7 Common Causes of Adult Ear Pain

2. Swimmer’s ear 

Another common cause of ear pain is swimmer’s ear, or otitis externa. This is an infection of your outer ear canal that can develop when water gets stuck in your ear, providing a moist environment for bacteria to grow.

“Swimmer’s ear is extraordinarily painful because the skin sits directly on bone,” Adunka says. “If you wiggle or pull your ear, that really hurts.”

Swimmer’s ear is usually treated with antibiotic eardrops, which clear it up quickly.

There are several things you can do to help prevent swimmer’s ear, including:

• Wear earplugs while swimming to keep your ears dry.
• After you swim, tilt your head from side to side to help the water drain from your ears.
• Don't swim in water that has a high bacteria count.
• Dry your ears safely with a blow dryer on the lowest heat and speed settings.
• Never use a cotton swab to dry your ear. Use only a soft towel to dry your outer ear.

3. Earwax buildup 

If you have a buildup of earwax, it can feel like pressure in your ears. If the wax gets too hard, it can irritate your ear canal and cause discomfort or pain in the ears.

Impacted earwax is more common among older adults, especially those who wear hearing aids, because they can block the normal way earwax moves out of your ear, says audiologist Sarah Sydlowski, audiology director of the Hearing Implant Program at the Cleveland Clinic.

If you think impacted earwax is causing your ear pain, don’t try to remove it yourself, Sydlowski advises. “You can compress the wax even further and push it deeper in the ear, cause damage and make it more difficult to remove,” she says.

Instead, make an appointment with your primary care doctor, audiologist or otolaryngologist to remove it.

4. Sudden change in air pressure 

Sudden changes in barometric (air) pressure can cause pain and damage to your ears. It’s known as barotrauma and sometimes airplane ear, because it happens a lot when you fly.

But barotrauma also can cause ear pain when you do something as simple as ride an elevator to the top of a high-rise, or when you scuba dive. That’s because, by definition, it’s damage to your middle ear because of a sudden change in air or water pressure. And it’s caused by pressure blocking the eustachian tube in your inner ear.

You probably know the feeling from flying: It makes it feel like you can’t hear or have fullness in your ears that’s uncomfortable or painful, especially when the plane is taking off or landing. Yawning, chewing gum and swallowing can help equalize the pressure and ease your pain, Adunka says.

If none of those help, he recommends what’s called a Valsalva maneuver. Here’s how to do it:

1. Take a breath.
2. Pinch your nostrils shut and close your mouth.
3. Keeping your mouth and nose closed, exhale like you’re blowing up a balloon.
4. Hold for 15 to 20 seconds.
5. Repeat until your ears pop.

Taking a decongestant or using nasal spray 30 minutes before takeoff and landing can also help relieve the pressure, Adunka adds, especially if you have an upper respiratory infection.

5. Uncomfortable hearing aids 

If you wear hearing aids, ear pain can be a sign your devices either aren’t placed in your ears properly or need to better fit for your ears, Sydlowski says. “It might feel a little bit like the pain that you get when your shoes don’t fit quite right,” she says. “You can get a sore spot that’s just not comfortable.”

Even if you’ve worn your hearing aids for years, they still could be the culprit, Sydlowski says, because your ear canal starts to change shape as you get older.

The good news is, most hearing aids can be easily modified. Audiologists typically have tools that allow them to buff earmolds to create a better fit, Sydlowski says. Or if you have hearing aids with a receiver dome and wire, you may just need a shorter wire or a different size or style of dome so they’re more comfortable in your ears.

6. Adult ear infection 

If your ear pain develops during or immediately after you’ve been sick with a cold or an upper respiratory infection, you may have otitis media. It’s an infection in the middle ear caused by a virus or bacteria that prevents fluid in your middle ear from draining. These infections also can happen when you have allergies.

Adult ear infections aren’t as common as ear infections in children, especially if you don’t have a history of ear problems, but they do happen, Adunka says. Often ear infections in adults can be more serious, though, and may require antibiotics, pain medications, decongestants or steroids to be treated. The type of treatment depends on the type of infection.

Sometimes, medication doesn’t help drain the fluid and your doctor might want to perform a minor procedure called a myringotomy, in which a hole is created in the ear drum to allow trapped fluid to drain out. Often, they’ll put a small tube near the opening of your eardrum to relieve the pressure in your middle ear and prevent fluid from building up. The tube will fall out in about six months to a year.

7. Ruptured eardrum 

A ruptured eardrum is when you have a hole or tear in the tissue between your outer and middle ear. It can be caused by several things, including:

• Middle ear infection
• Injury like a hard hit to your ear
• Loud sounds like an explosion or gunfire
• Barotrauma while flying or diving
• Damage from putting things like cotton swabs in your ears

While it sounds scary, a ruptured eardrum will cause ear pain but usually goes away quickly. It also can cause other symptoms like vertigo, tinnitus, drainage from the ear and hearing loss.

If you think you have a ruptured eardrum, call your health care provider right away for a diagnosis. Small eardrum perforations usually heal on their own. But your doctor can determine the best options for treatment, which could include antibiotic drops, eardrum patches or surgery to repair the tear.