Top of the pageCheck Your Symptoms

Topic Overview

Ear problems may be caused by many different health
problems. In children, ear pain is more likely to be a symptom of an
inflammation, infection, or fluid buildup in the external or middle ear. But
ear pain at any age may be a symptom of:

Ear problems caused by an injury to the ear can occur at any
age. Common injuries include the following:

  • A fall or a forceful, direct blow to the side of
    the head can
    burst the eardrum or damage the tiny bones in the
    inner ear that send sound to the brain.
  • An injury during contact sports can cause an injury, such as “cauliflower” ear from wrestling.
  • Loud noises or explosions
    can damage the eardrum (acoustic trauma).
  • Atmospheric pressure changes (barotrauma) can cause
    problems with the
    eustachian tube and trap air in or keep air out of the
    middle ear. Middle ear problems can be severe (for example, the eardrum can
    burst or the middle ear can fill with blood or pus) or mild and only be felt as
    changes in pressure.
  • Cuts or scrapes may injure the outside of the
    ear or ear canal. For more information, see the topic
    Ear Canal Problems (Swimmer’s Ear).
  • Cleaning the ear canal too
    often, too forcefully, or with a cotton swab, bobby pin, or sharp fingernail
    can cause irritation or injury.
  • Burns or frostbite can cause ear
    injuries (thermal injuries).
  • Objects placed in the ear can cause
    injury to the ear canal or the eardrum (tympanic membrane).

Hearing loss often comes with age. As people get older, ear
problems are more likely to be related to:

  • Heredity. The age of onset and how quickly the
    hearing loss progresses can often be determined by studying family members with
    hearing loss.
  • The buildup of
    earwax. For more information, see the topic
    Earwax.
  • Exposure to loud noises, such as
    setting off an air bag during a car crash, machines at work, power tools,
    gunshots, or loud music.
  • Other serious medical problems, such as
    Ménière’s disease or an
    acoustic neuroma.
  • Skin reaction
    (dermatitis) on the outside of the ear or in the ear canal from perfume, hair
    dye, or wearing hearing aids.

The ear shares nerves with other parts of the face, eyes, jaw,
teeth, and upper neck. Pain that feels as if it is in the ear may be coming
from another part of the head or neck. This is called
referred ear pain and is more common in older adults.
Causes of referred ear pain can include dental problems, jaw pain (temporomandibular disorder), salivary gland infection, or a
sinus infection.

Check your
symptoms
to decide if and when you should see a doctor.

