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Earache: Causes, symptoms, treatment and prevention

Earache can be painful. The NHS says it is the most common reason for parents to call out-of-hours doctor services about their child.

Earache is more common in children than it is in adults. The pain from earache can be constant or it may come and go. It can feel like a burning sensation or a sharp, or dull, pain. It can affect both ears at once or just one ear.

Causes of earache

Just as the pain from earache affects people in different ways, there are a variety of causes of earache. Some of them affect the ear itself, others are from conditions affecting areas close to the ears.
Common reasons for earache include:

  • Fluid building up deep inside the eardrum. Known as glue ear, this affects children more than adults
  • Infection of the ear canal outside the eardrum (otitis externa)
  • A boil or infected hair follicle in the ear canal
  • Eczema in the ear canal ( seborrhoeic dermatitis)
  • Injury in the ear canal from objects poked inside, such as cotton buds or sharp objects
  • Blockages in the ear from plugs of earwax or objects pushed in which have become stuck
  • Throat infections (including tonsillitis) and colds
  • Jaw pain, known as temperomandibular joint pain
  • Dental abscess in the mouth or other tooth pain, such as wisdom teeth problems
  • Trigeminal neuralgia or facial nerve pain

Symptoms of earache

As well as ear pain, earache from an ear infection can be especially troublesome for children and babies. Symptoms include:

  • Babies may appear hot and irritable
  • Children may pull, tug or rub an ear
  • A high temperature -  over 38C
  • Poor feeding in babies; loss of appetite in children
  • Sleep problems and restlessness at night
  • Coughing and runny nose
  • Not hearing as well as normal
  • Balance problems

Seek urgent medical advice if your child develops a stiff neck, appears very tired, responds poorly or cannot be consoled.

What is the difference between the symptoms of a cold and an ear infection?

An earache from a cold can be a sharp, dull, or burning pain that can range from mild to very painful. Even if the trapped fluid in the ear is not infected, the fluid puts pressure on the eardrum, causing it to bulge and throb.

With an earache from a cold, you or your child may have difficulty sleeping, begin sneezing, and have green or yellow mucus in the nose. Because colds are self-limiting an earache with a cold usually goes away on its own. If you have an earache medical advice may be advised for a proper diagnosis and appropriate treatment.

Some earaches from a cold virus may be followed with a secondary ear infection. These may come on suddenly and painfully.

How is an ear infection diagnosed?

When your doctor suspects an ear infection he or she will look in the ear using an instrument called an otoscope. A healthy eardrum is pinkish grey in colour and transparent. If an ear infection is present the eardrum may be inflamed, swollen or red. Further tests may be needed depending on what the doctor sees.

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