Ear pain usually comes from an infection or inflammation in the ear itself, but it can also be referred pain from your jaw, teeth, throat, or neck. In children, a middle ear infection is the most likely culprit. In adults, the pain often originates somewhere else entirely, with jaw problems and dental infections topping the list.
Understanding where your pain is coming from is the first step toward relief. Here are the most common reasons your ear hurts and what you can do about each one.
Middle Ear Infection
A middle ear infection, called otitis media, is the classic earache. It happens when bacteria or viruses get trapped behind the eardrum, often after a cold or upper respiratory infection. The two most common bacteria responsible are the same ones that cause sinus infections and pneumonia. Viruses that cause the common cold can trigger it too.
The pain tends to be deep, steady, and sometimes throbbing. You may also notice muffled hearing, fever, or fluid draining from the ear. In young children who can’t describe their symptoms, watch for tugging at the ear, fussiness, difficulty sleeping, or unexplained fever. Middle ear infections are far more common in kids than adults, partly because their eustachian tubes (the tiny channels connecting the middle ear to the back of the throat) are shorter and more horizontal, making them easier for germs to reach.
Swimmer’s Ear (Outer Ear Infection)
If the pain gets worse when you pull on your earlobe or press the small flap in front of your ear canal, you likely have an outer ear infection. About 90% of these are bacterial, with the remaining 10% caused by fungal infections. Water trapped in the ear canal after swimming or bathing creates the perfect breeding ground, which is why it’s called swimmer’s ear.
In the early stages, you’ll notice itching and slight redness inside the canal, along with mild discomfort. As it progresses, the pain intensifies and you may feel fullness in the ear as swelling and debris partially block the canal. Hearing often becomes muffled. In advanced cases, the pain can radiate to your face, neck, or the side of your head, and you may see fluid or pus draining from the ear.
Eustachian Tube Dysfunction
Your eustachian tubes equalize pressure between your middle ear and the outside world. When they get blocked or swollen, usually from allergies, a cold, or sinus congestion, pressure builds up and causes pain. The hallmark symptom is muffled hearing that makes everything sound like you’re underwater. You might also notice clicking or popping sounds, a sense of fullness, ringing in your ears, or dizziness.
This often resolves on its own, but if symptoms last more than two weeks, it’s worth getting checked. Simple tricks can help in the meantime: chewing gum, yawning, swallowing frequently, or trying the Valsalva maneuver (gently blowing out while pinching your nose shut and keeping your mouth closed). A saline nasal spray can also help clear the passages that connect to your eustachian tubes. Over-the-counter antihistamines or steroid nasal sprays can reduce the swelling if allergies are the underlying cause.
Earwax Buildup
A surprising amount of ear pain comes from impacted earwax. When wax builds up and hardens against the eardrum, it can cause an aching sensation, muffled hearing, and sometimes drainage. The temptation to dig it out with a cotton swab or bobby pin makes things worse by pushing the wax deeper and risking damage to the ear canal or eardrum.
Safe options include softening the wax with mineral oil, olive oil, or saline drops, which help it migrate out naturally. Over-the-counter drops containing carbamide peroxide also work well. If that doesn’t clear it, a healthcare provider can flush the ear with warm water or remove the wax with a small curved tool or suction. Skip ear candling entirely. Research shows it doesn’t work and can cause burns. Essential oils like tea tree or garlic oil are also unproven and not recommended. If you have an active ear infection, don’t use any ear drops unless a provider tells you to.
Pressure Changes From Flying or Diving
Rapid altitude changes during flights or underwater diving can cause barotrauma, a sharp, sometimes intense pain as the air pressure outside your ear shifts faster than the pressure inside. It typically hits during takeoff, landing, or changes in dive depth.
Prevention works better than treatment here. Chew gum during takeoff and start again before the plane begins descending. Blow your nose gently into a tissue. Try the Valsalva maneuver to push air into your eustachian tubes. Pressure-regulating earplugs, available at most pharmacies, can also help by slowing the rate of pressure change reaching your eardrum. If you’re congested from a cold or allergies, flying or diving carries a higher risk of barotrauma because swollen eustachian tubes can’t equalize pressure effectively.
Pain That Starts Somewhere Else
In adults, the most common cause of ear pain isn’t actually in the ear. The nerves supplying your ear also branch to your jaw, teeth, throat, and neck, so problems in any of those areas can produce pain that feels like it’s coming from your ear.
The two biggest offenders are jaw joint problems and dental infections. If you clench or grind your teeth, have jaw clicking, or notice that the pain worsens when you chew, your temporomandibular joint (TMJ) is a likely source. A tooth abscess can produce severe, throbbing pain that radiates from the tooth to the jawbone, neck, and ear. Sometimes the ear pain is more noticeable than the tooth pain itself.
Sore throats, tonsillitis, and sinus infections can also send pain to the ear through shared nerve pathways. Less commonly, neck problems like cervical spine degeneration irritate nerves that refer pain to the ear. In rare cases, ear pain has even been reported as a presenting symptom of heart problems due to irritation of the vagus nerve, though this is uncommon.
Managing Ear Pain at Home
For most types of ear pain, over-the-counter pain relievers provide meaningful relief. Ibuprofen helps with both pain and inflammation, while acetaminophen targets the pain itself. Adults and children 12 and older can take combination tablets containing both. Don’t exceed six combination tablets per day, and keep total acetaminophen under 4,000 milligrams in 24 hours from all sources. For children under 12, dosing should come from a pediatrician.
A warm compress held against the ear can also ease discomfort. If you suspect a middle ear infection in a child, keeping their head slightly elevated during sleep may reduce pressure on the eardrum.
When Ear Pain Needs Urgent Attention
Most ear pain improves within a few days, but certain symptoms signal something more serious. Thick, yellow, bloody, or foul-smelling discharge from the ear, sudden hearing loss in one or both ears, or ear pain accompanied by high fever all warrant prompt medical care. For young children, hearing problems deserve especially quick attention because hearing directly affects language development. If you notice facial weakness or numbness alongside ear pain, or if the pain is severe and spreading, don’t wait to get evaluated.