Ear Pain (Otalgia)

Ear Pain

(Otalgia)

Ear pain, referred to medically as otalgia, is a very common complaint. However, the underlying cause, severity, and required treatment can vary widely. Ear pain may occur on its own or be accompanied by other symptoms such as hearing loss, ear discharge, or a sore throat.

Pain in the ear can originate from the outer ear, the middle ear, the bone around the ear, or may even be referred from elsewhere (for example from the throat or jaw). A proper assessment by an ENT specialist is important to determine the right cause and treatment.

Symptoms & Causes

Ear pain can arise from different parts of the ear or from nearby structures. Some common causes include:

External Ear (Outer Ear / Ear Canal)

Impacted ear wax: Earwax pushed deep into the canal (for example by cotton-buds) can press on the ear canal or eardrum and cause pain, sometimes with hearing loss.
External ear infection (Otitis externa): Injury or repetitive picking of the ear canal skin may lead to bacterial or fungal infection. Bacterial infections typically cause pain, while fungal infections may also produce intense itching. Treatment often involves cleaning the ear canal and applying antibiotic or antifungal eardrops.
Foreign body in the ear: Objects (or insects) entering the ear canal may cause acute pain, trauma, itching or even infection.

Middle Ear

Middle ear infection (Otitis media): Especially common in children but can occur in adults. Often follows a cold or upper respiratory infection that spreads via the Eustachian tube. Symptoms may include ear pain, fever, blocked feeling or reduced hearing.
Barotrauma (pressure-related ear pain): Rapid or large changes in air pressure (for example during flights or diving), when the middle-ear pressure fails to equalize, may cause ear pain and even bleeding or injury.

Deeper or Serious Infections / Conditions

Temporal bone or canal infections (in vulnerable individuals, e.g. diabetics): These serious infections can lead to severe pain, discharge, hearing issues, and if untreated, worse complications.
Referred pain: Sometimes the source of pain is not the ear itself. For example, throat infections, dental problems, jaw or temporomandibular-joint (TMJ) disorders can trigger ear pain even though the ear might appear normal.

Diagnosis

At our clinic, the evaluation for ear pain usually includes:

Clinical history and examination

A doctor will ask about when the pain started, any associated symptoms (hearing loss, discharge, fever), and possible triggers such as recent water exposure or allergies.
Ear inspection and cleaning

Using an otoscope to inspect the ear canal and eardrum. If necessary, wax or debris is gently suctioned to better visualise the ear structures.
Hearing or balance tests

If hearing loss, ringing (tinnitus), or dizziness occur, audiometry or balance tests may be arranged.
Imaging or further tests

In cases where deeper bone infection, unusual lumps or structural issues are suspected, imaging (e.g. CT scan) or referral to other specialists may be recommended.
Referral to other specialists

If ear pain is referred from the throat, jaw or dental area, or linked to sinus or allergy problems, coordinated care may be arranged.

Treatment and Management

Treatment depends on the underlying cause of ear pain. Options include:

Wax Impaction or External Canal Causes

Professional ear cleaning and wax removal
Gentle cleaning and drying of ears — avoid cotton buds or sharp objects
Antibacterial or antifungal eardrops if infection is present

Middle Ear Infection or Fluid Build-up

Pain relief (analgesics) and observation if mild, especially in children or early cases. Many ear infections resolve on their own within days.
Antibiotics, if bacterial infection is diagnosed or symptoms worsen
Advice on ear-care and preventing re-infection

Barotrauma or Pressure-related Pain

Techniques to equalise pressure (e.g. swallowing, yawning, chewing gum)
Nasal decongestant or nasal spray if there is nasal congestion preventing Eustachian tube function
Avoid forceful nose-blowing or pressure changes until healed

Referred or Complex Cases

Treat underlying sinus, throat or jaw conditions if that is the cause
For serious infections, possible hospitalisation or specialist intervention when necessary

Frequently Asked Questions

1. Can earwax really cause severe ear pain?

Yes. Impacted earwax pressed against the ear canal or eardrum can cause pain, hearing loss and a blocked sensation. Professional removal usually resolves these symptoms.

2. Is it safe to use cotton buds to clean my ears?

No. Cotton buds often push wax deeper into the canal and may injure the ear canal or eardrum. Avoid inserting any objects into the ear.

3. My ear hurts after a flight or dive — what can I do?

Try swallowing, yawning or chewing gum to equalise pressure. If pain or fullness persists, or if you have hearing loss or discharge, see an ENT specialist.

4. Do all ear infections need antibiotics?

Not always. Many mild middle ear infections can resolve on their own. Antibiotics are used when bacterial infection is confirmed, or symptoms worsen or persist.

5. When should a child with ear pain see a doctor?

If ear pain lasts more than 2–3 days, is accompanied by fever or hearing loss, or if there is ear discharge, the child should be evaluated by a doctor. Frequent recurrences also warrant specialist review.

Next Steps — Book an ENT Consultation with Us

If you are experiencing ear pain, discharge, hearing loss or recurrent ear problems, we encourage you to schedule a consultation at My ENT Specialist. Our team will assess your condition comprehensively and recommend the most appropriate treatment plan tailored to your needs.