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Otalgia: Ear Pain – Causes and Treatment

Otalgia is the medical term for ear pain, a common symptom with many possible causes. Learn about causes, diagnosis, and treatment options.

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Things worth knowing about "Otalgia"

Otalgia is the medical term for ear pain, a common symptom with many possible causes. Learn about causes, diagnosis, and treatment options.

What is Otalgia?

Otalgia is the medical term for ear pain. The pain may originate in the external ear canal, the middle ear, or deeper structures. A distinction is made between primary otalgia, where the source of pain is directly within the ear, and secondary (referred) otalgia, where the underlying cause lies outside the ear – for example, in the teeth, jaw joint, or throat.

Causes

Otalgia can be triggered by a wide variety of conditions:

Primary Causes (Disorders of the Ear)

Otitis media: Middle ear infection – especially common in children
Otitis externa: Inflammation of the outer ear canal, often after water exposure
Barotrauma: Pressure-related injury from flying or diving
Foreign body in the ear canal
Cerumen impaction: Earwax blockage
Herpes zoster oticus (Ramsay Hunt syndrome): Viral inflammation with severe pain

Secondary Causes (Referred Pain)

Dental and jaw disorders (e.g., tooth decay, wisdom tooth problems)
Temporomandibular joint (TMJ) disorders
Tonsillitis or peritonsillar abscess
Cervical spine disorders
Inflammation or tumors of the oral cavity and throat

Symptoms

In addition to ear pain itself, accompanying symptoms may point to the underlying cause:

Pressure or fullness in the ear
Hearing loss or a sensation of numbness
Discharge from the ear (otorrhea)
Fever (in infectious causes)
Dizziness or balance disturbances
Tinnitus (ringing in the ears)
Pain when chewing or swallowing (in secondary otalgia)

Diagnosis

Diagnosis begins with a thorough medical history and an otoscopy – examination of the ear canal and eardrum using an otoscope. Depending on the findings, further tests may be required:

Audiometry: Hearing test to assess hearing function
Tympanometry: Measurement of eardrum mobility
Imaging: CT or MRI if a serious underlying cause is suspected
Dental or orthodontic examination: If a dental cause is suspected
Laboratory tests: If a systemic condition is suspected

Treatment

Treatment depends on the underlying cause:

Pharmacological Treatment

Analgesics (pain relievers) such as ibuprofen or paracetamol to relieve pain
Antibiotics for bacterial infections (e.g., otitis media)
Ear drops for otitis externa or earwax blockage
Antiviral medications for herpes zoster oticus
Corticosteroids to reduce inflammation in certain conditions

Non-Pharmacological Treatment

Application of heat to relieve pain
Removal of foreign bodies or earwax plugs by a healthcare professional
Physiotherapy for temporomandibular joint problems
Dental treatment for dental causes

When to See a Doctor?

Severe, persistent, or recurring ear pain should always be evaluated by a medical professional. Urgent medical attention is especially recommended in cases of:

Fever above 38.5 °C (101.3 °F)
Discharge from the ear
Sudden hearing loss
Dizziness or balance problems
Ear pain in children under 2 years of age

References

Earwood, J.S., Rogers, T.S., Rathjen, N.A.: Ear Pain: Diagnosing Common and Uncommon Causes. American Family Physician, 2018; 97(1):20-27. Available at: https://www.aafp.org/afp/2018/0101/p20.html
Lalwani, A.K. (Ed.): Current Diagnosis and Treatment in Otolaryngology – Head and Neck Surgery. 3rd edition. McGraw-Hill, New York, 2012.
World Health Organization (WHO): Ear care. Available at: https://www.who.int/health-topics/ear-care

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