The Truth Behind Ear Pain

Like so many other nonspecific symptoms ear pain can be part of a viral illness like a cold, be a hallmark of allergic disease or be the presenting symptom of an infection affecting the middle or outer ear.

The middle ear is the tympanic membrane and the bones immediately behind it. These small body parts are important because they are the building blocks of our ability to hear. Sound waves hit the ear drum (tympanic membrane) and are carried to our brain as a result of the small bones and nerves directly behind the membrane. If the membrane is thickened for any reason, our hearing will be affected.

The outer ear is the canal and the parts of the ear that we can all see. The external ear’s job is to  carry  sound waves to the ear drum. If that canal is infected or swollen or full of wax, our ability to hear will be impacted.

The inner ear is not visible without using x-ray techniques but is important in helping us with balance and knowing where we are. Sometimes the inner ear is infected with a virus. When that happens, a person will experience dizziness, that problem is called “labyrinthitis” Interestingly, inner ear problems do not present with pain but do present with problems with walking, nausea, vomiting and dizziness. The diagnosis of labyrinthitis is made by a provider after examining a patient and not seeing any other reason for their symptoms. This problem usually resolves in a few days and requires no follow up. If the symptoms persist, further evaluation including MRI may be needed.

Middle ear infections are usually painful with a feeling of pressure behind the tympanic membrane. Sometimes they present with fever and often present after a cold or upper respiratory infection or even after a bad bout of allergies. The patient may have a fever and often will feel very ill. The diagnosis is made by a provider using an instrument called an otoscope that is used to visualize the tympanic membrane. The doctor will look at the ear drum and if it is infected, it will look like a red water balloon. Some middle ear infections are caused by viruses and some are caused by bacteria. If the provider thinks the infection is bacterial, he will prescribe an antibiotic to treat the infection.

While ear infections can affect patients 1 year or older,children between the ages of 6 months and 3 years are more likely to get middle ear infections because their sinuses are not fully developed. Treatment of these infections is important because untreated, they can affect hearing and if children do not hear well during this important stage of development, it will affect their speech and ability to communicate effectively with others during a period of their lives when they are learning so much about the world we all live in. If children have recurrent infections, they may need to be seen and treated by a specialist, an otolaryngologist.

Ear infections in children can be prevented by breast feeding, immunization against H.flu (the most common cause of ear infections) and by not exposing them to cigarette smoke.

Outer ear infections can be infections in the wall of the canal itself or an infection of the part of the ear we can all see called the pinna. Most often these infections cause redness and swelling and are very painful. They are most often caused by strep or staph and do respond to antibiotics.

Another possible cause of outer ear infections are chronic fungal infections that cause itching more than pain and ironically are difficult to eradicate. Often these infections require specialty care.

Sometimes the canal gets filled with wax and this can also be somewhat painful although patients more often describe it as a pressure feeling and their hearing is often muffled. It is best to have this excess wax removed by a professional rather than trying to remove yourself. It is not unusual for a patient to make the problem worse by trying to treat himself at home with a Q tip.

All of the ear problems listed here can be diagnosed and most of them treated by the providersat Doctor’s Express. So, if your ear hurts, come on in and we’ll help you figure out what the cause of the pain is and how to alleviate it.