Earache (otalgia) in adults

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What is it about ?

Earache (otalgia) can have various origins. A distinction is made between primary otalgia and secondary otalgia.

In case of’primary earache, the cause of the problem is in the ear itself. In most cases, this is a inflammation of the ear canal or from the middle ear. Pain can also be caused by a trauma, like a blow to the ear, or by a pressure change (barotrauma), when traveling by plane or scuba diving. Cold or wind can also cause pain. Rarer causes are tumors in the ear or inflammation of the facial nerve.

In case of’secondary earache, the cause of the problem is not in the ear (it is called “extra-auricular”); the pain comes from elsewhere and radiates to the ear. It is possible to feel pain in the jaw in the ear, toothache and an neck pain. The pain can also radiate to the ear in the event of conditions of the throat, tongue or palate, for example in the event of angina. Rarer causes are disorders of the vocal cords, esophagus, thyroid gland, bronchi or large arteries in the thorax.

How to recognize them?

Inflammation often causes severe pain in the ear. There are usually other symptoms as well, such as a fever or a cold. The pain caused by the cold goes away with the heat.

It is often difficult to find a secondary cause of the problem. See the doctor for severe or prolonged ear pain.

How is the diagnosis made?

The doctor will start by looking at the ear. If the cause of the complaints and symptoms is found there, it is not necessary to do additional examinations. Otherwise, he will also examine the mouth, throat, jaw and neck. If he still cannot diagnose the problem with certainty, the doctor will refer you to an otolaryngologist (ENT) or dentist.

What can you do ?

You may take paracetamol for the pain. Avoid water in the ear. See the doctor if the pain does not go away on its own.

What can the pharmacist do?

The pharmacist can advise you on a paracetamol-based pain reliever. If this is not effective enough, you can switch to an anti-inflammatory (eg ibuprofen), unless you have asthma, have a kidney problem or are at risk of dehydration. Anti-inflammatory drugs can cause gastrointestinal symptoms: take them with or after a meal, and stop immediately if you have an upset stomach. Respect the dose and the minimum interval between two doses. If you are taking other medicines such as blood thinners, tell your pharmacist.

Ear drops containing an analgesic (eg lidocaine) are not indicated.

If the pain or fever has not gone away with the analgesia, you should see a doctor.

What can your doctor do?

Treatment depends on the cause. Viral infections go away on their own. Bacterial infections are sometimes treated with antibiotics.

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