Check Your Symptoms

Do you have an ear problem?
This includes problems like pain, hearing loss, and possible infection.
Yes
Ear problem
No
Ear problem
How old are you?
Less than 12 years
Less than 12 years
12 years or older
12 years or older
Are you male or female?
Male
Male
Female
Female
Have you had a recent head injury?
Yes
Recent head injury
No
Recent head injury
Do you have any new hearing loss?
Yes
New hearing loss
No
New hearing loss
Was the hearing loss sudden and complete?
Yes
Sudden and complete hearing loss
No
Sudden and complete hearing loss
Could you be having symptoms of a stroke?
Yes
Symptoms of stroke
No
Symptoms of stroke
Have you had an injury to your ear in the past week?
The ear can be injured by a direct hit, a very loud noise (like a gunshot or firecracker), or an object being pushed into the ear.
Yes
Recent ear injury
No
Recent ear injury
Do you have vertigo?
Yes
Vertigo
No
Vertigo
Is the vertigo making it hard to stand or walk?
Yes
Hard to stand or walk
No
Hard to stand or walk
Is there any pain in the ear?
Yes
Ear pain
No
Ear pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
How long has the pain lasted?
Less than 12 hours
Pain for less than 12 hours
12 to 48 hours (2 full days)
Pain for 12 to 48 hours
More than 48 hours (2 days)
Pain for more than 48 hours
Do you think you may have a fever?
Yes
Possible fever
No
Possible fever
Did you take your temperature?
Yes
Temperature taken
No
Temperature taken
How high is the fever? The answer may depend on how you took the temperature.
High: 104°F (40°C) or higher, oral
High fever: 104°F (40°C) or higher, oral
Moderate: 100.4°F (38°C) to 103.9°F (39.9°C), oral
Moderate fever: 100.4°F (38°C) to 103.9°F (39.9°C), oral
Mild: 100.3°F (37.9°C) or lower, oral
Mild fever: 100.3°F (37.9°C) or lower, oral
How high do you think the fever is?
High
Feels fever is high
Moderate
Feels fever is moderate
Mild or low
Feels fever is mild
How long have you had a fever?
Less than 2 days (48 hours)
Fever for less than 2 days
At least 2 days but less than 1 week
Fever for at least 2 days but less than 1 week
1 week or more
Fever for 1 week or more
Do you have shaking chills or very heavy sweating?
Shaking chills are a severe, intense form of shivering. Heavy sweating means that sweat is pouring off you or soaking through your clothes.
Yes
Shaking chills or heavy sweating
No
Shaking chills or heavy sweating
Do you have a health problem or take medicine that weakens your immune system?
Yes
Disease or medicine that causes immune system problems
No
Disease or medicine that causes immune system problems
Yes
Symptoms of external ear infection
No
Symptoms of external ear infection
Do you have diabetes?
Yes
Diabetes
No
Diabetes
Is there any drainage or bleeding from the ear?
Yes
Drainage or bleeding from ear
No
Drainage or bleeding from ear
Do you think that a medicine may be causing your symptoms?
Think about whether the symptoms started after you began using a new medicine or a higher dose of a medicine.
Yes
Medicine may be causing symptoms
No
Medicine may be causing symptoms
Have you had any ear symptoms for more than a week?
Yes
Ear symptoms for more than 1 week
No
Ear symptoms for more than 1 week

Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:

  • Your age. Babies and older
    adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
    disease, you may need to pay closer attention to certain symptoms and seek care
    sooner.
  • Medicines you take. Certain
    medicines, herbal remedies, and supplements can cause symptoms or make them
    worse.
  • Recent health events, such as surgery
    or injury. These kinds of events can cause symptoms afterwards or make them
    more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
    use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be
able to take care of this problem at home.

  • Try home treatment to relieve the
    symptoms.
  • Call your doctor if symptoms get worse or you have any
    concerns (for example, if symptoms are not getting better as you would expect).
    You may need care sooner.

Temperature varies a little depending on how you measure it.
For adults and children age 12 and older, these are the ranges for high,
moderate, and mild, according to how you took the temperature.

Oral (by mouth) temperature

  • High:
    104°F (40°C) and
    higher
  • Moderate:
    100.4°F (38°C) to
    103.9°F (39.9°C)
  • Mild:
    100.3°F (37.9°C) and
    lower

A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature.

Ear or rectal temperature

  • High:
    105°F (40.6°C) and
    higher
  • Moderate:
    101.4°F (38.6°C) to
    104.9°F (40.5°C)
  • Mild:
    101.3°F (38.5°C) and
    lower

Armpit (axillary) temperature

  • High: 103°F (39.5°C) and higher
  • Moderate:
    99.4°F (37.4°C) to
    102.9°F (39.4°C)
  • Mild: 99.3°F (37.3°C) and lower

Symptoms of an external ear infection
may include:

  • Moderate to severe pain in the outer
    ear.
  • Pain with chewing.
  • Redness and swelling of the ear, ear canal, or the skin around
    or behind the ear.

Vertigo is the feeling that you or
your surroundings are moving when there is no actual movement. It may feel like
spinning, whirling, or tilting. Vertigo may make you sick to your stomach, and
you may have trouble standing, walking, or keeping your balance.

Certain health conditions and medicines weaken the immune system’s ability to fight off infection and
illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease,
    and HIV/AIDS.
  • Long-term alcohol and drug
    problems.
  • Steroid medicines, which may be used to treat a variety
    of conditions.
  • Chemotherapy and radiation therapy for
    cancer.
  • Other medicines used to treat autoimmune
    disease.
  • Medicines taken after organ transplant.
  • Not
    having a spleen.

