Ear Pain and Ear Infections: What Helps, What Does Not, and When to See a Doctor

It started after a cold. Now one ear throbs, it feels blocked, and every time you swallow it pulls. Or it is your child, awake at 2 AM, pulling at one ear and crying. Ear pain is one of the most common reasons people call a clinic, especially as the weather turns and colds go round homes and schools.

The short answer: most ear infections get better on their own within about three days, and many do not need antibiotics. Some do need treatment, and a few need a hospital the same day. This page explains how to tell them apart, what you can safely do at home, what a doctor here will and will not do, and what it costs.

Where the pain is coming from

"Ear infection" covers a few different problems, and they are treated differently.

- Middle ear infection (otitis media) is behind the eardrum. It usually follows a cold or flu, and it is most common in young children. The ear aches, often with a fever, and hearing goes dull.

- Outer ear infection (otitis externa) is in the ear canal, the tube you can see into. It is common after water gets into the ear, after cotton buds, earplugs or a hearing aid, and in people with eczema. It affects adults as much as children.

- Pain that is not from the ear at all. Sometimes the ear looks completely healthy, and the pain is coming from a tooth, the jaw joint or the throat. In one large study of this kind of ear pain, teeth and the jaw joint together caused about three cases in four.

That last group matters, because no amount of ear drops will fix a tooth.

Symptoms, in the words people actually use

- "My ear is throbbing, and it is worse when I lie down"

- "It feels blocked, like I am under water"

- "Everything sounds muffled on one side"

- "It hurts when I touch the ear or pull the lobe"

- "It is itchy inside, and something is coming out"

- "It hurts when I chew or yawn"

- "There was a sharp pain, then fluid came out, and now it hurts less"

In a baby or young child: pulling or rubbing one ear, crying more than usual, being restless at night, not feeding well, not reacting to some sounds, or losing their balance. A fever is common.

Go to a hospital the same day if

Go to a hospital emergency department, or call 112, if you or your child has:

- Swelling, redness or tenderness behind the ear, especially if the ear is being pushed forward or sticks out

- A stiff neck, a severe headache, confusion or unusual drowsiness with the ear pain

- Weakness on one side of the face, such as a drooping mouth or an eye that will not close

- Hearing that has suddenly gone in one ear, over a few hours or a day or two, without a blocked-up cold to explain it

- Severe dizziness with vomiting, or not being able to stand

- An injury to the ear with bleeding, or pain and loss of hearing after a blast or a very loud bang

- A button battery, or anything you cannot see the end of, in a child's ear

Sudden hearing loss in one ear needs an ear specialist or an emergency department within 24 hours. Treatment works better when it starts early, so do not wait to see whether it comes back on its own. In festival season, a cracker going off close to the ear is a real cause of a torn eardrum; get it checked rather than hoping.

See a doctor soon, rather than waiting, if

- The earache has not started to improve after three days

- Fluid or pus is coming out of the ear

- A baby under one year may have an ear infection, and especially if both ears hurt

- You feel generally unwell, or have a very high temperature

- You have diabetes, or a weakened immune system, and the ear canal is painful and swollen

- The ear infections keep coming back

- Your child's hearing still seems dull weeks after the infection has settled

- You are over 50, or you smoke, and the ear keeps hurting while the ear itself looks normal. An ear specialist should then examine the throat and neck as well

What helps at home

For most middle ear infections, these are the treatment:

- Pain and fever medicine. Use the one your doctor or pharmacist advises, at the right dose for the person's age and weight. Read the box. Some painkillers meant for adults are not safe for children under 16, so ask which one suits your child. If you are not sure what something is, bring the strip with you.

- Rest, and plenty to drink. Stay home if you have a high temperature or cannot manage your normal day.

- Wipe away any discharge from the outside of the ear with clean cotton wool. Do not push anything inside.

- Keep water out of the ear while it is infected. No swimming, and keep shampoo out when you wash your hair.

- Keep children away from smoke. Smoky air, including cigarette smoke at home, makes ear infections more likely.

What does not help. Decongestants and allergy medicines have no good evidence for ear infections. Cotton buds and fingers make outer ear problems worse, not better.

Please do not put anything into a painful or leaking ear. That includes warm oil, garlic or onion juice, and ear candles. If the eardrum has a hole in it, whatever goes in can reach the middle ear. Ear candles have no proven benefit, and the US Food and Drug Administration has received reports of burns, punctured eardrums and blocked ear canals from them.

Do I need antibiotics?

Often not. A large Cochrane review of children with middle ear infections found that about six in ten were already better within 24 hours, whether or not they had antibiotics. At two to three days, antibiotics helped about one child in twenty have less pain, while about one child in fourteen had vomiting, diarrhoea or a rash from them. Serious complications were rare either way.

That is why a doctor may suggest waiting a couple of days, with pain relief, and starting antibiotics only if things are not improving. Antibiotics are more likely to help a child under two with infection in both ears, anyone with discharge from the ear, and anyone who is very unwell. In those cases, the doctor will usually prescribe them straight away.

