Ear pain without a runny nose, cough or sore throat does not automatically point to middle ear infection. In adults, common causes include irritation of the ear canal, a wax plug, a pressure equalising problem, the jaw, referred pain from the teeth or a small break in the skin. The way the symptom feels often gives a clue to where the cause may be found.
If the pain is severe, fluid comes from the ear, hearing drops clearly, strong dizziness appears or swelling and tenderness develop behind the ear, assessment should be sought quickly. Even milder pain should be watched carefully if the cause does not seem clear.
Ear canal irritation and swimming#
Ear canal irritation often feels like clear pain when the earlobe is pulled or the opening of the canal is pressed. The cause can be swimming, picking the ear, a cotton swab, headphones or broken skin in the canal. In that case the pain is usually felt near the opening of the ear, not deep inside the head.
If the ear is tender to touch and it itches or produces discharge, the cause may be in the ear canal. The ear should not be cleaned deeply, because the skin is easily irritated further.
Wax plug and pressure#
A wax plug more often causes a blocked feeling, muffled hearing and pressure than strong pain. The ear can still ache, especially if it has been picked at or if the wax swelled after water exposure. A blocked ear without fever more often points to wax or a pressure equalising issue than to infection.
If the ear only feels blocked and hearing is reduced, wax is a possible cause. If the pain is severe or fluid comes from the ear, do not start softening the ear on your own before assessment.
Jaw, teeth and referred pain#
Pain felt in the ear can also come from the jaw joint or the teeth. Jaw-related pain often gets worse when chewing, yawning or waking up in the morning if the teeth are clenched at night. In that case the ear may hurt even though the real problem is not in the ear itself.
Pain from a tooth can also spread into the ear, especially if the symptom is linked with biting, cold, sweet food or one specific tooth. If the pain changes when you eat or bite, an oral and dental assessment may be the right direction.
What can be done at home#
If the pain is mild and you otherwise feel well, the situation can often be watched for a short time at home. Keep the ear dry, avoid picking at it and use a suitable pain medicine if you normally tolerate one and the package instructions allow it. A warm cloth near the ear may ease aching if the area is not red or swollen.
Do not put drops, oil or other products into the ear if you do not know the cause of the pain or if fluid is coming out of the ear. Wrong self-care can worsen the situation if the eardrum is not intact or if an infection is present.
When to contact healthcare services in Finland#
Contact healthcare services if ear pain is severe, lasts for several days, keeps coming back without a clear reason, or comes with fever, clear hearing loss, dizziness or swelling in the face area. Assessment is also needed if the pain returns as soon as pain medicine wears off or if the cause remains unclear.
Seek prompt assessment if fluid or blood comes from the ear, tender swelling appears behind the ear, the pain is extremely strong or your general condition worsens. If the pain is linked with a cold or a child's symptoms, a broader ear pain guide may be more useful.
Further reading and sources#
Further reading: