WHY DOES MY EAR HURT?
In few words
TYPICAL OF A VARIETY OF CONDITIONS, EARACHE IS OFTEN ACCOMPANIED BY OTHER UNPLEASANT SYMPTOMS: SWELLING, HEARING LOSS, SECRETIONS AND/OR ITCHING ... IDENTIFYING THESE SENSATIONS WILL HELP IDENTIFY THE CAUSE OF OTALGIA: WHY DOES MY EAR HURT?
EARACHE: A COMMON SYMPTOM OF MANY PATHOLOGIES
Earache can be a symptom of various conditions, whether or not they directly affect the ear organ. There are two types of earache:
- Reflex or projected otalgia, which is a consequence of a disorder of a nearby organ. A disorder of the throat, sinuses, nose or temporomandibular joint may cause earache. (1)(2)
- Otodynia, which is pain related to a disorder of the ear itself, specifically the pinna, external auditory canal (EAC) or middle ear. (2)
To best define the cause of these pains, the following questions can be asked: Do I currently have a sore throat or nose? How long has my ear been hurting? How would I describe this pain: is it stabbing, throbbing, pulsing? Do I have any other concomitant symptoms, such as swelling or itching? Is the otalgia accompanied by hearing loss, secretions or dizziness? Where would I locate the pain: more likely in the ear canal?
Ear disorders are diverse and varied, so taking the time to describe the characteristics of the pain and identify the concomitant sensations is essential. With regard to the duration of otalgia, it is referred to as chronic pain when you have been in pain for 2 to 3 weeks. If it is more recent, it is referred to as acute pain.(1)
Different types of ear infections can cause earaches, which is the main symptom of otitis externa .(3) Earache can also be the result of a wax blockage , especially if it is accompanied by hearing loss and a feeling of pressure in the ear.(4)
Finally, earache is particularly noticeable in the case of inflammation, which is also characterised by swelling and itching!
WHY DOES IT HURT SO MUCH WHEN THE EAR IS INFLAMED?
Inflammation is an immune response to a local injury caused by chemical or physical agents or pathogenic germs.5 Located in the external auditory canal (EAC), it can cause severe pain, which is characteristic of the inflammatory reaction, but not just that!
The associated swelling also has a role to play since it will stretch the skin of the EAC... In the ear canal, the skin adheres to a special subcutaneous tissue called the periosteum, the membrane that covers the bone.6 Inflammatory oedema will pull this extremely fragile membrane with it and will, in fact, cause severe otalgia.
The cylindrical shape of the EAC also contributes to the intensity of the pain: as it swells, the tissues of the ear canal will touch and crush each other... At the very least, this proximity will cause itching within the EAC.
WHAT DO YOU DO WHEN YOUR EAR HURTS?
As mentioned above, the solution chosen to treat the underlying cause of earache should therefore relieve this symptom. To do this, a doctor should be consulted to get a diagnosis.
However, it is possible to get initial relief from otalgia with products available in pharmacies. Depending on the characteristics of the pain, the use of paracetamol, non-steroidal anti-inflammatory drugs or ear drops may be an option.1 Ask your pharmacist for advice and don't hesitate to consult your doctor.
Please note that in the case of perforated eardrum, the use of a liquid solution in the ear is strongly discouraged.
(1) MSD ; Douleurs auriculaires ; David M. Kaylie MS, MD, Duke University Medical Center. 2019 https://www.msdmanuals.com/fr/accueil/troubles-du-nez,-de-la-gorge-et-de-l’oreille/symptômes-des-maladies-de-l’oreille/douleurs-auriculaires
(2) « Otalgie : conduite à tenir » ; C. Bodénez chef de clinique des Universités, assistant des Hôpitaux, F. Tankéré maître de conférence des Universités, praticien hospitalier. 2008 https://www.em-consulte.com/article/188180/otalgie-conduite-a-tenir
(3) Symptômes, diagnostic et évolution d’une otite externe. 2019 https://www.ameli.fr/
(4) Définition, causes et symptômes du bouchon de cérumen. 2019 https://www.ameli.fr/
(5) Futura Santé : inflammation, définition. https://www.futura-sciences.com/sante/definitions/biologie-inflammation-15288/ (consulté le 28/10/20)
(6) Service ORL du CHU d’Angers http://www.orl-chu-angers.fr/media/1conduitauditifexterne__093403600_1002_11062012.pdf (consulté le 28/10/20)