Four Causes of Ear Pain You Should Know About

Ear pain is one of the most common symptoms that cause patients to seek medical care, leading to tens of millions of visits to healthcare providers each year.

Ear pain can have many causes that require care and treatment. Here are five common causes of ear pain you should know about.

Otitis Externa

Otitis externa (OE) is an infection of the skin in the ear canal. It’s commonly referred to as “swimmer’s ear” because it is most likely to occur when water gets trapped in the ear canal and then becomes colonized with bacteria, leading to an infection. This can happen with swimming, or even when you take a shower or a bath.

The symptoms of otitis externa include ear pain, ear canal swelling, and ear discharge. The most common treatment for OE is antibiotic drops.

Otitis Media

Otitis media (OM) is an infection in the middle ear, in the space behind the eardrum. OM is much more common in children than adults. In fact, other than wellness check-ups, it’s the most common reason parents bring their child to a health care provider.

OM happens when fluid in the ear becomes colonized with bacteria from the upper respiratory tract. It can also happen when a child has congestion from a viral upper respiratory infection (like a common cold), and mucus settles in the middle ear and becomes infected.

In older children, OM often resolves on its own without antibiotics. But in younger children, children with a high or sustained fever, or children with recurrent ear infections, oral antibiotics are often warranted.

Eustachian Tube Dysfunction

The eustachian tube is a small tube that connects your middle ear to the back of your nose and throat. Normally the eustachian tube drains excess fluid out of your middle ear, which helps to reduce the risk of a middle ear infection. It also helps to equalize the pressure in your ears when you encounter pressure changes, which is why your ears “pop” when you change altitudes or swim in deep water.

Eustachian tube dysfunction occurs when the tube seals shut and prevent pressure in the middle ear from equalizing.

Eustachian tube dysfunction often improves with decongestants, nasal steroid sprays, or anti-inflammatory medications (or a combination of these when recommended by a medical provider!). 

Patients also often benefit from doing what’s called “eustachian tube exercises,” which is anything you do to get your ears to pop when you’re on a flight or driving through the mountains.


One of the less common but more serious causes of ear pain is a condition called mastoiditis. The mastoid bone sits just behind the ear and connects to the skull. This bone supports the delicate structures of the middle and inner ear.

The mastoid is filled with air cells, and mastoiditis occurs when these air cells become infected with bacteria, often as a result of an untreated middle ear infection (otitis media).

Symptoms of mastoiditis include pain in or around the ear, ear swelling, and a fever.  If it’s not detected and treated quickly, mastoiditis can cause serious complications, including facial paralysis, hearing loss, vision changes, brain abscesses, and meningitis.


*Disclaimer: This information is not intended to serve as medical advice. Please visit your local GoHealth Urgent Care center to receive a proper medical diagnosis for your rash.

Written by Sarah Thebarge, Physician Assistant