An infection of your ear canal is called otitis externa or swimmer's ear. Learn about the symptoms of ear canal pain and why the inside of your ear hurts.
6 most common cause(s)
Ear canal pain symptoms
Your ear canal is about one inch long and runs from your eardrum to the outer opening of your ear. It tends to be a common location for painful infection, especially in young children and in swimmers. However, your doctor can easily treat this condition, and there are several things you can do to keep it from happening again. Ear pain is also called otalgia. An infection of your ear canal is called otitis externa or swimmer's ear.
Common characteristics of ear canal pain
If you're experiencing ear canal pain, it can likely present as:
- Moderate to severe pain just inside your ear
- Itching within your ear: This itchiness may intensify if you pull on the outside of your ear.
- Feeling that your ear is blocked, full, or under pressure
- Discharge: A thick greenish or yellowish drainage of pus may come from within the ear.
- Difficulty hearing
- Red, swollen skin around the opening of your ear: The skin may also look rough and scaly.
Common accompanying symptoms
It's also likely to experience the following.
- Fever
- Feeling tired and ill
- Swollen lymph nodes in your upper neck
- Poor appetite in babies and toddlers
Who is most often affected by ear canal pain?
The following people are more likely to experience ear canal pain.
- Children
- Anyone swimming regularly: Especially in non-chlorinated water such as lakes, rivers, or the ocean
- Anyone diving from heights: Diving can force water into the ear canal.
Are ear canal pain symptoms serious?
The severity of ear canal pain depends on the cause.
- Not serious: A mild earache, treated right away, will usually clear up readily with no lasting effects.
- Moderately serious: If not treated properly or precautions are not taken, such as refraining from using cotton swabs or other objects for cleaning, infections can become recurrent and never really heal.
- Serious: Neglected infections can become severe because the infection can spread and permanently damage your hearing.
Causes of ear canal pain
The following details may help you better understand your symptoms and if and when you need to see a physician.
Most common causes
The most common causes of ear canal pain include the following.
- Infections: Bacterial or fungal infections may occur if you submerge your head in a hot tub, swimming pool, lake, river, or ocean. If the water becomes trapped in your ear canal, the bacteria or fungus can multiply. The risk of infection increases if you have a buildup of earwax inside your canal or you have damage within your canal (a scratch, cut, or scrape) from cotton swabs or other instruments.
- Irritants: Irritation from hair color, hairspray, etc. may find its way inside your ear.
- Itching: Your ear may itch from a case of dermatitis or eczema that spread from your arms or face.
Less common causes
Less common causes of ear canal pain include the following.
- Allergy: A contact allergy, from something you've touched, or a systemic allergy, from something you've consumed, can show up in the skin of your ear canal and cause itching and inflammation.
- Earplugs, hearing aids, Bluetooth devices, and other objects: Keep objects you place in your ear clean.
- Lodged foreign objects: Children will sometimes place small foreign objects inside the ear canal, which can scrape the skin and cause damage and infection.
Rare and unusual causes
Ear pain can be "referred" pain, meaning it is actually coming from somewhere else but is felt in your ear [5]. The pain may come from the teeth or jaw in teething children, an infection or inflammation in the structures of your mouth and throat, or a tumor growing in the vicinity.
9 ear canal pain conditions
This list does not constitute medical advice and may not accurately represent what you have.
Chronic earwax blockage
Earwax production is a normal process, as the body makes wax to protect the ear from infection. Sometimes ear wax can build up and cover the eardrum which is a thin layer of skin that stretches across the end of the ear canal and picks up sound from outside.
Rarity: Common
Top Symptoms: dizziness, dry cough, ear canal pain, ringing in the ears, ear fullness/pressure
Symptoms that always occur with chronic earwax blockage: ear canal pain
Symptoms that never occur with chronic earwax blockage: swollen ear, fever
Urgency: Phone call or in-person visit
Ear plug made of skin cells
Keratosis Obturans is a rare disease where materials that make up the skin create a plug in the ear, causing pain, discharge, and hearing changes.
Rarity: Rare
Top Symptoms: hearing loss, pain in one ear canal, ear discharge, hearing loss in both ears, severe ear canal pain
Urgency: Primary care doctor
Temporomandibular joint (TMJ) dysfunction disorder
Temporomandibular joint (TMJ) dysfunction disorder refers to long-term pain and dysfunction in the TMJ, the joint that connects the upper and lower jawbones.
The TMJ is a complex joint with complicated movements and is subject to strain and injury. Symptoms may come and go for no apparent reason. Misalignment of the teeth and jaw, and tooth grinding, are no longer believed to be a cause. Women seem to be more susceptible than men.
TMJ disorder has three types:
- Pain or discomfort in the muscles controlling the TMJ.
- Dislocation or injury to the jawbone.
- Arthritis of the TMJ.
Diagnosis is made through patient history, physical examination, and imaging. The goal is to rule out other causes such as sinus infection or facial nerve damage.
