Ear pain causes,classification, types, and treatments

Ear pain causes,classification, types, and treatments

Ear pain or the medical term “otalgia” is a common symptom that many people present with to the hospitals. It can have a spectrum of a mild tightening feeling of the ears to unbearable, severe pain. Ear complaints are particularly common among the paediatric population. This is itself not a disease, but a clinical presentation of an underlying pathology of the body. Further in this article you will get to know more about Ear pain causes, types,treatments in detail.


Classification of ear pains

Ear pain is categorized as primary ear pain and referred ear pain for the ease of diagnosis and management. Ear pain that originates due to a primary pathology of the ear is called as primary ear pain. The pain of another organ or structure (away from the ears), appearing as a pain of the ear is called referred pain of the ear. Have you ever heard, pain in an organ referring its pain to another site of the body? Yes, it’s amusing. but it happens.

Primary Ear Pain

Primary ear pain is again classified according to the site of origin. Anatomically ear is divided in to 3 parts. The external ear; the external ear canal and ear drum, the middle ear; an air filled cavity with 3 bony ossicles and the inner ear; the nervous part of the ear. Inner ear diseases and ear cancer usually do not produce pain.

Most of the time, ear pain occurs due to simple reasons. Some of them are mentioned below.

  • water trapped inside the ear canal
  • Altitude changes
  • Allergic reactions
  • Ear injuries due to scratching
  • Foreign objects inside the ear
  • Vax accumulation with subsequent obstruction of the ear

However, ear pains that last more than several days should be medically investigated.

Skin diseases that cause ear pain

The external ear canal and ear drum are lined by normal skin. Therefore, each and every disease that affects the skin have the potential to affect the ear. Of them, furuncles; an infection of a hair follicle, are quite common. Rarely eczema, Psoriasis and herpes zoster reactivation can occur.

Otitis externa

Infection of the external ear canal and ear drum is one of the frequent causes of ear pain. This is known as otitis externa. Those people present with severe pain in the jaw and ear. Characteristically, the tragus of the ear of these people is extremely tender to touch. The ear canal appears oedemaotus, obstructed and there may be visible pus pouring from the meatus. They typically complain of severe headache, hearing impairment and difficulty in opening the mouth.


Otitis media

Infections of the middle ear; otitis media, also gives rise to a similar presentation. However, in those people tragus is not tender to touch. Pus discharge from the ear canal can either be minimal or profuse. Pus accumulation inside the middle ear exerts a pressure on the ear drum. This manifests as an extreme pain inside the ear. At this stage there is no ear discharge. But severe tension may perforate the ear drum. A substantial decrease in ear pain and simultaneous purulent ear discharge indicates that.


Ear pain is a key symptom of the inflammation of the pinna of the ear. Commonest aetiology of it is trauma (e.g. – squeezing the pinna). Occasionally infections of the pinna may give rise to similar pain. In such instances pinna appears reddened, swollen with abscess formation. This can progress to perichondritis; infection of the cartilage of the ear. Untreated perichondritis may cause necrosis of the cartilage and permanent deformation of the pinna. Thus aggressive treatment is needed.

Referred pain of the ear

Referred ear pain can occur due to pathologies of the nose, mouth or throat. Infections of the nose or sinuses of the face or throat are well-known to cause episodes of ear pain. Nasal congestion and allergic rhinitis are benign causes of ear pain. Dental caries, tonsillitis, pharyngitis, temporo-mandibular arthritis and cervical spondylitis may also present as an ear pain. It may be a symptom of a sinister cause like a tumor or cancer of the nasal cavity, throat or mouth.

Treatments for ear pain


Since the underlying reason of the ear pain can range from a mild to life threatening cause, self-treatment should not be done at any cost. Especially if the ear pain doesn’t settle within several days. Vigilant examination by an experienced physician may aid in the diagnosis of any sinister causes.

Infections of the ear are traditionally managed by antibiotic therapy. However, abscesses may require surgical drainage. Ear vax is cleaned by adding ear drops to dissolve the vax and subsequent syringing of water. Surgical interventions may need to relieve the ear pain due to pathologies of the nose, mouth or throat. Nasal congestion and sinusitis can be relieved by steam inhalation.

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Author: Dr. Pulasthi MilanPulasthi Milan Lankarathna is a graduated doctor from the Faculty of Medicine, University of Colombo, Sri Lanka. Currently, he is working as a medical-officer at the National Hospital of Sri Lanka. Writing has been his passion throughout his life. He loved to read books since his childhood. He believes that the essence that he gained by reading, motivated him to be a writer. He started writing as a creative writer during his College days. He has written over hundreds of short stories, poems, and articles, etc. After graduating as a Doctor, he switched himself to write about medical topics with an idea of improving the medical knowledge among the general population.