Earache

Symptoms of earache 

Earache can be a sharp, dull or burning pain in the ear that comes and goes or is constant. You may get pain in just one or both ears.

When to get medical advice 

It's not always necessary to see your GP if you or your child have earache. The pain will often improve in a few days. There are things you can do to help (see what you can do at home).

You should contact your GP or GP out of hours service if: 

• you or your child also has other symptoms, such as a high temperature (fever), vomiting, a severe sore throat, swelling around the ear, or discharge from the ear
• there's something stuck in your or your child's ear
• the earache doesn't improve with painkillers within four days
• children are under two years of age with pain and infection in both ears

What you can do at home 

To treat the pain, you can use painkillers, such as paracetamol or ibuprofen. These can be bought over the counter. Children under the age of 16 shouldn't take aspirin.

If the discomfort is mild, and in the outer ear, placing a warm flannel against the affected ear may also help relieve the pain. Care must be taken to make sure the flannel is not hot, to avoid scalding or burning of the skin.

Your pharmacist may be able to recommend over-the-counter eardrops for your earache. Tell them about your symptoms and ask for their advice first.

Eardrops or olive oil drops shouldn't be used if your eardrum has burst (a perforated eardrum), and if treating an ear infection.

It's important to avoid getting the affected ear wet if you have an ear infection.

Common causes of earache 

Ear infections 

If an ear infection is causing your earache, there may be a watery or pus-like fluid coming out of your ear.

Common causes of earache include:

• outer ear infections (infections of the tube connecting the outer ear and eardrum)
• middle ear infections (infections of the parts of the ear behind the eardrum) are very common causes of earache

Ear infections often clear up on their own without treatment after a few days or weeks.

Many infections in the middle ear are viral and would not improve with antibiotic treatment.

Many outer ear symptoms can be caused by non-infectious conditions such as dermatitis. In some cases, depending on the cause, your GP may prescribe eardrops or antibiotics.

Glue ear 

Glue ear is also known as otitis media with effusion (OME). It is a build-up of fluid deep inside the ear. Glue ear commonly causes some temporary hearing loss. The condition tends to be painless. However, sometimes the pressure created by the fluid can cause earache.

Glue ear often clears up on its own. This can take a few months. If the problem is ongoing, a minor procedure to place small tubes called grommets in the ear may be recommended. This is to help drain the fluid.

Ear damage 

Earache can sometimes be caused by an injury to the inside of the ear – for example, by:

• scraping earwax from the ear canal using a cotton bud
• poking a cotton bud too far into your ear, which can puncture the eardrum

The ear canal is very sensitive and can be easily damaged. The ear should heal on its own without treatment. It can take up to two months for a perforated eardrum to heal.

If you have a perforated eardrum, you shouldn't use eardrops.

Earwax 

A build-up of earwax can sometimes cause earache.

If you have a build-up of earwax in your ear, your pharmacist will be able to recommend eardrops to soften it so it falls out naturally.

In some cases, your GP may need to remove the wax (once softened with eardrops) by flushing the ear with water. This is known as ear irrigation.

An object in the ear 

If there's something in your or your child's ear that's causing pain, don't try to remove it yourself. This is because you may push it further inside which could damage the eardrum.

Contact your GP or GP out of hours service. Your GP may need to refer you or your child to a specialist to have it removed.

Throat infections 

If you find it painful to swallow and you have a sore throat, your earache could be a symptom of a throat infection, such as:

• tonsillitis – inflammation of the tonsils that's usually caused by a viral infection
• quinsy – an abscess on one side of the back of your throat, which can sometimes make it very difficult to swallow even fluids

Most sore throats clear up after a few days without the need for antibiotics. 

If you have quinsy, you'll need to see your GP as soon as possible for treatment. You may have quinsy if you have a sore throat that gets worse very quickly.

Jaw problem 

Earache can be caused by a problem with the joint of your jaw bone (where the jaw meets the skull).

This is known as temporomandibular joint pain and can occur as a result of problems such as arthritis or teeth grinding.

Jaw pain can often be relieved:

• with painkillers
• warm or cold compresses
• trying not to clench your jaw and grind your teeth

Dental abscess 

A dental abscess is a collection of pus that can form in your teeth or gums as a result of a bacterial infection. The main symptom is pain in the affected tooth, which can be intense and throbbing. Sometimes, the pain can spread to your ear.

Make a dental appointment as soon as possible if you think you have a dental abscess. Your dentist will need to remove the source of the infection and drain the pus from the abscess.

•  Find information about emergency dental services in Northern Ireland

More useful links

• How to use your health services