Ear aches are usually caused by an ear infection, also called otitis media. It's one of the most prevalent conditions in infants and children, especially those between the ages of 6 months and 2 years. Ninety percent of children will experience at least one ear infection with fluid buildup by the time they enter school, according to the American Academy of Pediatrics (AAP).
In adults, ear aches do not commonly stem from infection and more likely result from "referred" pain - discomfort that actually begins somewhere other than the ear. Its origin can be dental, throat or temporomandibular joint (TMJ) pain.
Ear aches can also happen after insects or objects get into the ear. Patients -- especially children -- may insert a variety of small items including beans, cotton swabs, erasers and toys. Ear wax buildup is another source of ear aches.
Signs of Ear Infection
Pain is only one of the symptoms of an ear infection. Others include:
- Pressure in one or both ears
- Distorted hearing
- Fever
- Drainage
- Crying, irritability, sleeplessness, pulling on ear (especially in infants)
- Nausea, vomiting or diarrhea (mostly in infants)
Causes of Ear Aches
The visible part of the ear and the ear canal are known as the outer ear. Further inside are the eardrum, the middle ear, inner ear and eustachian tube, a passageway that runs from the middle ear to the nose.
Colds and allergies can create fluid (effusion) in the ear, just as they do in the nasal passages. The eustachian tubes are designed to let fluid drain out of the middle ear. If the middle ear is infected by bacteria or a virus, it can swell and trap the liquid. The small and narrow dimensions of children's eustachian tubes make kids more susceptible to ear infections than adults.
Another cause of obstruction is the overgrowth of adenoid glands, located near the ear. If adenoids are overgrown, fluid can accumulate and affect hearing (even if there is no infection).
Diagnosing Ear Aches
Pulling on the affected ear can help determine what the issue is. If tugging doesn't make it hurt more, it is probably a middle ear infection. This type may involve effusion but doesn't always.
Pulling on the outer ear will increase the pain of outer ear infection, or swimmers ear, which is more common in older children and adults.
If symptoms persist for a day or more, the child should see a doctor. Even medical professionals may have trouble making a determination, especially in very young children: Crying might cause reddening of the eardrums or ear wax could block a doctor's view.
Treatment of Ear Aches
Treatment depends on the origin of the pain, the kind of ear infection, its severity and the age of the child. In 2004, the AAP released guidelines with new criteria for which patients should receive prescription antibiotics for middle ear infections:
- All those under six months
- Children between six months and two years with certain diagnosis
- Those under two with tentative diagnoses but severe symptoms
- Children with chronic ear infections
Children over two who've been diagnosed but have mild symptoms and no significant history of infections should be observed for 48 to72 hours before antibiotics are prescribed. During the observation period, pain relievers such as acetaminophen or ibuprofen -- but never aspirin -- can be taken as needed.
In one isolated 2007 incident, the ear infections of several Rochester, N.Y. children were resistant to all antibiotics approved for children. A medication usually prescribed for adults was the cure.
In many cases, persistent ear infections in children can be alleviated through a procedure called tympanostomy tube placement. Doctors typically recommend this surgery for those who've had three middle ear infections in six months, four in 12 months or hearing loss caused by trapped fluid for three months. It requires the child to undergo general anesthesia before a slim tube is inserted into the eardrum. Children can resume normal activities the next day.
Treatment of swimmers ear often involves antibiotic ear drops to fight infection. The drops may also contain corticosteroids to reduce itching and inflammation. Pain relievers are prescribed in severe cases.
Objects such as bugs, plants, food or small batteries should be removed by a doctor as soon as possible to prevent infection or burns. If the insect is buzzing, you can place a drop of mineral oil in the ear to kill it before a doctor's visit. If symptoms are minor, other objects can remain in the ear for several hours or overnight.
Do not use a cotton swab to remove ear wax because it may push the wax in further. Warm water from the shower or over-the-counter drops can melt the wax. See a doctor if you still have symptoms after three days.
Prevention
Ear infections are not contagious, but many stem from colds. Avoiding other children and adults who have colds is one of many ways to prevent middle ear infections. Others include:
- Giving your child a vaccine called Prevnar
- Breast feeding your baby for 6 months to 1 year
- Keeping children away from cigarette smoke
- Never "propping" a bottle or giving your baby a bottle when he or she is horizontal
- Treating any known allergies
- Asking your doctor to check your child's adenoid
Swimmers' ear can be avoided with the use of over-the-counter drops, ear plugs or shaking the head sideways, to remove water from ears after swimming.
Prevention and treatment not only relieve symptoms, but also prevent long term implications in children such as delayed language development. Early research also indicates children with frequent ear infections stand a greater chance of becoming obese as an adult, perhaps because ongoing infections damage nerves that control taste.
Related Ear Aches Sources
About.com Cancer: Six Common Oral Cancer Symptoms [1]
About.com Childcare: What is Acute Otitis Media? [2]
About.com Cold and Flu: What is Otitis Media? [3]
About.com Ear, Nose and Throat Disorders: Ear Infections - How to Treat Ear Infections [4]
About.com Headaches: Headache and Pressure in Ear [5]
About.com Pediatrics Ear Infections [6]
About.com Pediatrics Ear Tubes [7]
About.com Pediatrics Ear Fluid and Language Development [8]
About.com Pediatrics Swimmer's Ear [9]
About.com Health Topics A to Z: Ear Aches [10]
About.com Health Topics A to Z: Ear Infections (Otitis Media) in Children [11]
About.com Pediatrics Persistent Middle Ear Fluid [12]
About.com Pediatrics Treatments [13]
About.com Pediatrics Vaccine [14]
About.com Surfing: Surfer's Ear - Exostosis [15]
About.com Swimmer's Ear Symptom Checker [16]
About.com Swimming: Ear Ache from Swimming - Swimmer's Ear [17]
About.com Swimming: Treating Swimmer's Ear at Home [18]
About.com Video: Ear Tubes and Tympanostomy [19]
American Academy of Pediatrics: Clinical Guidelines Abstract from the journal Pediatrics [20]
American Academy of Pediatrics: Guidelines for Treatment [21]
Brigham and Women's Hospital: Ear Wax [22]
Cleveland Clinic: Ear Infections [23]
Cleveland Clinic: Ear Infections and Your Child [24]
Cleveland Clinic: Children's Ear Infections [25]
Cleveland Clinic Swimmer's Ear [26]
Drugs.com: Adults' Ear Infections [27]
FamilyDoctor.org: Ear Infections [28]
Kids Health: Ear Infections [29]
FamilyDoctor.org: Ear Infections with Fluid [30]
HealthBasis: Earache [31]
Mayo Clinic: Ear Infections Definition [32]
Mayo Clinic: Ear Tubes [33]
Mayo Clinic: Symptom Checker [34]
MedicineNet: Objects in Ear [35]
National Institutes of Health: Ear Infections [36]
National Institute on Deafness and Communication Disorders: Ear Infections [37]
Science Daily: Antibiotic-Resistant Ear Infections [38]
University of Michigan: Ear Infections [39] [40]
Web MD: Children's Ear Infections Linked to Obesity [41]
Mayo Clinic Symptoms of Swimmer's Ear [42]