Managing Ear Pain (And Conditions That Cause It)

Common causes and treatments of ear pain

The various causes of ear pain are almost too numerous to count. This article will take a look at the most common causes and explore methods for managing pain related to individual conditions.

A woman with ear pain getting an ear exam
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Otitis Media (Middle Ear Infections)

Otitis media is an infection of the middle ear. It is most commonly seen in children (often in infants and toddlers) but can occur in adults as well. Signs of this infection include pain that increases at night.

The most crucial step you can take in managing pain related to otitis media is by getting a proper diagnosis from your doctor, and then, if necessary, using prescribed antibiotics. In the meantime, over-the-counter ibuprofen and acetaminophen are usually effective. It also helps to prop your child into a more upright position to sleep at night, as this decreases pressure in the ears and pain.

  • Another treatment option for pain control is analgesic ear drops. These ear drops contain a local anesthetic, similar to lidocaine or bupivacaine, which can be inserted directly into the ear.

Ruptured Ear Drum

A ruptured ear drum is a common cause of ear pain. The eardrum separates the middle ear from the outer ear. A ruptured eardrum can occur either by an acoustic injury, such as very loud sustained noise; a direct injury, such as damage from a cotton swab or other object being inserted in the ear; or barotrauma (caused by flying on an airplane or scuba diving).

  • If the perforation is caused by pressure building behind the eardrum, you may have a sudden decrease in pain at the time of rupture. Subsequent pain is usually related to medical repair of the eardrum (tympanoplasty), which can be done in the physician's office or in surgery if the tear is large. In this case, oral pain medications ranging from over-the-counter analgesics, like ibuprofen and acetaminophen, to prescription opioids, such as Lortab or Percocet will likely be used. You should also keep your ear dry at all times if you have ruptured your ear drum.

Swimmer's Ear (Otitis Externa)

  • Swimmer's ear is an infection of the outer ear, which can be quite painful. Some signs of this condition include pain, redness, itchiness and scaly flaking skin. This condition usually requires medical intervention. When managing ear pain related to swimmer's ear, it may be helpful to use a heating pad over the affected ear. Again, ibuprofen and acetaminophen are helpful in managing pain caused by swimmer's ear. You should also keep your ear dry at all times with swimmer's ear.

Perichondritis

  • Perichondritis is a painful condition in which the tissue surrounding the cartilage of the outer ear becomes infected. Perichondritis is usually caused by some sort of trauma to the outer ear from an accident or from ear piercing. Perichondritis can also be caused by ear surgery. In its early stages, ear pain can be managed using over-the-counter pain medications. If the infection has progressed far enough to require surgery, prescription medications, such as Lortab or Percocet, may be necessary. Keep your upper body elevated and use an ice pack to reduce pain and swelling.

Surgery Injury

Many options are available for controlling ear pain after surgery or in the case of an injury. Your doctor will ultimately decide what treatment should be used, but you should be aware of your physician's options, which include:

  • Heat and ice: Advantages include pain control and a reduction in inflammation and swelling. The risks of using heat or ice are small but include tissue damage.
  • NSAIDs (non-steroidal anti-inflammatories), such as ibuprofen and naproxen: Advantages of these medications are that they usually do not cause nausea, vomiting or drowsiness. Drawbacks of using these medications include the risk of internal bleeding, especially in the elderly or those who have stomach problems.
  • Ultram (tramadol): This medication is a non-opioid pain reliever that can be used to treat moderate to severe pain. The advantages of this medication are a decreased risk of nausea, vomiting, drowsiness or dizziness. Tramadol can be a good alternative for patients with an aversion to narcotic pain medication. The way this drug works is not clearly understood, though it appears to affect the neurotransmitter norepinephrine.
  • Narcotic pain medications, such as Lortab and Percocet: Benefits of these drugs are that they are effective in controlling pain and relatively safe when used properly. Contrary to popular belief, the risk of addiction (when these medications are legitimately used for pain control) is low. Drawbacks include nausea and vomiting, constipation, dizziness and drowsiness and the risk of a decreased breathing rate.
  • It should be noted that some surgeries, including the removal of tonsils and adenoids, can cause ear pain even though the ear is not operated on directly.

Pain Management

Many patients would prefer to use natural methods for controlling their pain. Here are some examples of alternative pain treatments that have been proven effective for some people.

Talking to your doctor about these treatments before using them is a good idea, especially if you have a serious condition, such as perichondritis, which may be affecting the bones in your face. In this instance, for example, a facial massage is probably not the best idea.

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Article Sources
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  4. Otitis Externa (Swimmer’s Ear). American Academy of Family Physicians. January 2019.

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