Otalgia – Ear Ache or Pain

What Is Otalgia?

Otalgia is the medical word for ear ache or ear pain. It may be burning, stabbing, dull, sharp, sore, full, or clogged. There are many causes that range from benign to serious. Benign causes are more common than serious ones.

What Causes Otalgia?

There are two categories of otalgia. Primary otalgia is caused by a problem with the ear. Referred otalgia is caused by a problem of another structure usually near the ear. Referred otalgia is much more common than primary otalgia.

What Are Common Ear Causes of Otalgia?

Ear infections are the most common cause of ear pain in this category. Swimmer’s ear (infection of the ear canal) and otitis media (fluid or infection behind the ear drum) cause primary ear pain. Trauma to the ear with a cotton tipped applicator or finger nail may also cause ear pain and ear wax impaction. Dull ache or fullness may also result be experienced. Under ventilated ears (Eustachian tube dysfunction) or excess fluid in the inner ear (Meniere’s syndrome) should be considered by your doctor. Very rarely otalgia is a sign of malignancy (cancer) of the ear. Usually primary ear pain will cause hearing loss, tinnitus, or vertigo as a clue that the ear is directly involved.

What Are Common Causes of Referred Otalgia?

In referred otalgia, other ear symptoms like hearing loss, tinnitus, or vertigo are usually absent. The jaw joint and muscles are the most common cause of referred otalgia. Anxiety, stress, bruxism (grinding teeth), large bites of food, excessive yawning, nail biting, and excessive gum chewing are risk factors. Strain of the chewing muscles or sprain of the jaw joint can occur.

Neck pathology can also cause referred otalgia. Anxiety, stress, arthritis, whiplash injury, excessive office work, excessive cell phone scrolling, and neck popping are risk factors.

Gingivitis, cavities, and infected or abscessed teeth can cause referred ear pain along with dental problems.

Trigeminal neuralgia (nerve pain) may cause referred ear pain along with stabbing cheek pain after light touch or wind exposure.

Cancers of the head and neck may cause referred ear pain. Throat cancer may present with ear pain associated with difficulty swallowing or hoarseness. Cancer of the salivary glands may cause ear pain, mass of the cheek/jaw/neck, or facial droop.

Where Does Treatment Start?

With otalgia, the response to treatment can be useful to help find the culprit. Most causes are not serious. Conservative treatment is a good place to start. If you have risk factors for jaw strain/sprain, begin by resting your jaw. Maintain a soft diet for 1 week. Stop chewing gum and hard candies. Apply ice and/or heat to your jaw joint. Take ibuprofen daily for a week. Consider talking to your dentist about a bite guard to wear at night so that you do not grind your teeth. Also, if you have hurting teeth, you may be compensating your bite in a way that strains your jaw. Have this evaluated by your dentist as well.

If you have risk factors for neck strain take regular breaks when straining you neck. Stop habitual popping or cracking your neck. Take breaks from looking down at your cell phone. Take ibuprofen daily for a week. Consider neck physical therapy especially if you have had a whiplash injury.

If conservative measures do not work or if you have red flag symptoms such as hearing loss, tinnitus, vertigo, difficulty swallowing, hoarseness, mass, facial droop an evaluation of your ear pain is recommended. It is important to find the cause of persistent ear pain and make sure the ear is healthy.