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Earache: causes, treatment, prevention

by Josephine Andrews
Published: Last Updated on 375 views

Earache can have many causes. They are usually triggered by inflammation. But there can also be other causes behind it, such as an eardrum injury or a blockage of the ear canal. (Small) children are particularly prone to earache. Find out here what can cause pain in the ear, how it can be treated with conventional medicine and home remedies, and how earaches can be prevented!

quick overview

  • What is earache? Pain in the outer, middle, or inner ear . They can be continuous or flare up and feel different (stabbing, throbbing, dull, etc.). Sometimes they get stronger as you chew.
  • Possible accompanying symptoms: feeling of pressure or itching in the ear , ringing in the ears, hearing problems, dizziness, fever, etc.
  • Causes: Inflammation and infections, auditory canal obstruction, injuries, jaw or tooth problems, tumors
  • Treatment: depends on cause and severity. Decongestant nasal drops or sprays, pain relievers, antibiotics, and antifungals are available . An operation may be necessary. Foreign bodies in the ear are carefully removed by the doctor (e.g. with fine pliers).
  • Home remedies: onion wraps, mustard wraps, cold compresses, ear steam, oil wraps, infrared light, etc.

Ear pain: causes and possible diseases

The ears are particularly sensitive organs that contain many nerve endings. Even small disturbances can therefore trigger ear pressure or earache. The complaints can be localized in the outer, middle or inner ear , persist continuously or occur in paroxysms. The pain can feel different, for example stabbing, throbbing or dull . Sometimes they are accompanied by other symptoms (uncomfortable ear pressure, dizziness, hearing problems, etc.).

Inflammation and infection are very often the reason for earaches. Other possible causes include a blockage in the ear canal and injuries.

inflammation and infection

Inflammation is very often the cause of earaches. They are usually the result of an infection, such as with bacteria or viruses . In the area of ​​the auricle and the external auditory canal, allergies or sunburn can also be triggers.

The following inflammations and infections are common causes of earache:

  • Acute or chronic middle ear infection (otitis media): It can cause particularly severe ear pain.
  • Inflammations in the area of ​​the external auditory canal such as ear canal inflammation, ear and auditory canal furuncles, erysipelas (erysipelas) or shingles (herpes zoster)
  • Inflammation of the mastoid ( mastoiditis ): The mastoid is a highly aerated bony process on the temporal bone, just behind the ear canal.
  • Tooth infections
  • Inflammation of the tonsils (tonsillitis)
  • Parotid gland inflammation (e.g. in mumps or measles )

When infected, earache is often accompanied by fever.

closure of the ear canal

If the ear canal becomes blocked, it can also cause ear pain and reduced hearing. An occlusion can result from:

  • a plug of earwax (cerumen)
  • Foreign objects (e.g. a marble that a child put in its ear while playing)


External earaches often result from cuts, bruises, and abrasions . If pain occurs in the ear after a more severe accident, a bone fracture in the skull area may be behind it.

An eardrum injury ( eardrum perforation ) is also a possible cause. Tissue injury can manifest as a short, stabbing pain in the middle ear. The eardrum can rupture, for example, if a pointed object penetrates the ear canal or if the ears are improperly cleaned with cotton swabs. Pressure waves or pressure fluctuations can also result in a ruptured eardrum. Such barotrauma can occur, for example, when diving or traveling by air. Loud noises, an explosion and a blow to the ear can also rupture the eardrum. In any case, the injury can be quite painful and accompanied by dizziness, ringing in the ears ( tinnitus ) and hearing loss.

Other causes of earache

The ear is close to the jaw . This is why problems with the jaw joint (e.g. arthrosis of the jaw joint) or tooth problems can also make your ears hurt. Sometimes tumors on the auricle, in the external auditory canal or in the middle ear cause pain. Ear herpes (herpes zoster oticus) can also trigger earache, especially in older people: the herpes viruses cause blisters and pain in the area of ​​the auricle and/or in the external auditory canal.

Earache: treatment

If you experience mild pain or uncomfortable pressure in your ear after a walk in cold weather, a visit to the pool or a flight, this is usually not a cause for concern. The symptoms usually subside quickly on their own. You can help a little with home remedies such as the onion bag.

However, see a doctor if the ear pain persists and/or is accompanied by other symptoms , such as fever, hearing problems, dizziness, or blood or other secretions coming out of the ear canal. Pain in the ear caused by a foreign body or after an accident (such as a fall on the head) must also be examined by a doctor!

What does the doctor?

