Earache: causes and treatments

Ear pain occurs not only in connection with an ear disease, but also as an accompanying symptom in connection with other causes. For example, tonsillitis, thyroid disease or Pfeiffer's glandular fever, also known as “kissing disease”, are possible. The symptoms should therefore always be taken seriously as a possible sign and should generally be clarified by a doctor.

Occurrence and causes of earache

Children are particularly often affected by ear pain. There are anatomical reasons for this, because the connection between the nasopharynx and the ear (Eustachian tube) is still very short and horizontal in childhood. This makes it easier for pathogens to collect and settle there than is possible for adolescents and adults. Experience has shown that more boys than girls are affected by ear infections, particularly in the area of ​​the middle ear. Since the ear is an extremely sensitive organ, pain in the external and internal auditory canal can hardly be endured.

Inflammation of the external ear canal

Pathogens, such as bacteria, viruses and fungi, can lead to inflammation of the external ear canal (otitis externa). The causes for this are, for example, infections from unclean bath water. In addition, frequent bathing in chlorinated water dries out the skin in the external ear canal, which makes it easier for pathogens to settle.

Mechanical irritation caused by ear cleaning with a cotton swab can cause an ear infection. If the ears are cleaned too often with ear sticks and too much ear wax is removed, this can also cause inflammation, since the ear wax has an important protective function.

Allergic reactions to hairspray, care products and cosmetics are considered to be possible triggers for inflammation of the external ear canal. People with diabetes have an increased risk of external otitis.

The disease is characterized in part by very severe ear pain, which is often accompanied by itching, discharge, ringing in the ears and possible hearing loss. Significant reddening and swelling can often be seen.

As part of the treatment, the ear, nose and throat doctor (in short: ENT specialist) cleans the ear canal and takes a smear to determine the pathogen. Swabs soaked in alcohol or strips of ointment containing cortisone are placed in the ear canal to relieve the inflammation. Ear drops are also regularly used.

Foreign body in the ear

Children are mostly affected by foreign bodies in the ear. Small parts (e.g. pearls, marbles, peas) block the ear canal and must be professionally removed by an ENT doctor. Attention: When trying to remove the foreign body yourself, these often get further into the ear and are pushed towards the eardrum. Therefore, a doctor should be consulted as soon as possible.

Ear wax can also cause the eardrum to move if it gets too far into the ear. This usually happens through incorrect cleaning with the cotton swab.

If there is a foreign body in the ear, there is a lighter earache, usually a form of pressure pain, possibly accompanied by ringing in the ears and reduced hearing.

Tube catarrh

A so-called “tube catarrh” is an inflammation of the ear trumpet (tuba auditiva). This is the connection between the nasopharynx and the middle ear, the main task of which is pressure equalization. The ear trumpet is lined with mucous membrane that can ignite and then swell. This swelling causes mild ear pain, often in conjunction with short-term hearing loss.

The tubular catarrh occurs both acutely and chronically. In the acute case there is a temporary inflammation, which is mainly caused by an infection. The chronic variant leads to a permanent accumulation of secretions in the tympanic cavity and is usually accompanied by a significant hearing loss. This can lead to speech delay, especially in children. In addition, there is constant pressure on the ears, "gurgling" noises when yawning or blowing your nose and earache.

Decongestant nasal drops, anti-inflammatory drugs (anti-inflammatory drugs) and pain relievers are used to reduce swelling.

Cause otitis media

The mostly bacterial otitis media often occurs in younger children. It most often arises from the fact that the pathogens rise from the inside via the ear trumpet in connection with an infection in the ear, nose and throat tract. The mucous membrane in the tympanic cavity swells and a secretion is formed.

In connection with otitis media, massive, sometimes unbearable earache occurs. In infants and toddlers, unspecific symptoms such as abdominal pain or diarrhea often appear in parallel. Typically, children often touch the affected ear. The disease is usually accompanied by a high fever. Smaller children are extremely restless and usually want to be carried around in their arms all the time.

Most of the time, otitis media is preceded by a cold or flu infection or a sinus infection. Childhood diseases, such as measles, can also be associated with inflammation of the middle ear.

The treatment is carried out with decongestant nose drops and painkillers. An antibiotic is often the drug of choice. In the case of massive ear pain and a bulging eardrum, a small incision may be necessary so that the effusion can run off. Natural home remedies for otitis media can be used to assist. These include the tried-and-tested onion bag or a layer of roses and wormwood.

Mastoiditis: inflammation of the mastoid

The mastoid process is the bony area behind the ear. This can catch fire, which is a fairly serious illness. The disease, called "mastoiditis", is one of the most common complications of an untreated acute otitis media. In the worst case, the bone has to be opened surgically. With inflammation of the mastoid process, those affected suffer from massive ear pain, painful swelling behind the ear, fever and discharge.