If you’re not sure if a fever is high, moderate, or mild,
think about these issues:

With a high fever:

  • You feel very hot.
  • It is likely one of
    the highest fevers you’ve ever had. High fevers are not that common, especially
    in adults.

With a moderate fever:

  • You feel warm or hot.
  • You know you have
    a fever.

With a mild fever:

  • You may feel a little warm.
  • You think
    you might have a fever, but you’re not sure.

Pain in adults and older children

  • Severe pain (8 to 10): The pain
    is so bad that you can’t stand it for more than a few hours, can’t sleep, and
    can’t do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your
    normal activities and your sleep, but you can tolerate it for hours or days.
    Moderate can also mean pain that comes and goes even if it’s severe when it’s
    there.
  • Mild pain (1 to 4): You notice the pain,
    but it is not bad enough to disrupt your sleep or activities.

Symptoms of a stroke may
include:

  • Sudden numbness, tingling, weakness, or paralysis
    in your face, arm, or leg, especially on only one side of your body.
  • Sudden vision changes.
  • Sudden trouble speaking.
  • Sudden confusion or trouble understanding simple statements.
  • Sudden problems with walking or balance.
  • A sudden,
    severe headache that is different from past headaches.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and
    arrange for care.
  • If you cannot reach your doctor or you don’t have
    one, seek care in the next hour.
  • You do not need to call an
    ambulance unless:

    • You cannot travel safely either by driving
      yourself or by having someone else drive you.
    • You are in an area
      where heavy traffic or other problems may slow you down.

Seek Care Today

Based on your answers, you may need care soon. The
problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms
    and arrange for care.
  • If you cannot reach your doctor or you don’t
    have one, seek care today.
  • If it is evening, watch the symptoms and
    seek care in the morning.
  • If the symptoms get worse, seek care
    sooner.

Make an Appointment

Based on your answers, the problem may not improve without medical
care.

  • Make an appointment to see your doctor in the
    next 1 to 2 weeks.
  • If appropriate, try home treatment while you
    are waiting for the appointment.
  • If symptoms get worse or you have
    any concerns, call your doctor. You may need care sooner.

Call 911 Now

Based on your answers, you need
emergency care.

Call 911 or other emergency services now.

Head Injury, Age 4 and Older
Ear Problems and Injuries, Age 11 and Younger

Home Treatment

Home treatment may be all that is
needed to relieve minor or intermittent ear discomfort.

  • To ease ear pain, apply a warm washcloth. There may be some drainage from
    the ear when the heat melts
    earwax.

    • Do not use a heating pad when you are in bed. You may fall asleep and burn yourself.
    • Do not use a heating pad on
      a child.
  • Try an
    ice or cold pack to reduce swelling from a minor injury or sunburn. Apply
    for 15 minutes 3 or 4 times a day during the first 48 hours after the injury.
    The sooner you apply a cold pack, the less swelling you are likely to have.
    Place a cloth between the ice and your skin.
  • Oral or nasal
    decongestants may relieve ear pain, especially if the
    pain is related to fluid behind the eardrum (otitis media with effusion). Avoid products that contain antihistamines, which tend to
    cause more blockage, unless allergies seem to be the problem.
  • Chewing gum may help relieve pressure changes
    in the ear, such as when flying in an airplane.
  • Try a
    nonprescription earwax remover if your ear feels plugged but you do not have
    obvious
    signs of infection. Be sure to follow the label
    directions carefully.
  • Do not use ear candles. They have no proven benefit in the removal of earwax or the
    treatment of other ear problems, and they can cause serious injury.
Medicine you can buy without a prescription
Try a nonprescription
medicine to help treat your fever or pain:
Safety tips
Be sure to follow these
safety tips when you use a nonprescription medicine:
  • Carefully read and follow all directions
    on the medicine bottle and box.
  • Do not take more than the
    recommended dose.
  • Do not take a medicine if you have had an
    allergic reaction to it in the past.
  • If
    you have been told to avoid a medicine, call your doctor before you take
    it.
  • If you are or could be pregnant, do not take any medicine other
    than acetaminophen unless your doctor has told you to.
  • Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home
treatment:

  • Pain develops or increases.
  • Fever
    or other
    signs of ear infection develop.
  • New or
    different drainage from the ear develops.
  • Other symptoms develop,
    such as hearing loss or vertigo.
  • Your symptoms become more severe
    or frequent.