The treatment of earache by the doctor depends on the location and cause of the symptoms. For example, in the case of an ear canal infection, the doctor can, depending on the causative agent

  • Antibiotics (against bacteria)
  • Prescribe antifungal drugs (against fungi).

The doctor may also prescribe antibiotics for a middle ear infection.

The drugs are usually applied locally, for example in the form of ointments or drops . In severe cases, it may also be necessary to use the medication systemically, for example in the form of tablets or infusions .

nasal drops or sprays

For a middle ear infection, the doctor usually prescribes decongestant nasal drops or sprays . They also work in the auditory tube, the connecting canal between the middle ear and the pharynx. In this way, the middle ear is well ventilated again. In addition, secretions that form in the middle ear due to inflammation can drain off better.

Strips containing alcohol

If the earache is caused by a furuncle in the external auditory canal, strips containing alcohol are usually inserted into the auditory canal. In addition, the patient receives painkillers and – in severe cases – sometimes antibiotics.

Remove clog and foreign bodies

If the ear pain is caused by a plug of earwax or a foreign object in the ear canal, the doctor will carefully remove it . A small suction device or another medical instrument helps him with this.


Injuries to the eardrum usually heal on their own. In some cases, however, an operation is necessary. For example, an injury to the edge of the eardrum usually does not heal very well. To help, the doctor can splint the injured eardrum with paper or silicone. An artificial eardrum may also need to be inserted.

Earache: home remedies

There are several home remedies for earaches. However, they should only be used if a serious cause for the symptoms has been ruled out . The following home remedies have proven themselves:

Onion for earache

An onion packet (onion bag) has an analgesic and anti-inflammatory effect on earache and loosens mucus. The reason for this is the mustard oil contained in the onion . How to prepare:

Peel an onion, cut into small pieces and wrap in a cloth. Warm the packet between two hot-water bottles, over steam, in the microwave or on the heater. Wring out if necessary. Put the packet on the ear and the bone behind the ear and fix it with a hat or cloth. Leave on for 20 minutes. Use once or twice a day.

Onion ear drops are also a proven home remedy: Squeeze a raw onion. Put a few drops of the juice in the ear canal and seal the ear with a cotton plug.

Saline nasal drops

Saline nose drops relieve a stuffy nose when you have a cold and can reduce the pressure in the ear when you have an earache. To do this, dissolve exactly 9 grams of table salt in one liter of boiled water.

Fill this saline solution into a pipette bottle or a bottle with a spray attachment (rinse out with hot water first!). Put three to five drops or two sprays in each nostril several times a day. Renew the saline solution every two days.

tea for pain

Some medicinal plants have a slight pain-relieving effect and are therefore also used as home remedies for earaches. This includes:

The preparation can be found in the respective medicinal plant texts.

Warmth against earache

Heat can have a beneficial effect on milder, more frequent earaches. It increases blood circulation and improves the metabolism in the diseased ear. There are several ways to warm the ear:

  • Steam : With a spout and a rubber hose, direct the warm steam from a tea kettle to the sore ear at a distance. Caution: Only heat the water moderately, do not let it boil!
  • Oil wraps: Oil retains heat particularly well. Oil wraps are also suitable as a home remedy for earache. Soak a compress in warm cooking oil and place it behind the ear as a poultice.
  • Infrared light: In the case of chronic ear pain, the warmth of an infrared radiator can also have a soothing effect.

Acute bacterial inflammation of the paranasal sinuses or the middle ear can be aggravated by heat. In this case, cold is the better remedy. When choosing a home remedy, seek advice from a doctor or pharmacist.

Cold for earache

In the case of acute inflammation of the ear, cold can relieve earache. These compresses and wraps are suitable:

  • Cold compress : Wrap a squeezed compress soaked in cold water in a cloth and place it over the ear. Fix them with a wool hat.
  • Cold Clay Wrap : Whip a cold mush of healing clay or clay into a damp cloth and leave the wrap on your ear until the mush dries.

Cold treatment is only advisable if the patient finds it more comfortable than heat treatment!

Home remedies for earache in children

The onion bag is also suitable as a home remedy for children or babies with earaches. If your child finds the smell of the onion unpleasant, you can wrap chamomile flowers in the sachet and place them on the ear instead. They also have an anti-inflammatory effect and can relieve earache.

Home remedies have limits. If the symptoms persist over a longer period of time, do not get better or even get worse, you should always consult a doctor.

