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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.

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.

Earache treatment

Earache is usually treatable and unlikely to lead to long-term problems.

Treatment may include over-the-counter age appropriate painkillers, such as paracetamol or ibuprofen for pain and fever.

Holding a cold flannel to the painful ear for around 20 minutes is one self-help tip the NHS offers for earache. However, if an ear infection is suspected, avoid getting the inside of the ear wet.

A pharmacist may be able to recommend over-the-counter eardrops for earache. Olive oil may also help loosen earwax.

Don't use eardrops or olive oil if the eardrum has burst.

If a child has long-term earache or repeated ear infections small tubes called grommets may be recommended by a doctor to help keep the ear free of fluid and infection.

A doctor may prescribe antibiotics for ear infections, although some research suggests antibiotics may not always be an effective treatment.

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