Earache can be either a dull or burning pain in one or both ears and it may persist for several days or ease after a few minutes; all depending on the cause.  Whatever the reason for developing earache, it is important to seek prompt treatment to ease the pain and to lessen the possibility of causing hearing loss.  

The outer ear (ear lobe) leads to the ear drum, sealing off the middle and inner ear from substances entering the ear canal. The middle ear is connected to a tube, the eustachian tube, which goes to the back of the throat.  If this tube gets blocked then fluid can build up and cause an ear infection.  

Ear infections caused by fluid in the middle ear is generally the cause of earache in children, who may signal this by pulling at their ear lobe.  It may affect one or both ears.  Other symptoms of an ear infection apart from pain include fever, irritability and feeling unwell. There may be hearing loss but this usually temporary unless the infection is persistent or not treated with the correct medicine or for long enough.

Adults may complain of earache when they have sinus or throat infections causing the eustachian tube blockages, and also from what is called ‘referred pain’ from dental infections or from a nerve that runs down the jaw line. This may occur in one or both ears, depending on the cause.

Earache may also be caused by changes in pressure, such as experienced with altitude change or when an aircraft drops altitude when landing. This is usually relieved by attempting to swallow frequently, suck on a drink if an infant, or by chewing gum, thus relieving the pressure change by unblocking the eustachian tube.  

‘Swimmers ear’ may also cause earache because of low grade infections or irritation of the ear drum, and is resolved by using drops to dry out the ear canal used after the ears are wet from showering, shampooing hair and from swimming.  

Physical damage to the outer ear may be caused by over-enthusiastic drying and ear wax removal from using cotton tipped applicators or other implements to remove ear wax.  This is best avoided as it can also lead to infections of the ear canal. If earwax is a concern then use special products available from your pharmacy to soften and remove the wax.

If you or your family suffer from earache then seek help as soon as possible. Your community pharmacist has products and advice to help you treat and prevent simple ear problems, and can refer you to your doctor if further help is required to resolve the cause of the pain.

Simple methods to relieve pain before you can get help include using warm face cloths or wheat bags to diffuse the sharp pain that is the sign of an infection. Paracetamol can also help relieve the pain in the short term, provided there is no fluid leaking from the ear. Remember to check for a safe effective paracetamol dose.

See your doctor immediately if there is a sharp pain or leakage of fluid from the ear canal, severe headache or swelling around the ear as this may be a symptom of a more serious condition.

If you have concerns about ear pain or recurrent issues with earache for you or your family then your community pharmacist is the best first step to manage this distressing symptom. And remember, the smallest thing one should put in one’s ear is one’s elbow.