Question: I have had this ear infection for more than a week. It causes me headaches, and the pain on both of my ears is unbearable. I was hoping you could help me by telling me the possible causes of this ear infection pain.
I wish I could give you an answer without knowing more about your problem. Unfortunately, there are many different causes of ear pain. Most can also cause facial pain as well.
An outer ear infection is a skin infection of the ear canal. Often, there can be a discharge, but not always. Typically, pulling hard on one’s ear lobe will be painful if that is the problem. This usually is treated with ear drops.
A middle ear infection is an infection in the space behind the eardrum. That typically comes with nasal congestion, such as from a cold, or can occur with the change in pressure- such as in airplane flights. Usually, the hearing will be diminished, and you won’t be able to “pop” your ears- that is opening the eustachian tube that goes to the back of the nose from the ear. It is usually (but now not always) treated with antibiotics and medications to open the nasal passages.
An inner ear infection is deep to these structures, commonly viral, and frequently presents with a hearing loss, with or without feeling dizzy.
There are also noninfectious causes of ear and facial pain.
Commonly people can have persistent pain in the ear and face from the jaw joint. That is the space just in front of the ear. If you push there and open and close your jaw, people with such problems, (TMJ) will experience tenderness and often pain. This pain can be quite severe (think of your back “going out”) and typically is worse with chewing. That is treated with warm compresses, a soft diet, and an anti-inflammatory such as Advil or Aleve.
Finally, one can have what we call “referred ear pain.” That is like when someone has a heart attack, and they get left shoulder pain. The nerves that go to the throat also go to the ear, so something like a bad sore throat, or rarely a tumor, can cause ear pain.
Unfortunately, it seems like the best idea would be to have your ear examined by someone who can help you find out which problem you have.
Robert Pincus MD
Co-director NY Sinus Center