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Ear Problems and Injuries, Age 12 and Older

Topic Overview

Anatomy of the ear

Ear problems may be caused by many different health problems. In children, ear pain is more likely to be a symptom of an inflammation, infection, or fluid buildup in the external or middle ear. But ear pain at any age may be a symptom of:

Ear problems caused by an injury to the ear can occur at any age. Common injuries include the following:

  • A fall or a forceful, direct blow to the side of the head can burst the eardrum or damage the tiny bones in the inner ear that send sound to the brain.
  • An injury during contact sports can cause an injury, such as "cauliflower" ear from wrestling.
  • Loud noises or explosions can damage the eardrum (acoustic trauma).
  • Atmospheric pressure changes (barotrauma) can cause problems with the eustachian tube and trap air in or keep air out of the middle ear. Middle ear problems can be severe (for example, the eardrum can burst or the middle ear can fill with blood or pus) or mild and only be felt as changes in pressure.
  • Cuts or scrapes may injure the outside of the ear or ear canal. For more information, see the topic Ear Canal Problems (Swimmer's Ear).
  • Cleaning the ear canal too often, too forcefully, or with a cotton swab, bobby pin, or sharp fingernail can cause irritation or injury.
  • Burns or frostbite can cause ear injuries (thermal injuries).
  • Objects placed in the ear can cause injury to the ear canal or the eardrum (tympanic membrane).

Hearing loss often comes with age. As people get older, ear problems are more likely to be related to:

  • Heredity. The age of onset and how quickly the hearing loss progresses can often be determined by studying family members with hearing loss.
  • The buildup of earwax. For more information, see the topic Earwax.
  • Exposure to loud noises, such as setting off an air bag during a car crash, machines at work, power tools, gunshots, or loud music.
  • Other serious medical problems, such as Ménière's disease or an acoustic neuroma.
  • Skin reaction (dermatitis) on the outside of the ear or in the ear canal from perfume, hair dye, or wearing hearing aids.

The ear shares nerves with other parts of the face, eyes, jaw, teeth, and upper neck. Pain that feels as if it is in the ear may be coming from another part of the head or neck. This is called referred ear pain and is more common in older adults. Causes of referred ear pain can include dental problems, jaw pain (temporomandibular disorder), salivary gland infection, or a sinus infection.

Check your symptoms to decide if and when you should see a doctor.

Check Your Symptoms

Do you have an ear problem?
This includes problems like pain, hearing loss, and possible infection.
Yes
Ear problem
No
Ear problem
How old are you?
Less than 12 years
Less than 12 years
12 years or older
12 years or older
Are you male or female?
Male
Male
Female
Female
Have you had a recent head injury?
Yes
Recent head injury
No
Recent head injury
Do you have any new hearing loss?
Yes
New hearing loss
No
New hearing loss
Was the hearing loss sudden and complete?
Yes
Sudden and complete hearing loss
No
Sudden and complete hearing loss
Could you be having symptoms of a stroke?
Yes
Symptoms of stroke
No
Symptoms of stroke
Have you had an injury to your ear in the past week?
The ear can be injured by a direct hit, a very loud noise (like a gunshot or firecracker), or an object being pushed into the ear.
Yes
Recent ear injury
No
Recent ear injury
Do you have vertigo?
Yes
Vertigo
No
Vertigo
Is the vertigo making it hard to stand or walk?
Yes
Hard to stand or walk
No
Hard to stand or walk
Is there any pain in the ear?
Yes
Ear pain
No
Ear pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
How long has the pain lasted?
Less than 12 hours
Pain for less than 12 hours
12 to 48 hours (2 full days)
Pain for 12 to 48 hours
More than 48 hours (2 days)
Pain for more than 48 hours
Do you think you may have a fever?
Yes
Possible fever
No
Possible fever
Did you take your temperature?
Yes
Temperature taken
No
Temperature taken
How high is the fever? The answer may depend on how you took the temperature.
High: 104°F (40°C) or higher, oral
High fever: 104°F (40°C) or higher, oral
Moderate: 100.4°F (38°C) to 103.9°F (39.9°C), oral
Moderate fever: 100.4°F (38°C) to 103.9°F (39.9°C), oral
Mild: 100.3°F (37.9°C) or lower, oral
Mild fever: 100.3°F (37.9°C) or lower, oral
How high do you think the fever is?
High
Feels fever is high
Moderate
Feels fever is moderate
Mild or low
Feels fever is mild
How long have you had a fever?
Less than 2 days (48 hours)
Fever for less than 2 days
At least 2 days but less than 1 week
Fever for at least 2 days but less than 1 week
1 week or more
Fever for 1 week or more
Do you have shaking chills or very heavy sweating?
Shaking chills are a severe, intense form of shivering. Heavy sweating means that sweat is pouring off you or soaking through your clothes.
Yes
Shaking chills or heavy sweating
No
Shaking chills or heavy sweating
Do you have a health problem or take medicine that weakens your immune system?
Yes
Disease or medicine that causes immune system problems
No
Disease or medicine that causes immune system problems
Yes
Symptoms of external ear infection
No
Symptoms of external ear infection
Do you have diabetes?
Yes
Diabetes
No
Diabetes
Is there any drainage or bleeding from the ear?
Yes
Drainage or bleeding from ear
No
Drainage or bleeding from ear
Do you think that a medicine may be causing your symptoms?
Think about whether the symptoms started after you began using a new medicine or a higher dose of a medicine.
Yes
Medicine may be causing symptoms
No
Medicine may be causing symptoms
Have you had any ear symptoms for more than a week?
Yes
Ear symptoms for more than 1 week
No
Ear symptoms for more than 1 week

