.
The pressure of this fluid can also cause earache. Glue ear is more common in children than in adults.
Your GP will usually be able to diagnose glue ear based on your child’s symptoms and history.
It often clears up on its own without treatment.
Earache caused by an infection
If the cause of earache is an ear infection, there may be watery or pus-like fluid coming out of the ear.
In either adults or children, this may be an outer ear infection affecting the ear canal. The whole ear canal (tube leading into the ear) may become inflamed and sore, or there may be a boil (an infected hair follicle) inside the ear canal, which you may be able to see.
A boil inside the ear will usually burst, drain and heal by itself after a few days, but if you are in considerable pain and discomfort and do not want to wait for this to happen, see your GP. They may be able to remove the pus using a surgical needle.
Many ear infections clear up on their own without treatment, but in some cases you may be prescribed antibiotic tablets or eardrops.
Earache caused by damage to the ear
Earache can sometimes result from injury to the inside of the ear – for example, by scraping earwax from the ear canal using a cotton bud, or poking a cotton bud too far into your ear, which can puncture the eardrum.
The ear canal is very sensitive and can easily become damaged. The ear should heal on its own without treatment, but it can take 6-8 weeks
for a perforated eardrum to heal. If you have a perforated eardrum, eardrops can be used with caution (see below).
Earache caused by earwax
If your earache is due to a plug of hard earwax, do not attempt to move this with a cotton bud, as this will only push it further inside and you may damage your eardrum.
Your pharmacist will be able to recommend eardrops to soften the wax so that it falls out naturally. In some cases, your GP will need to remove the wax (once softened with eardrops) by flushing the ear with water. This is known as ear irrigation.
Earache caused by a throat infection
If you find it painful to swallow and you have a sore throat, your earache is likely to be a symptom of a throat infection, such as tonsillitis or quinsy (an abscess in the back of your throat).
Some types of tonsillitis will clear up after a few days without the need for antibiotics. But if you have quinsy, you will need to see your GP
as soon as possible for treatment. You may have quinsy if your sore throat gets worse very quickly.
Less common causes of earache
Less commonly, earache can be caused by a number of other conditions. You should visit your GP or dentist if you think you have any of these.
A problem with your jaw bone
You may have a problem with the joint of your jaw bone, where the jaw meets the skull.
This is known as temperomandibular joint pain, and it may be caused by arthritis or teeth grinding.
A Dental Abscess
A dental abscess is a collection of pus that can form in your teeth or gums as a result of a bacterial infection.
It can cause earache, although the main symptom of a dental abscess is pain in your affected tooth, which can be intense and throbbing. Your dentist will need to remove the abscess and drain the pus.
An Impacted Tooth
Earache can be caused by a wisdom tooth or molar (back tooth) that has not fully broken through the skin.
Have a look inside your mouth if you think this is causing your earache – some of the tooth will still be below the gum line.
Your dentist will be able to advise you about whether the tooth needs to be removed. Read more about wisdom tooth removal.
Facial nerve pain
Sometimes, ear pain can actually be trigeminal neuralgia, which is sudden, severe nerve pain in the face. It is usually caused by pressure on the main nerve inside the skull. The pain is felt in the jaw, cheek or eye and can last from a few seconds to a couple of minutes. Prescription medicine can often provide temporary pain relief.
Eczema in the ear canal
A type of eczema called seborrhoeic dermatitis can also sometimes cause earache.
It affects any area of skin that is naturally greasy, such as the ears, and causes the skin to become irritated and inflamed, with red, scaly patches.
Your GP will be able to prescribe eardrops that contain corticosteroids to help clear it up.