Prevention

You may be able to prevent ear
problems.

  • Teach your children to blow their noses gently.
    Remember to do this yourself also.
  • Keep soap and shampoo out of the
    ear canal. These products can cause itching, which can be mistaken for an ear
    infection because of the need to scratch or pull at the ears.
  • Do
    not put cotton swabs, bobby pins, or other objects (especially if they are
    sharp) in the ear canal.
  • Limit your contact with others who have
    colds, when possible.
  • Protect your ears from sunburn and frostbite.
    • Apply sunscreen to your ears and wear a hat
      that shades the ears in the summer.
    • Wear a hat that covers the ears
      in the winter.
  • Limit or avoid exposure to loud noises such as
    music, power tools, gunshots, and industrial machinery.
  • Wear
    protective earplugs or earmuffs if you can’t avoid loud noises.

    • Avoid the prolonged use of earplugs. They
      can cause irritation, itching, and can plug the ear with wax.
    • Do
      not use wadded-up tissue or cotton balls. These do not protect adequately
      against loud noises (especially the more dangerous high frequencies) and they
      may become lodged in the ear canal.
  • Avoid exposing children to cigarette smoke, which
    is linked with more frequent ear infections. If you smoke and are unable to
    stop, smoke outside, away from children.
  • Stop smoking. Smoking
    irritates the mucous membranes that line the nose, sinuses, and lungs, and it
    may contribute to inflammation or infection of the ear. See the topic
    Quitting Smoking.
  • If ear pain appears to
    be related to a problem with your jaw, see the topic
    Temporomandibular (TM) Disorders for tips on relaxing
    the muscles in this area.
  • Take good care of your teeth. Daily
    brushing and flossing, along with regular dental checkups, helps prevent tooth
    decay, infections, and other dental problems that can lead to referred ear
    pain.
  • If you wear hearing aids, be sure to follow the
    manufacturer’s recommendations carefully for cleaning and storing
    them.
  • For tips on how to prevent swimmer’s ear, see the topic
    Ear Canal Problems (Swimmer’s Ear).

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your
doctor diagnose and treat your condition by being prepared to answer the
following questions:

  • Do you have ear pain?
    • When did the pain start?
    • What
      were you doing when the pain started?
    • Does the pain come from the
      inside or the outside of your ear?
    • Has the pain been constant, or
      does it come and go?
    • Does anything make the pain better or
      worse?
  • Have you ever had this type of ear problem before?
    If yes, what was the diagnosis and how was it treated?
  • What other
    symptoms do you have? Do you have a fever, runny nose, cough, congestion, or
    jaw discomfort?
  • Do you suspect a hearing problem? Be prepared to
    describe your symptoms.

    • Do you have hearing loss or ringing in the
      ears (tinnitus)?
    • Does your hearing problem
      affect just one ear or both ears?
  • Do you use hearing aids?
  • Have you had a
    recent injury to the ear?
  • Do you have any other symptoms in your
    eye, teeth, jaw, facial muscles, or neck that might suggest
    referred pain?
  • Do you have drainage from
    the ear? If yes, what does it look and smell like?
  • Have you had
    problems with earaches or ear infections in the past?
  • Have you been
    swimming or had other recent exposure to water, such as through surfing,
    kayaking, or scuba diving?
  • Do you regularly use a hot tub or home
    spa?
  • Have you recently traveled by plane?
  • What home
    treatment measures have you used? Be sure to include nonprescription and
    prescription medicines you have tried.
  • Do you have any
    health risks?

Credits

ByHealthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP – Emergency Medicine
Kathleen Romito, MD – Family Medicine
Specialist Medical Reviewer Adam Husney, MD – Family Medicine

Current as ofApril 7, 2017