Earaches

There are several possible causes of earaches. The most common is an infection of the middle ear. Middle ear infections (otitis media) are especially common in children: Up to 70 percent of children will develop an ear infection during their first 3 years of life. Other common causes of earaches can include swimmer's ear (otitis externa), earwax buildup and traveling on airplanes.

Middle Ear Infections

Middle ear infections (otitis media) result from a buildup of fluid in the middle ear that gets infected. Fluid buildup is caused by congestion that blocks the natural channel (eustachian tube) that allows air to go in and mucus to go out of your middle ear. Once the fluid is infected with bacteria, a middle ear infection develops. Colds or allergies are almost always to blame for the congestion of the eustachian tube and fluid buildup. This is why ear infections often occur on the second or third day of a cold. In severe cases, the eardrum can rupture and a yellowishor blood-tinged fluid drains out the ear canal. If the eardrum ruptures, ear pain typically decreases because the abnormal pressure in the middle ear has been relieved. If your child is not being treated, he or she should see a health care provider to see if treatment is needed.

When infants or young children tug at their ears, act irritable or have a fever after a cold, suspect an ear infection and seek medical attention. Ear infections may require treatment with antibiotics.  Alternatively, your doctor may recommend that an ear infection not be treated with antibiotics because of problems with resistant bacteria. Some ear infections will get better on their own.  If your child has frequent ear infections, your child's doctor may recommend ear tubes to drain fluids from the ears, to remove fluid that does not go away, to prevent persistent hearing loss or to treat conditions that are not responding to treatment.

To help prevent ear infections in children, try these tips: breastfeed infants; if using a bottle, feed the infant in an upright position; don't prop bottles in the crib when the infant is going to sleep; avoid exposure to passive smoke; limit exposure to large numbers of children as much as possible or to children who appear ill; wash hands carefully -- both adults and children; limit exposure to viral upper respiratory infections; and avoid pacifier use in children older than 10 months of age.

Swimmer's Ear

Swimmer's ear (otitis externa) is an infection of the skin in the ear canal and is often caused by water trapped in the canal. The symptoms of swimmer's ear are an itchy feeling, redness of the outer ear, extreme pain (more than with otitis media) and pus-like drainage from the ear.

Earwax Buildup

Earwax protects your ears, but sometimes it becomes impacted. The most common reason for impacted earwax is that something was inserted into the ear canal, often in an attempt to clean it. Impacted earwax is hard to remove and makes the ear feel plugged. Symptoms of earwax buildup are partial hearing loss, earache, buzzing or ringing or other noise in the ear; a feeling that the ear is plugged.

Ear Stuffiness/Airplane Ears

The pilot says, "We will now begin our descent," but your ears have already told you there's something going on. Sound is muffled and there's a painful, uncomfortable feeling in your ears. You have barotitis, commonly called "airplane ears." The air pressure in your middle ear is usually the same as the air pressure outside your body. This balance is maintained by the eustachian tubes of the ears. If these tubes are blocked, the air pressure cannot equalize. Yawning or swallowing helps open eustachian tubes. As the plane descends, the air pressure inside your ears is lower than the pressure outside your ears. This creates a pressure differential across the eardrum with the pressure relatively lower inside the middle ear and higher outside, pushing your eardrums inward and making your ears feel full or stuffed up. If you have allergies or a cold when traveling by plane, the congestion can block the eustachian tubes and descent can cause real pain. Your doctor may advise you to postpone a trip by air if you have an upper respiratory or ear infection .

Airplane ears usually cause temporary discomfort. They may cause fluid to accumulate, which can make your ears feel like they are plugged. Airplane ears can also cause an infection.

To prevent airplane ears, don't sleep during descent. You don't swallow as often when you're asleep. Ask the flight attendant to wake you. You can try to gently exhale while you hold your nostrils closed and close your mouth. This creates pressure in your upper airway that might open the eustachian tubes. For children too young to chew gum, give them something to drink to make them swallow. If you must fly when you have an upper respiratory infection, ask your doctor about using decongestant about 2 hours before you expect to land. Use a nasal decongestant spray an hour before landing and then again 5 to 10 minutes later. Don't use nasal decongestant sprays if you have high blood pressure or angina, and never use them for more than 3 days.

Plugging of the eustachian tube leads to fluid buildup in the middle ear. Fluid can come from congestion caused by colds or allergies. This fluid can become infected with bacteria, resulting in a middle ear infection. Middle ear infections may require medical attention.

Self-Care Steps for Middle Ear Infection

• If your doctor has prescribed antibiotics, take as directed to reduce the risk of recurring problems. That means not skipping doses, measuring doses carefully and taking the medication exactly the way it is prescribed. Store the antibiotic as directed; some require refrigeration.

• Follow your doctor's recommendations for follow-up exams or other measures to prevent future ear problems.

• For relief from pain or help with sleep, use acetaminophen ibuprofen or aspirin. (Do not use aspirin in children under age 12) .

• Ask your doctor if swimming or going under water is okay. Avoid driving in mountainous or hilly areas, because the pressure change could cause ear pain.

Self-Care Steps for Swimmer's Ear

• Don't swim in polluted water or improperly maintained pools or hot tubs.

• Dry your ears after swimming. Use a clean towel or hair dryer set on low.

• You may also want to use drying eardrops if your doctor recommends them. You can make your own drops by mixing equal parts of rubbing alcohol and vinegar.  Put one to two drops in each ear after swimming.

• A heating pad or warm cloth on the ear may provide pain relief.

Self-Care Steps for Earwax Buildup

• If earwax has built up, do not probe in the ear with cotton swabs. They can push earwax farther into your ear, causing even more problems. Instead, direct a warm (never hot) shower at your ear to loosen the wax, and then wipe it out with a clean towel. Sometimes, gently squeezing warm water into the ear using a soft, rubber-nose syringe helps. Don't try to wash your ear if you think you have ruptured your eardrum or if you have ear drainage. (Symptoms of a ruptured eardrum are earache, partial hearing loss and slight bleeding or discharge from the ear.)

• Ask your pharmacist for over-the-counter earwax drops, which help soften the wax for easier removal.

• If earwax can't be easily removed or if you still have ear stuffiness, muffled hearing or blocked ear passages after 3 days of self-care, call your doctor.

Self-Care Steps for Airplane Ears

• Clear your ears by swallowing, yawning or chewing gum.

• Try the ear-clearing technique pilots use. Squeeze your nostrils shut, take a big gulp of air and tightly close your mouth. Then try to blow the air out against your closed mouth and nose. If you're successful, you'll feel your ears pop.