Due to the difficulty of diagnosing TMJ disorder, treatment begins with conservative methods that do not permanently change the jaw or teeth. Ice packs, soft foods, gentle stretching of the jaw muscles, and reducing stress are all encouraged. Short-term pain medications may be used. Splints, Botox, implants, and surgery are not recommended.
Rarity: Common
Top Symptoms: dizziness, pain, restricted movement, and clicking sounds from jaw, history of headaches, jaw pain, pain in the back of the neck
Symptoms that always occur with temporomandibular joint (tmj) dysfunction disorder: pain, restricted movement, and clicking sounds from jaw
Urgency: Primary care doctor
Swimmer's ear (otitis externa)
Swimmer's ear, or otitis externa, is an infection of the canal which runs from the eardrum to the opening of the ear.
It is caused by anything that introduces bacteria, fungus, or a virus into the canal. Water that stays inside the ear after swimming is a common cause, as are cotton swabs used for cleaning or earpieces that create irritation.
Most susceptible are children, because they have narrower ear canals that do not drain well.
Early symptoms include redness, itching, and discomfort inside the ear canal, sometimes with drainage of clear fluid.
Even mild symptoms should be treated because they can quickly get worse. The infection can spread and intensify, becoming very painful with increased drainage, swelling, fever, and loss of hearing.
Diagnosis is made through patient history and physical examination of the ear canal. Lab tests may be done on a sample of the discharge from the ear.
Treatment includes having a medical provider clean the ear canal of debris and discharge, and a prescription for antibiotic and/or steroid eardrops.
Rarity: Common
Top Symptoms: fever, ear canal pain, ear fullness/pressure, jaw pain, ear pain that gets worse when moving
Urgency: Primary care doctor
Middle ear infection
Middle ear infection, also called acute otitis media, is a bacterial or viral infection of the air-filled space behind the eardrum. An ear infection is usually secondary to a cold, allergy, or influenza.
Young children are most susceptible due to weaker immune systems and to the small size and shape of the Eustachian tubes in the ears. Children in group care settings are more exposed to colds and flu and therefore more prone to ear infections.
Symptoms include ear pain due to inflammation; drainage of fluid from the ear; and sometimes hearing difficulty. Children may cry, run a fever, and pull at the affected ear.
If symptoms last more than a day, a medical provider should be seen. Long-lasting or repeated ear infections can lead to hearing damage and to speech and learning problems.
Diagnosis is made through physical examination.
Middle ear infections often clear up on their own and antibiotics may only be needed for infants and severe cases. Warm compresses and over-the-counter pain relievers can be used. Do not give aspirin to children.
Rarity: Common
Top Symptoms: fatigue, sore throat, new headache, fever, ear canal pain
Symptoms that always occur with middle ear infection: ear canal pain
Symptoms that never occur with middle ear infection: vertigo (extreme dizziness), face weakness, facial numbness
Urgency: Primary care doctor
Glue ear (otitis media with effusion)
Glue ear is caused by fluid built up in the middle ear (under the eardrum). It happens more frequently in kids than adults because of having frequent colds and less developed tubes in the ear. In adults, it's caused by acute or chronic sinusitis in 66 percent of cases. It may also be caused by cigarette smoke, allergies, reflux, genetics, or bacteria, all of which stimulate the production of the fluid.
90 percent of cases resolve without treatment in 6 months. If you do go to the doctor, he/she would take a look in the ear to confirm the diagnosis. Adults can request vasoconstrictor nose sprays (Neo-Synephrine or Afrin), but that can't be used long term. Flonase can also be prescribed. Follow up with a doctor if things don't get better in 1 week!
Rarity: Common
Top Symptoms: ear fullness/pressure, constant hearing loss, hearing loss in one ear, trouble hearing that is better in noisy environments, ear canal pain
Symptoms that always occur with glue ear (otitis media with effusion): ear fullness/pressure, hearing loss in one ear, constant hearing loss
Symptoms that never occur with glue ear (otitis media with effusion): ear canal pain, fever
Urgency: Wait and watch
Earwax blockage
Ear wax production is a normal process, as the body makes wax to protect the ear from infection. Sometimes ear wax can build up and cover the eardrum, which is a thin layer of skin that stretches across the end of the ear canal and picks up sound from outside. Ear wax buildup has nothing to do with poor hygiene, and it is not possible to prevent a build-up by washing.
You should go to a retail clinic to be treated. You should NOT try removing the wax with cotton swabs, because you run the risk of pushing the ear wax further into the ear canal, and potentially damaging the ear canal or eardrum. A variety of ear drops exist that can be bought at the pharmacy, such as Debrox, Murine, and Cerumenex. You may also use other remedies such as mineral oil, baby oil, or glycerin ear drops instead of brand-name drops.
