Earache is most often a sign that the middle ear has become infected. The resulting inflammation, known as otitis media, is particularly common in young children, usually as a side-effect of a cold.
Other causes of earache are inflammation of the outer ear (otitis externa), where infection of the ear canal produces a skin complaint like eczema; or, more rarely, blisters in the ear canal due to a herpes zoster (shingles) infection.
A middle ear infection will often start with a cold. The infection then spreads from your throat to your ear, which will feel blocked and painful. Other symptoms may include a rise in temperature, swollen glands, temporary loss of hearing or fluid running out of the ear.
Children are more likely to get a middle ear infection because the link between their throat and ear (the Eustachian tube) is shorter than in an adult. This means the tube is more vulnerable to bacteria when a child has a cold and fills up with mucus more easily, putting pressure on the child's eardrum.
In some cases the build-up of pus from a middle ear infection will result in a burst or perforated eardrum. This is marked by a yellowish discharge from the ear or slight bleeding. The pain in your ear may disappear but you should check with a doctor if you think your eardrum is perforated.
With an inflammation of the outer ear, you may feel pain and irritation, either in one place or throughout the ear canal. In some cases a boil or abscess may form. There may be a discharge of fluid from your ear and a slight loss of hearing.
If you have shingles, the earache may last for weeks or months after the infection has cleared up.
• Raising your head a little in bed by using extra pillows or adjusting the mattress may help.
• If your ear feels blocked, do not attempt to clean it with cotton buds or anything else. You may damage your ear permanently. If the problem is a build-up of dried wax in the ear, trying to get rid of it may just push the wax further in. You can buy ear drops from your pharmacist that will soften the wax.
• If your ear canal is inflamed, try not to get your ear wet until the infection has cleared up.
• Your pharmacist will stock a variety of products for easing the pain of earache or relieving inflammation. Unless your ear is running, you will not usually need antibiotics for a middle ear infection.
• Take general steps to avoid catching a cold, such as staying away from people who already have a cold or from crowded and badly ventilated places.
• Infection of the outer ear is often passed on through water (e.g. at the swimming baths). If you are a regular swimmer, you can reduce the risk of infection by wearing earplugs.
• Scratching the inside of your ears can make you more prone to infection.
Standard painkillers such as paracetamol, aspirin and ibuprofen will give you relief from earache, as well as bringing down your temperature if you have a fever. Ask your pharmacist which products are suitable for children.
You can also ease your earache with nose drops, steam inhalations or mentholated sweets. If you have a middle ear infection, special ear drops are available to soothe the inflammation.
• If your earache is not relieved by painkillers and/or lasts for more than 24 hours.
• If your ear is running or you think your eardrum may be perforated.
• If your earache is accompanied by vertigo (dizziness) or sudden loss of hearing.
• If you are worried about your hearing.
• If your child has been given painkillers but still has severe earache after 12 hours.
• If your child has slight earache for more than three days.
• If you believe your child may have an ear infection.
• If the area around your child's ear is painful.
You Should Contact A Doctor Immediately If:
• There is fluid coming out of your child's ear and no improvement in the pain and/or fever.
• Your child starts getting drowsy.
• Prop your head up in bed to relieve the pressure on your ears.
• Do not try to clear a blocked ear with cotton buds.
• Use standard painkillers or cold remedies such as nose drops and steam inhalations.
• Go to a doctor if the earache persists, your ear is running or you are worried about your hearing.
Written by Peter Mansell - medical writer. Edited by Dr Peter Stott.