While kids’ ear pain is typically caused by ear infections, in adults it’s often the result of other problems — some of which may not originate in the ear, experts say.
“Most of the time when your ear hurts, it’s not your ear’s fault,” says Oliver F. Adunka, M.D., director of the Division of Otology, Neurotology, and Cranial Base Surgery at The Ohio State University College of Medicine. “It’s usually an issue somewhere else that is referred to the ear.”
A visit to an ear, nose and throat doctor (an otolaryngologist) can help identify what’s causing your pain, and it’s often an easy fix, Adunka says.
But if you experience blood or drainage coming from your ear, ringing sounds, or sudden dizziness or hearing loss, those may be signs of a serious medical issue and you should contact your health care provider.
Here are some common causes of ear pain and what you need to know about each.
1. A jaw disorder (or toothache)
If you experience ear pain that’s sharp, “like someone is stabbing your ear,” it may be caused by a temporomandibular disorder (TMD), Adunka says. Also called TMJ because it affects the temporomandibular joint that connects your jaw to your skull, the disorder can develop if you grind your teeth or if arthritis wears away the cartilage around your jaw joint, he explains. Recent orthodontic work can also trigger TMJ pain.
Because the jawbone is near a major nerve that radiates back to your ear, the pain often manifests as repeated episodes of ear pain and tenderness. “If it’s on one side, then goes to the other side and comes back, it’s usually TMD,” Adunka says.
If your doctor suspects a jaw problem, he or she will probably refer you to a dentist, who may fit you with a mouth guard or recommend other treatments.
Toothache pain can also radiate up to your ear. As with TMD, a visit to your dentist can help address ear pain caused by a toothache.
2. Swimmer’s ear
Another common cause of ear pain is swimmer’s ear, or otitis externa, an infection of the skin in your ear that often develops when water sits in the outer ear canal, 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.”
The condition is usually treated with antibiotic eardrops, which clear it up quickly. To prevent swimmer’s ear, dry your ears well after swimming and consider using a blow dryer on the lowest heat and speed settings to get all the moisture out, Adunka suggests.
3. Wax buildup
A buildup of earwax often presents as pressure in your ear. If the wax gets too hard and firm, it can irritate the ear canal and cause discomfort or pain. Wax buildup is more common among older adults, especially those who wear hearing aids, because the devices can block the normal migration of wax out of the ear, says audiologist Sarah Sydlowski, audiology director of the Hearing Implant Program at the Cleveland Clinic.
If you suspect a buildup of wax, 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. Airplane air pressure
Changes in air pressure while flying can cause a feeling of fullness in your ears that can be uncomfortable or painful, especially when the plane is ascending or descending. Yawning, chewing gum and swallowing can help equalize the pressure and ease your pain, Adunka says.
If those steps don’t work, he recommends something called a Valsalva maneuver. To perform it, pinch your nostrils shut, close your mouth and gently try to exhale as if you are blowing up a balloon, until your ears pop.
Taking a decongestant or using nasal spray 30 minutes before takeoff and landing can also help relieve the pressure, he adds, especially if you have an upper respiratory infection.
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5. Ill-fitting hearing aids
If you wear a hearing aid, ear pain can be a sign your device is not placed in your ear properly or that it needs a modification for a better fit, 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 device for years, it may still be the culprit, Sydlowski notes, because your ear canal starts to collapse and change shape as you get older.
The good news is, most hearing aids can be easily modified. Audiologists typically have tools in their office that allow them to buff down an earmold for a better fit, she says. Or, if you have a hearing aid with a dome and wire, you may simply need a shorter wire or a different size or style of dome.
6. Adult ear infection
If your ear pain develops during or immediately after being sick with a cold or an upper respiratory infection, you may have otitis media, an infection in the middle ear caused by a virus or bacteria. The infection may cause a fever as well.
Adult ear infections are rare, especially if you don’t have a history of ear problems, but they do happen, Adunka says. Some infections require antibiotics; others go away on their own. Contact your health care provider if your symptoms don’t resolve within a few days.
7. Mask-related ear pain
If you wear a face mask for long periods of time, you may experience ear soreness or discomfort from the loops tugging at your ears. The discomfort can be especially bad if you also wear hearing aids, Sydlowski says.
She recommends looking for a mask that ties behind the neck or has an elastic band that goes behind your head. Another option is to buy or make an “ear saver” product, whether it’s a strip of fabric with two buttons sewn on each end (attach the mask loops to the buttons instead of your ears and let the fabric strip rest at the back of your head, holding the mask in place) or a commercial product specifically marketed for that purpose. “The most successful solution is something that takes the loops off of your ears,” she notes.
Michelle Crouch is a contributing writer who has covered health and personal finance for some of the nation's top consumer publications. Her work has appeared in Reader's Digest, Real Simple, Prevention, The Washington Post and The New York Times.