Sore ears due to injuries to the eardrum

Pointed objects such as Knitting needles, pencils or cotton swabs can pierce the eardrum directly. Indirect influences are a blow to the ear, an explosion or a diving accident. Both direct and indirect eardrum injuries cause sudden earache, possibly accompanied by escaping fluid and blood and / or dizziness. The eardrum usually heals itself within two weeks, but can also be closed with surgery.

Exaggerated cleanliness

Especially in adolescents and adults, too frequent and incorrectly applied ear hygiene can cause inflammation in the ear with the cotton swab. Improper ear cleaning, which usually uses a cotton swab or other pointed object, quickly leads to the slightest injuries in the ear canal. As a result, bacteria or fungi can settle more easily and lead to unpleasant inflammation, which is usually associated with acute ear pain.

Earache while flying

A common phenomenon is pain in the ears when starting and / or landing an aircraft. The rapid pressure differences cause difficulties for air travelers, which can lead to pressure in the ear, hearing loss and sometimes considerable pain.

The situation is exacerbated if those affected get on the plane with a cold. People who are prone to earache while flying or who are even going on a plane trip with a cold should therefore be sure to get ear and nose drops before they travel. Chewing chewing gum during the flight helps with pressure equalization.

Causes outside the ear area

Ear pain does not have to have its causes directly in the area of ​​the ears. Instead, disorders around the sensory organ and other diseases can also be responsible for the symptoms. For example, people who grind their teeth at night usually suffer from tight jaw muscles, which can lead to pain in the ear area.

Inflammation in the oral cavity, throat or throat

The ear is an extremely sensitive organ, so toothache or TMJ can manifest itself in part in the form of ear pain. With a side-strand angina, inflammation of the pharynx wall, patients often complain of painful ears in addition to difficulty swallowing. The same often happens with angina tonsillaris (tonsillitis).

Inflammation of the parotid gland / mumps

Mumps (medical: parotitis epidemica), colloquially called "goat peter", is an acute viral inflammation of the parotid gland. The disease mainly occurs in community facilities such as kindergartens or schools. The causative agent is the mumps virus, which is transmitted from person to person by droplet infection and then, after entering the nasopharynx, affects the parotid glands via the bloodstream.

It is typical that initially only one side of the face swells in those affected, but in the course of the disease, the other side is also affected in seventy-five percent of cases. Patients show the typical "hamster cheeks" and sometimes experience severe pain that radiates up to the ears. Since most children are vaccinated against mumps these days, this disease is now relatively rare.

Herpes zoster (shingles)

Shingles is a viral disease caused by chickenpox (varicella zoster virus). After a chickenpox disease that has already gone through, a second infection, in this case herpes zoster, can develop with reduced immunity.

The general symptoms are usually minor, but an extremely painful, itchy rash occurs. The chest and stomach area are most often affected. As an ophthalmic zoster, the painful vesicles extend in the area of ​​the scalp, nose and / or eye area. Zoster oticus, however, affects the ear and ear canal, which can lead to considerable ear pain.

Cause trigeminal neuralgia

The so-called "trigeminal neuralgia" is a pain disorder in the supply area of ​​the fifth cranial nerve, the trigeminal nerve. Mostly people from the age of fifty are affected with existing neurological diseases.

Trigeminal neuralgia is characterized by sudden onset of tearing pain caused by movements when speaking or chewing or lightly touching certain areas of the face. The pain attacks usually last only a few seconds, but can occur again in an interval of a few minutes.

Cervical spine problems

In the area of ​​the cervical spine there are many nerves that supply the head, shoulders and arms. Problems that arise here, such as a cervical disc prolapse (herniated disc in the area of ​​the cervical spine), can lead to pain in the neck as well as headache starting from the neck and shoulder area as well as headache.

Thyroiditis (inflammation of the thyroid gland)

The thyroid is located in the front of the neck. In relatively rare cases, the hormone gland can become inflamed, which usually happens in the context of an autoimmune disease such as Hashimoto's thyroiditis. Other possible reasons for inflammation include bacteria, injuries, and certain medications.

The symptoms may vary depending on the cause. In addition to pain and swelling, reddening and overheating in the area of ​​the thyroid gland, swelling of the lymph nodes, difficulty swallowing, strong weakness and high fever are possible. The sore throat can radiate into the jaw, ears or the whole head, sometimes even the chest area is affected.

Pfeiffer's disease - glandular fever - mononucleosis infectiosa

Pfeiffer's glandular fever (also known as “kissing disease”) is a widespread, contagious disease that used to occur primarily in the student age. Today, it mostly occurs in childhood or adolescence, which means that the infection with the triggering Epstein-Barr virus is relatively high.

Typically, the first symptoms of glandular fever are similar to those of a common cold. Patients suffer from severe sore throats that can radiate into the ears, body aches, cough, runny nose and fever. At the same time, swellings of the lymph nodes in the neck area and partially under the arms or in the groin area can be seen. In some cases there is an tonsillitis (angina tonsillaris), which is shown by a whitish-gray coating on the tonsils (tonsils).

