Owwwww! Why Does My Ear Hurt So Much?

Ear pain is a common symptom. Many people find it unbearable, similar to a tooth ache. It can seem so severe because it is in your head and so is difficult to ignore. Working as an Emergency Doctor it is one of the commonest reasons I see people with accidental overdoses of painkillers.  People keep taking them because they can't stand it.

The commonest cause of ear pain is a middle ear infection. When the Eustachian tube

swells and becomes blocked fluid builds up in the middle ear. The tube connects the middle ear space with the passage in the nose. The fluid then becomes infected, and more of it forms. The pressure in your ear increases and pain occurs.

The tympanic membrane is stretched, this is one of the main causes of the pain. Eventually it may rupture, relieving the situation. In this case the pain builds to a crescendo and is relieved suddenly with a rush of pus and blood.

If you think you may have an ear infection or have ear pain you must visit your doctor. You may need some treatment such as eardrops or tablet antibiotics. Once the eardrum bursts treatment is not usually required as air can now get into the middle ear space. This kills the germs and dries the area out.  Most of the germs which cause middle ear infections are killed by air.  They usually grow in the blocked off space behind the eardrum.  The medical name for this is 'anaerobic'.

It is often worth speaking to a pharmacist as they will be able to recommend over the counter medications.  These include pain killers, anti-inflammatories and decongestants.

If you have an infection it is worth avoiding swimming. Definitely do not stick anything in your ear, including your finger. This can make infection and inflammation worse. Pen lids and finger nails can tear the delicate skin, worsening the pain.

Dr Toby Bateson

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