Earaches are among the most common complaints that lead both children and adults to see their family doctor or an ENT specialist. They can occur suddenly or develop gradually, affect one or both ears, and feel dull, sharp, or throbbing. The causes of earaches are varied—ranging from minor infections to serious illnesses. These are the most common causes of earaches:

Earaches occur particularly frequently in connection with respiratory illnesses. When you have a cold, the infection can spread to the ear through the connection between the throat and the middle ear—the Eustachian tube. Fluid can accumulate there and cause a painful middle ear infection (otitis media). This condition is particularly common in children and is often accompanied by fever, fatigue, hearing loss, and a feeling of pressure in the ear.

An ear canal infection (otitis externa), often caused by bacteria or fungi after swimming or excessive ear cleaning, can also cause severe pain, especially when chewing or touching the ear.

Changes in air pressure—such as those that can occur during flying, diving, or even riding in a high-speed elevator—put strain on the middle ear. If pressure equalization via the Eustachian tube does not work—for example, due to a stuffy nose—underpressure or overpressure develops in the middle ear. The result: an uncomfortable sensation of pressure or even pain. This condition, known as barotrauma, is particularly common in children with a cold.

Young children, in particular, tend to put small objects such as beads or toy parts into their ear canals. Water left in the ear after showering or swimming can also irritate the ear canal and lead to inflammation. In both cases, this can result in a feeling of pressure, pain, and even hearing loss. Important: Please never try to remove the foreign object yourself using cotton swabs or sharp objects.

Ear pain does not always originate in the ear. Due to the close anatomical connection between the temporomandibular joint, the teeth, and the ear, referred pain often occurs. Craniomandibular dysfunction (CMD)—that is, a dysfunction of the temporomandibular joint—can therefore cause ear pain just as easily as a tooth root infection or improper stress on the teeth caused by chewing and grinding.

Skin irritation on the outer ear or in the ear canal can also trigger ear pain. Allergies, contact dermatitis (e.g., caused by nickel in earrings), atopic dermatitis, or seborrheic dermatitis can lead to redness, itching, flaking, and inflammation. The sensitive skin of the ear canal is particularly susceptible.

A relatively rare but serious cause is a herpes virus infectionin the area around the ear. Ramsay Hunt syndrome is caused by the varicella-zoster virus (which causes chickenpox), the same virus that can also cause shingles (herpes zoster). Typical symptoms include severe ear pain, blisters on the ear or in the ear canal, and facial nerve paralysis. Immediate medical attention is required to prevent any long-term damage.

Not every earache is a cause for concern. However, there are warning signs that indicate you should definitely seek medical attention:

This is especially true for young children and infants: It’s better to see a doctor once too soon than once too late. Here you can find an ENT specialist near you.

Fall brings with it the season of colds. Children, in particular, should protect their ears in cold, wet weather to prevent middle ear infections. Find out here how you and your family can stay healthy during the cold season.