Cancer of the mouth and throat / larynx cancer

Malignant tumors in the mouth and larynx cause difficulty swallowing, difficulty breathing, coughing, sore throat and earache.

Rare causes

Rarely, malignant growths in the area of ​​the outer and inner auditory canal, but also in the auricle as well as growths in the nasopharynx can lead to complaints in the area of ​​the ears.

Treatment of ear pain

Since the symptoms are a symptom and not a disease, the underlying disease is treated first. In addition, there is symptomatic therapy in the form of anti-inflammatory and analgesic drugs. If there is inflammation in the external ear canal, ointments containing cortisone may be used. In the event of injuries or proliferation, surgical interventions are sometimes necessary.

In addition to the physical examination, a detailed medical history is important for a diagnosis. The type of pain (e.g. pulsating, tapping, pulling or drilling), the intensity, possibly the time of the onset of pain and the exact location of the pain are asked. In addition, accompanying symptoms such as fever, hearing loss and general exhaustion and fatigue are important. Previous illnesses such as a flu infection, a childhood illness or precise information about injuries and accidents contribute to an exact diagnosis.

Treatment in naturopathy

In the naturopathic treatment of earache, the therapy of the underlying disease is of course also in the foreground. In the case of recurrent (recurrent) infections, methods are primarily used that strengthen the immune system. These include, for example, relaxation procedures for stress relief, such as yoga or autogenic training, Kneipp treatments or autologous blood therapy.

The use of an antibiotic is often unavoidable, especially in the case of more serious diseases such as otitis media. In many cases, naturopathic remedies can be used promisingly in parallel to conventional therapy.

In order to treat acute tube catarrh or otitis media, cantharid plasters, among others, are used. These are placed behind the ear. The plasters contain the poison cantharidin, which is obtained from the Spanish fly. This contains substances that promote blood circulation and strengthen the immune system. The body is supported to stimulate excretion in order to remove pathogens from the body.

Another effective home remedy for otitis media is an onion compress or a potato bag. In the former, chopped onions are placed in a cloth and then fixed on the ear with a headband or hat. The effect can be supported by an additional heat source. Children often reject this wrap because it does not smell pleasant. But if the effect is felt on your own body, children will always ask for the use of this home remedy if they have complaints.

Potato parcel for earache:
  1. Two potatoes are cooked gently and mashed
  2. Put the mass on a linen cloth, handkerchief or cloth diaper and fold the cloth into a packet
  3. Let it cool down a bit
  4. Place the slightly warm cloth on the affected ear for about half an hour

Schüssler salts and homeopathy

In alternative medicine, decongestants from phytotherapy, homeopathy or Schüssler salts are administered to treat the painful ears. Examples are the Schüssler Salt No. 3 (Ferrum phosphoricum), which helps against redness and inflammation. Salt No. 4 (potassium chloratum) is a well-known mucosal agent, No. 11 (Silicea) is well suited for the treatment of bacterial infections. 6 (potassium sulfuricum) is used in mineral therapy with Schüßler salts when the disease has settled.

From classic homeopathy, chamomilla is the drug of choice when infants and small children suffer from ear pain and are extremely uncomfortable, uncomfortable and tearful. For the Otits externa, agents such as Schüssler Salt No. 4 are available both for internal use and for external use in the form of ointment.

Proven home remedies for earache

In natural medicine - with an intact eardrum - ear drops may be used. These include, for example, aconite (aconite) for acute and severe pain, lavender oil for calming and alleviating irritation, and / or levisticum for inflammation.

If the pain occurs in connection with an acute flu infection, inhaling with sea salt and administering nasal drops (also based on sea salt) will help. Because this causes the mucous membrane in the nasopharyngeal duct to swell and the inflammatory secretion to run off, which reduces the pressure on the eardrum.

Unless there is a serious underlying disease, a number of other effective home remedies for earache can be considered for the natural treatment of the symptoms. A cold wrap with healing earth or a warm envelope made from finely ground mustard flour can provide relief. (sw, nr)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Susanne Waschke, Barbara Schindewolf-Lensch


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  • Annette Limberger; Christiane Koitschev; Assen Koitschev: Short Textbook Otorhinolaryngology, Urban & Fischer, 2014
  • Working Group of the Scientific Medical Societies (AWMF) e.V .: (accessed: August 30, 2019), earache: Guideline 053 - 009
  • Pschyrembel Online: (access: August 29, 2019), Otalgie
  • Dietrich Michalk; Eckhard Schönau: Differential Diagnosis Pediatrics, Elsevier Health Sciences, 2018
  • Dietmar Thurnher; Matthäus Ch. Grasl; Boban M. Erovic; Piero Lercher: Otolaryngology, Springer, 2011

Video: What Causes an Earache? Ear Problems (January 2022).