Outer ear infections are different. They usually need ear drops from a doctor, and the drops only work if they are used properly: clean away the discharge, lie on your side with the bad ear up, put the drops in, gently move the ear to help them run in, and stay lying down for about five minutes.

After the infection: two things that worry people

A blocked, dull ear for weeks. After a middle ear infection, sticky fluid can stay behind the eardrum. This is often called glue ear. Hearing is muffled, but it usually clears on its own within three months. If a child's speech, schoolwork or concentration seems affected, see a doctor; it should be checked, not just waited out.

A sudden pop, then leaking. When pressure builds behind the eardrum, it can tear. The pain often eases suddenly, and fluid comes out. Most small tears heal within a few weeks if the ear is kept dry. See a doctor to confirm it, and to have it checked again once it has healed.

What we will not do

- We will not prescribe antibiotics for every earache. If they are likely to help, we will prescribe them. If they are not, we will tell you why, what to watch for, and when to come back.

- We will not wash out or suction an ear that is infected, leaking, or may have a torn eardrum. Wax removal waits until the ear has healed.

- We will not offer ear candling, oil treatments or "ear cleaning" as a treatment for an infection.

- We will not manage swelling behind the ear, a weak face or sudden hearing loss at the clinic. Those need a hospital the same day, and we will tell you to go straight there.

Who you will see, and what it costs

For a first earache, a general physician is the right first doctor. Dr. Waquar Yunus (MBBS), our general physician, is in the clinic for the full clinic day, Monday to Saturday, 8:00 AM to 9:00 PM, so you can be seen before or after work. He will look into the ear with a light, check the throat, teeth and jaw if the ear looks normal, and tell you whether you need treatment.

For ear infections that keep coming back, ongoing discharge, a torn eardrum, or hearing that has not returned, see Dr. Aparaajita Mundra, our ENT surgeon: MBBS, MS (ENT) as a gold medallist, and DNB, with 10 years' experience. Specialist slots are limited, so please call for her next available time.

For a baby or child, our paediatrician Dr. Mannat Verma (MBBS, MD Paediatrics, Fellowship in Neonatology) sees children by appointment between 11 AM and 7 PM. Please call to confirm a time.

| | Fee |

|---|---|

| General physician consultation | from ₹800 |

| ENT consultation, Dr. Aparaajita Mundra | ₹1,000 |

| Paediatric consultation, Dr. Mannat Verma | ₹1,200 |

| Ear wax removal, if wax is the cause and the ear is not infected | ₹200 per ear |

Most ear infections need no test at all. If you need a hearing test or any other investigation, we will tell you what it costs and where it is done before anything is booked. Fees are for booking directly with us; fees for appointments booked through third-party platforms are set on those platforms and may differ.

Frequently asked questions

Can I put warm oil in my ear for the pain?

Please do not. If the eardrum is torn, oil can reach the middle ear, and it makes it harder for a doctor to see what is wrong. Use pain medicine as advised and see a doctor if it is not settling after three days.

Does every ear infection need antibiotics?

No. Most middle ear infections in children get better within about three days without them. Antibiotics help some people more than others, and a doctor will tell you whether you are one of them.

Why does my ear hurt when I chew?

Pain on chewing, or pain with a normal-looking ear, often comes from the jaw joint or a tooth. A doctor can check both. If it is a tooth, a dentist is the right next step.

Can my child go to school with an ear infection?

Ear infections themselves do not spread, but the cold behind them can. Keep your child home if they have a high temperature or cannot manage a normal day, and send them back when they feel well enough.

My ear started leaking and the pain suddenly eased. What happened?

The eardrum has probably torn to let the pressure out. Most small tears heal within a few weeks. Keep the ear dry, do not put anything in it, and see a doctor to have it checked.

Can I come without an appointment?

Please call first and we will give you a time. If you have any of the hospital signs above, go to a hospital emergency department instead.

All Is Well Medical Centre

Shop no. 1, Central Market, Sector B Rd, opposite Vasant Square Mall, Masoodpur, Sector B, Vasant Kunj, New Delhi, Delhi 110070

Clinic hours: Monday to Saturday, 8:00 AM – 9:00 PM. Closed Sunday.

Phone: 8800844793 · WhatsApp: https://wa.me/918800844793 · Book an appointment: https://alliswellmedicalcentre.com/doctors-appointments

Rated 4.9★ by patients on Google.

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Medically reviewed by Dr. Aparaajita Mundra, MBBS, MS (ENT), DNB — ENT surgeon, All Is Well Medical Centre.

This article is general information and is not a substitute for a consultation with a doctor. If you are worried about your symptoms, please see a doctor. In an emergency, call 112 or go to the nearest hospital.

Contact

Call 8800844793. Home nursing 6 am to midnight

Phone

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Shop no. 1, Central Market, Sector B Rd, opposite Vasant Square Mall, Masoodpur, Sector B, Vasant Kunj, New Delhi, Delhi 110070

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