In this article:
Why do children suffer from earache more frequently than adults?
Earaches in children can be caused by external or middle ear infections. Middle ear infections are known as otitis media and are much more common in kids.
Children have a skull shape that causes their Eustachian tube (the tube that connects the middle ear, where most ear infections occur, to the back of the nose) to be flat and narrow.
The flat and narrow Eustachian tube gets blocked easily and a poorly ventilated middle ear then gets easily infected or filled with fluid.
This, coupled with the increased frequency of viral upper respiratory infections as their immune system is still developing, leads to a much higher incidence of middle ear infections especially in ages 6 months to 3 years.
External ear infections, also known as swimmers’ ear, are seen in older children who swim.
They can also be seen in combination with middle ear infections when the latter cause eardrum rupture and drainage of fluid into the ear canal.
External ear infections are often associated with ear drainage or swelling of the external ear canal.
Why does earache usually worsen during the night?
Ear pain tends to be worse at night, particularly when you lie down to sleep.
Because you are not in an upright position, the fluid in the ear flows into the Eustachian tube due to the lack of gravity-assisted drainage.
The congestion in the Eustachian tube is made worse by the swelling brought on by an ear infection, which causes further accumulation of pus within the ear and triggers pain.
Additionally, kids are usually given medications such as Tylenol or Motrin to reduce fever or pain, but their effects often wear off during sleep time.
As a result, the medicated children and sometimes even adults wake up from their sleep with severe ear pain.
Lastly, you are usually distracted during the day, which keeps your mind off the pain. However, as you lie down to sleep, your brain can focus more on the pain that was not as noticeable before.
Can sinus infection lead to earache?
Yes, sinus infections can often lead to ear infections in children or adults who are prone to ear infections.
Sinus infections cause swelling and drainage of pus in the back of the nose or the nasopharynx.
This can cause irritation and swelling in the ear and allows the easy spread of the viral or bacterial infection to the middle ear space via the Eustachian tube.
Is putting a few drops of olive oil in the aching ear helpful in relieving earache?
Although there is no scientific literature or evidence to support the claim that putting a few drops of olive oil in your ear can help relieve earache, different variations of this treatment have been used across many cultures.
Is it possible to cure earache without any medication?
Our bodies can actually fight ear infections and heal without antibiotics.
According to the guidelines of the American Academy of Pediatrics, keeping your child under careful observation should be enough to address a unilateral ear infection (one side only).
This may be the case if the child is older than 6 months, does not have a high fever or any other signs suggesting severe ear infection, and is up-to-date with his/her immunization schedule.
If the child has a bilateral ear infection and is older than 2 years old, does not have a high fever, and has no complications or indications of a severe ear infection, then once again careful observation can be instituted.
However, the child should be seen within 24-48 hours for follow-up by the health care providers.
Meanwhile, antibiotic treatment becomes a must to treat middle ear infections in the following cases:
- All infants less than 6 months of age
- All kids less than 2 years of age with a bilateral ear infection
- Any child or adult with signs of severe ear infection such as high fever (>102.2 °F), irritability, significant pain, ear drainage, bulging and red eardrum, and redness around the ear especially at the back of the ear and those who are behind on their immunization schedule
- Any child or adult who is unavailable for close follow-ups
In adults, earaches can be due to many causes.
If the pain is due to jaw joint dysfunction, then applying heat, massaging the chewing muscles, avoiding chewing for a few weeks, and using a tooth guard can be helpful.
Most external ear infections can be treated with a variety of antibiotics or antifungal ear drops, but one home remedy that can be used, especially to prevent external ear infections, is “ear beer.”
Ear Beer is made by mixing one-part rubbing alcohol with one-part white vinegar. Put 5 drops of this solution into the affected ear after swimming, or once a week in general, to keep external ear infections at bay.
What are the important points to remember while addressing an earache?
Earaches have different causes in children and adults.
In most children, the cause is a middle ear infection, which warrants medical evaluation by a primary care physician/provider.
Ear infections are more prevalent among kids who:
- Are bottle-fed while lying on their back
- Are regularly exposed to irritants such as smoke
- Go to daycare
- Have a family history of ear infections
- Develop allergies as they get older
Some avoidable risk factors include making sure the baby is either breastfed or bottle-fed in a more upright position and avoidance of cigarette smoke or wood-burning stoves.
- Never use a Q-tip inside the ear canal as that can cause trauma and can damage the sensitive inner lining of the ear, often paving the way for external ear infections.
- In adults, earaches are usually triggered by an ear infection, which includes both an external ear infection and a middle ear infection
- Adults with diabetes should be very careful and have their external ear infection treated aggressively and promptly to keep the infection from spreading outside the ear canal.
- Jaw joint dysfunction can also induce ear pain in adults.
In rare cases, ear pain may be traced back to some form of cancer, which can be far more worrying.
Thus, persistent ear pain without a clear-cut cause should be referred to an ENT doctor for further evaluation. This will help rule out any serious underlying health concern.
Can earache be a symptom of cancer?
In adults, persistent ear pain, especially if associated with a history of smoking and drinking and no significant history of ear problems, can be a concerning symptom that warrants referral to an ENT specialist.
Ear pain can be symptomatic of cancer in the following cases:
- Throat cancer causes referred pain. The nerve that innervates the throat also innervates the eardrum and hence irritation of throat can often lead to referred pain to the ear.
This is also why sore throat-inducing tonsillitis can also cause ear pain.
- Cancer in the back of the nose (nasopharynx) or rarely nasal cancer can block the Eustachian tube, usually causing a buildup of ear fluid and less commonly an ear infection.
- It is very rare to have primary cancer of the ear but that can cause ear pain as well.