Ear Pain and Ear Infections: What Patients Should Know Before Their VitaleENT Visit
Feb 02, 2026
Ear pain can be intense and anxiety-provoking—especially when fever, hearing changes, or a child’s irritability enters the picture. The key point: not all ear pain is an “ear infection,” and the correct treatment depends on where the problem is located.
Swimmer’s ear (otitis externa) affects the ear canal. Common clues:
Pain when pulling the ear or pressing the tragus
Itching, canal swelling, and sometimes drainage
Often follows water exposure
Treatment usually centers on prescription ear drops and keeping the ear dry.
Middle-ear infection (acute otitis media) occurs behind the eardrum. Common clues:
Deep ear pain, pressure, reduced hearing
Fever more common (especially in children)
Often follows a cold
Treatment may include observation vs antibiotics depending on severity, age, and exam findings.
Many adults with “ear infection” symptoms actually have:
Eustachian tube dysfunction (pressure, popping, fullness)
Fluid behind the eardrum after a cold (muffled hearing, fullness)
Cerumen (wax) impaction
TMJ/clenching/grinding causing referred pain
Throat inflammation (tonsil issues can refer pain to the ear)
This is why the physical exam—looking at the eardrum and ear canal—matters more than symptoms alone.
Use acetaminophen/ibuprofen as directed (if medically appropriate)
Hydration and rest if you’re also ill
Avoid putting objects in the ear (cotton swabs often worsen things)
If swimmer’s ear is suspected, avoid water exposure and don’t self-treat with random drops unless directed—some drops are unsafe if there’s a perforation
Call for urgent evaluation if you have:
Significant hearing loss (especially sudden)
Severe pain with swelling behind the ear
High fever or worsening symptoms despite initial treatment
Drainage with severe pain (canal infection) or drainage with relief of pressure (possible eardrum rupture)
Dizziness/vertigo with ear symptoms
ENT evaluation can include:
Microscope exam for detailed view of ear canal and eardrum
Assessment for wax, canal swelling, eardrum bulging, or fluid levels
Sometimes tympanometry (tests eardrum mobility)
If hearing is a concern, audiogram to map hearing thresholds
Antibiotics are most helpful for confirmed bacterial middle-ear infection with significant symptoms. They are not helpful for:
Viral colds
TMJ pain
Most canal irritation without infection
Simple fluid behind the eardrum after a cold
For swimmer’s ear, topical drops are often the right treatment because they deliver medication directly to the infected canal tissue.
Ear pain is common, but the causes vary. A focused exam determines whether you need drops, antibiotics, wax removal, TMJ management, or watchful waiting. If you have hearing loss, severe pain, fever, or persistent symptoms, an VitaleENT visit can quickly clarify the diagnosis and shorten the path to relief.