Ear pain is a common complaint. For children, earaches are among the most common reasons for a visit to the doctor. However, ear pain doesn’t always indicate a standard ear infection. Ear pain can also be caused by outer ear infection or trauma, or it might be referred pain, which is pain originating somewhere else.
The most common ear infection occurs in the middle ear, the area behind your eardrum. The middle ear is susceptible to infection from bacteria or viruses that “back up” from the nose and throat. The eustachian tube is the connection from the middle ear to the back of the nose. This tube is why you would feel a pop when flying or driving through the mountains. The eustachian tube is a portal for pressure to be released, but it’s also where bacteria can travel from the nose to the ear. Such pressure or infection could cause pain.
Risk factors for ear infections in kids include day care, pets in the house (allergies), parents who smoke, or not breastfeeding until age 1. Children with earaches will often complain of ear pain, tug on their ears, have a fever, have drainage from the ear, and exhibit trouble sleeping. Often, ear infections are accompanied by nasal symptoms.
Trauma to the ear is another common cause of ear pain. Cotton swabs are a common way to injure the ear canal, sometimes even bursting the eardrum. In many cases, a burst eardrum will heal on its own but still requires medical attention.
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A child with an earache might have a foreign object in the ear, so look inside the ear if possible. Beads, bugs, corn kernels, toys and more can all find their way into the ear canal, causing infection or injury.
For adults who have a chronic earache, the cause of ear pain might not be found in the ear at all. Referred pain can often be to blame. Ear pain could stem from a swollen lymph node around the ear, acute throat infection, or irritation at the temporomandibular joint, or TMJ.
The temporomandibular joint is very close to the ear canal and the middle ear. The muscles, ligaments and cartilage of this joint are closely related to the ear. The joint works like a sliding hinge and connects the jawbone to the skull. The cause of TMJ can be difficult to pin down, but it can result from a combination of factors, including an incorrect bite, genetics, arthritis or jaw injury. Grinding or clenching teeth is also associated with the disorder.
Ear pain comes in many forms and has many causes. If you or your child experience ear pain, visit an ear, nose and throat physician to determine the cause — it might not even be your ear at all.
Ron Shashy MD is at Saint Joseph ENT Center, part of KentuckyOne Health.