Ear Pain (Otalgia)

Common causes of primary otalgia include:

• Extreme changes in pressure (barotrauma) – this can occur as a result of events such as scuba diving or flying at high altitudes

• A foreign object in the ear

• Eustachian tube dysfunction – the tubes that connect the middle ears to the upper throat become blocked

• Swimmers ear (otitis externa) – an infection of the outer ear, commonly caused by water becoming trapped in the ear canal

• A middle ear infection (otitis media)

• A tumour in the ear – this is very rare

Common causes of secondary otalgia include:

• Temporomandibular joint syndrome (TMJ) – the bony part of this joint sits just in front of the ear with the cartilage and connective tissues that also form the joint situated all around the outside of the ear. When the joint isn’t working properly (which can be associated with things like teeth grinding at night or jaw clicking when chewing), it can cause persistent pain around the ear

• Problems in the neck, or the nerves around the ear

• A sore throat or infections of the throat such as tonsillitis

• Throat cancer

• Dental problems such as cavities or abscesses

• Gastroesophageal reflux disease (GERD)

An ENT specialist will be able determine the cause by assessing your symptoms, examining your ears, throat and jaw, and may consider running some tests.

Tests to investigate otalgia may include:

• Flexible nasal endoscopy – a camera on the end of a tube is passed through your nose to look at your throat in detail

• Hearing and pressure tests such as tympanometry and audiometry

• An MRI or CT scan to get a clearer picture of what’s happening inside the ear

The treatment you’ll require depends on the type of otalgia you have and the cause. To help treat your symptoms at home, you can take over-the-counter painkillers and apply hot and cold compresses to the affected ear(s). If your ear pain is due to an infection, you will need to be prescribed antibiotics and/or steroids as prescribed by your consultant. Sometimes procedures such as microsuction and wick insertion are required.

If the pain is due to a condition such as TMJ, or a dental issue, it is important to address these with a referral to a specialist for this condition in order to tackle the underlying cause. Doing so will lead to a relief of symptoms in most cases.