Ear pain in babies and toddlers

Babies and young children are particularly prone to earache. In the first three years of life, most children suffer from at least one middle ear infection. The problem: Earaches cannot usually be identified with the naked eye from the outside – and very small children cannot tell exactly where it hurts. That’s why parents need to watch out for telltale signs:

Does the child often grab his ear, is he restless and easily irritable? Then it could be plagued by earache. Fever, chills and diarrhea, vomiting and refusal to eat can indicate a middle ear infection. When the eardrum is ruptured, a purulent-bloody secretion often runs out of the ear. Parents should also take a look inside the auditory canal if their child (suspected) has an earache. Maybe there is a foreign object in it that the child put in while playing.

Causes of earache in babies and toddlers

Earaches are often caused by a cold or flu . Such acute respiratory infections are often accompanied by a middle ear infection – just like a measles infection: The germs can get from the pharynx via the auditory tube into the middle ear and cause a painful inflammation there.

In children, the auditory tube is also so narrow that it can be completely closed if the mucous membrane swells. Pus and inflammatory fluid can then no longer flow out of the middle ear – pressure is created that can cause severe ear pain.

In mumps, a common childhood illness, the parotid gland becomes inflamed and swollen. Those affected have severe pain in the ear area.

Treating earache in children

Earaches in children are very often due to a middle ear infection, and this should always be examined and treated by a doctor. Depending on the need, the doctor then prescribes, for example, decongestant nose drops, painkillers (such as paracetamol ), expectorant agents and possibly antibiotics. Parents can support the treatment by making an onion wrap for their child, for example. It relieves the pain in the ear.

When children complain of ear pain on an airplane, the tube in the ear has usually closed. It can often be opened again by closing your nose and mouth and exhaling against resistance. It is also helpful to chew gum, yawn or drink a lot (in small sips).

Earache: investigations and diagnosis

The doctor will first talk to you to take your medical history (anamnesis). He inquires about:

  • Duration, severity and course of the complaints
  • Type of earache (e.g. stabbing, dull)
  • previous or current infections
  • treatments that have already taken place (including the use of home remedies)
  • any underlying diseases (e.g. diabetes mellitus, skin diseases, HIV) or recent accidents

Also, tell your doctor about any swimming pool visits and diving vacations – they could be related to your earache.

The anamnesis interview can give the doctor initial indications of the cause of the earache. Depending on the requirements, various examinations are carried out to ensure a reliable diagnosis :

The doctor takes a look into the mouth and throat and feels the lymph nodes in the neck. He also performs an ear mirror (otoscopy): The doctor uses a small, illuminated magnifying glass to take a closer look at the outer auditory canal and the eardrum. If, for example, a middle ear infection causes the pain, the eardrum is red or bulging due to fluid in the middle ear. A foreign body or a plug of earwax can also be seen with an otoscopy.

tube function test can be used to test whether the Eustachian tube (ear trumpet) is patent. This connecting channel ensures pressure equalization between the middle ear and the nasopharynx. The test can be carried out, for example, by means of a Valsalva test (Valsalva maneuver). The doctor asks the patient to breathe out forcefully with their mouth closed and their nose pinched. A previously “closed” ear trumpet often opens again.

In some cases, imaging procedures are necessary to clarify ear pain. If the doctor suspects the cause of the pain, for example in problems in the jaw joint or in changes in the bony auditory canal or in the mastoid process, he can order an X-ray examination or computer tomography (CT).

Hearing tests are also often carried out. They can help to narrow down the cause of the complaints, since the different disturbances in sound conduction or sound processing often have typical resonance and frequency patterns.

Blood tests and the analysis of secretions from the ear canal can show whether the ear pain is due to an inflammation or infection.

If these tests do not provide a satisfactory diagnosis, referral to another specialist (for example, a dentist) can help to determine the cause of the ear pain.

Earache: tips to prevent

There are a number of things you can do to prevent earaches. For example, drink enough. This helps the body to secrete and flush germs from the mucous membranes. It should normally be two to three liters of fluid per day for an adult.

Avoid drafts – especially if you are sensitive – and protect your ears with a hat if necessary. This is also recommended in cold weather.

If you have a cold, the secretion should be able to drain off easily. If necessary, decongestant nose drops can help in such cases. But please only use it for a limited period of time! Otherwise the nasal mucosa can be damaged.

When swimming , special plugs or ear drops can help keep or get water out of your ears. Because water in the ear can be painful and also lead to a middle ear infection.

If you sleep with earplugs, you should change them regularly so that no germs can multiply on them and get into your ears.

If pressure-related earaches occur on a flight , it can help if you consciously swallow, move your jaw, chew gum or close your nose and mouth and breathe out.

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