Earache

Written by Dr John Pillinger, GP and Dr Stuart Crisp, paediatric specialist registrar



Earache is mainly due to problems in either the outer ear (from the earlobe to the eardrum) or the middle ear (behind the eardrum). In some cases, problems in the throat or the mouth, such as tonsillitis, can also cause earache.

Listed below are some common reasons for earache.

If you have earache

Try sleeping with your head in an elevated position.

Take a mild pain reliever such as aspirin or paracetamol.

Aspirin should not be given to children under 16, unless on the advice of a doctor.

Ear wax

Ear wax can gather in the ear canal (auditory canal). Eventually it can form an ear plug, which impairs hearing and may cause pain.

Using a cotton bud doesn't help because this usually only pushes the wax further inside the ear, doing more harm than good. It also carries the risk of perforating the eardrum.

A plug can be softened with a little olive or vegetable oil. Drops can also be bought at the chemists that are designed for this purpose.

The practice nurse at your doctor's surgery may syringe the ears by flushing out the ear wax with water.

Inflammation of the middle ear

Usually earache starts further inside the ear. Inflammation of the middle ear is the most frequent cause and is often (although not always) due to an infection.

Because of increased pressure in the middle ear, the eardrum is stretched and swollen. This impairs hearing and is painful.

Mild painkillers such as paracetamol can be used if the pain is severe.

Antibiotics may also be prescribed. However, the role of antibiotics is still uncertain. They probably do not offer any benefit in the majority of people with inflammation of the middle ear, and often are associated with side effects.

Eczema

Eczema can occur in the auditory canal, causing dry, red, scaly and itchy skin. This can also become infected and painful.

Eczema sufferers should be careful about putting cotton buds into their ear because it usually only makes matters worse. Ear drops containing corticosteroids may relieve and heal the irritated auditory canal. Antibacterials or antifungals may be required if there is infection.

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