Rarity: Uncommon
Top Symptoms: dizziness, dry cough, ear canal pain, ear fullness/pressure, ringing in the ears
Symptoms that never occur with earwax blockage: swollen ear, fever
Urgency: Phone call or in-person visit
Cholesteatoma (a non-cancerous growth in the ear)
Cholesteatoma is a type of skin growth located in the ear, behind the eardrum. While it can be present from birth, it is usually caused by an ear infection. Symptoms include dizziness, hearing loss and pressure in the affected ear, and discharge from the affected ear.
You should consider visiting a medical professional in the next week or two to discuss your symptoms. Cholesteatoma can be evaluated with a review of your symptoms and an ear exam. Imaging such as a CT scan may be performed to rule out other conditions. Once diagnosed, it can be treated with ear cleaning, antibiotics, and eardrops. Surgery to remove the growth may be needed in some cases.
Rarity: Rare
Top Symptoms: ear fullness/pressure, ringing in the ears, pain in one ear canal, vertigo (extreme dizziness), hearing loss in one ear
Urgency: Primary care doctor
Burst ear drum
The ear drum is a thin membrane that vibrates as sound hits it, transmitting that vibration into signals that the brain understands! When it bursts, your hearing is affected. It typically happens after some force to the ear drum, such as a blow to the ear, an exploding firecracker, a fall onto water, or even a sharp object in the ear.
You should go to an urgent care center immediately. There, a doctor can confirm the diagnosis by looking in the ear. Further, he/she can clean out any debris and put in a protective cotton plug. Treatment involves keeping the ear dry to heal along with antibiotic ear drops (ofloxacin 5mL, 2-5 drops) if the ear is contaminated with dirty water or objects. You will then be referred to an otolaryngologist who will follow your recovery.
Rarity: Rare
Top Symptoms: ear canal pain, constant ear pain, ringing in the ears, vertigo (extreme dizziness), hearing loss
Symptoms that always occur with burst ear drum: ear canal pain, recent ear injury, constant ear pain
Urgency: Primary care doctor
Ear canal pain treatments and relief
When it is an emergency
Seek immediate ear canal pain treatment in the emergency room or call 911 if:
- You have severe, unrelenting ear pain: Along with fever, hearing loss, and sometimes deformity of your skull around your outer ear due to infection. There is a risk of this infection spreading to your brain or spinal cord.
- You have a painful earache and also have another condition: Such as diabetes, chronic kidney disease, or lung disease, or you are on chemotherapy
- You have ear canal pain with facial paralysis: Or you have a bloody discharge from your ear.
When to see a doctor
Schedule an appointment for the following.
- You have chronic ear infections that appear one after the other
- You have persistent itching within your ear
- You have excessive wax: A specialist can properly clean your ear without damaging your ear canal.
At-home treatments
Ear canal pain remedies you can try at home include the following.
- Make overall lifestyle changes: Strengthen your immune system through improvements in diet and exercise.
- Keep your ears dry: Keep your ears dry by using earplugs when swimming and remove them promptly afterward.
- Dry your ears if you do get wet: After swimming or showering, use a hair dryer on a low setting to dry the inside of your ears. You can also use over-the-counter after-swim drops to help prevent swimmer's ear.
- Avoid cleaning tools: Don't use cotton swabs (or any other object) to clean your ears. They can damage your skin and push dirt and germs farther into your ear canal, increasing chances of infection.
- Protect your inner ears: Place cotton balls in your ears when using hair color or hairspray.
- Heat or cold: Try a hot or cold compress on the painful ear.
- Pain medication: Take over-the-counter pain relievers such as ibuprofen (Advil, Motrin) or other non-steroidal anti-inflammatory drugs (NSAIDs).
Questions your doctor may ask about ear canal pain
- Any fever today or during the last week?
- Have you been experiencing dizziness?
- What makes your ear hurt worse?
- Have you noticed a change in your hearing?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
Ear canal pain statistics
People who have experienced ear canal pain have also experienced:
- 7% Sore Throat
- 7% Headache
- 5% Pain Behind The Ear
People who have experienced ear canal pain were most often matched with:
- 36% Middle Ear Infection
- 36% Swimmer'S Ear (Otitis Externa)
- 27% Temporomandibular Joint (Tmj) Dysfunction Disorder
People who have experienced ear canal pain had symptoms persist for:
- 43% Less than a week
- 25% Less than a day
- 13% Over a month
Source: Aggregated and anonymized results from Buoy Assistant (a.k.a. the quiz).
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References
- Ely JW, Hansen MR, Clark EC. Diagnosis of Ear Pain. American Family Physician. 2008;77(5):621-628. AAFP Link.
- Otitis Media (Middle Ear Infection). Columbia University: Department of Otolaryngology. ENT Columbia Link.
- Otitis Externa. NHS inform. Updated September 6, 2018. NHS inform Link.
- Earwood JS, Rogers TS, Rathjen NA. Ear Pain: Diagnosing Common and Uncommon Causes. American Family Physician. 2018;97(1):20-27. AAFP Link.
- Taziki MH, Behnampour N. A Study of the Etiology of Referred Otalgia. Iranian Journal of Otorhinolaryngology. 2012;24(69):171-6. NCBI Link.