If you're not sure if a fever is high, moderate, or mild, think about these issues:

With a high fever:

  • You feel very hot.
  • It is likely one of the highest fevers you've ever had. High fevers are not that common, especially in adults.

With a moderate fever:

  • You feel warm or hot.
  • You know you have a fever.

With a mild fever:

  • You may feel a little warm.
  • You think you might have a fever, but you're not sure.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
  • Long-term alcohol and drug problems.
  • Steroid medicines, which may be used to treat a variety of conditions.
  • Chemotherapy and radiation therapy for cancer.
  • Other medicines used to treat autoimmune disease.
  • Medicines taken after organ transplant.
  • Not having a spleen.

Vertigo is the feeling that you or your surroundings are moving when there is no actual movement. It may feel like spinning, whirling, or tilting. Vertigo may make you sick to your stomach, and you may have trouble standing, walking, or keeping your balance.

Symptoms of an external ear infection may include:

  • Moderate to severe pain in the outer ear.
  • Pain with chewing.
  • Redness and swelling of the ear, ear canal, or the skin around or behind the ear.

Temperature varies a little depending on how you measure it. For adults and children age 12 and older, these are the ranges for high, moderate, and mild, according to how you took the temperature.

Oral (by mouth) temperature

  • High: 104°F (40°C) and higher
  • Moderate: 100.4°F (38°C) to 103.9°F (39.9°C)
  • Mild: 100.3°F (37.9°C) and lower

Ear or rectal temperature

  • High: 105°F (40.6°C) and higher
  • Moderate: 101.4°F (38.6°C) to 104.9°F (40.5°C)
  • Mild: 101.3°F (38.5°C) and lower

Armpit (axillary) temperature

  • High: 103°F (39.5°C) and higher
  • Moderate: 99.4°F (37.4°C) to 102.9°F (39.4°C)
  • Mild: 99.3°F (37.3°C) and lower

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Ear Problems and Injuries, Age 11 and Younger
Head Injury, Age 4 and Older

Call 911 Now

Based on your answers, you need emergency care.

Call911or other emergency services now.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Symptoms of a stroke may include:

  • Sudden numbness, tingling, weakness, or paralysis in your face, arm, or leg, especially on only one side of your body.
  • Sudden vision changes.
  • Sudden trouble speaking.
  • Sudden confusion or trouble understanding simple statements.
  • Sudden problems with walking or balance.
  • A sudden, severe headache that is different from past headaches.

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Home Treatment

Home treatment may be all that is needed to relieve minor or intermittent ear discomfort.

  • To ease ear pain, apply a warm washcloth. There may be some drainage from the ear when the heat melts earwax.
    • Do not use a heating pad when you are in bed. You may fall asleep and burn yourself.
    • Do not use a heating pad on a child.
  • Try an ice or cold pack to reduce swelling from a minor injury or sunburn. Apply for 15 minutes 3 or 4 times a day during the first 48 hours after the injury. The sooner you apply a cold pack, the less swelling you are likely to have. Place a cloth between the ice and your skin.
  • Oral or nasal decongestants may relieve ear pain, especially if the pain is related to fluid behind the eardrum (otitis media with effusion). Avoid products that contain antihistamines, which tend to cause more blockage, unless allergies seem to be the problem.
  • Chewing gum may help relieve pressure changes in the ear, such as when flying in an airplane.
  • Try a nonprescription earwax remover if your ear feels plugged but you do not have obvious signs of infection. Be sure to follow the label directions carefully.
  • Do not use ear candles. They have no proven benefit in the removal of earwax or the treatment of other ear problems, and they can cause serious injury.
Medicine you can buy without a prescription
Try a nonprescription medicine to help treat your fever or pain:
Safety tips
Be sure to follow these safety tips when you use a nonprescription medicine:
  • Carefully read and follow all directions on the medicine bottle and box.
  • Do not take more than the recommended dose.
  • Do not take a medicine if you have had an allergic reaction to it in the past.
  • If you have been told to avoid a medicine, call your doctor before you take it.
  • If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to.
  • Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

  • Pain develops or increases.
  • Fever or other signs of ear infection develop.
  • New or different drainage from the ear develops.
  • Other symptoms develop, such as hearing loss or vertigo.
  • Your symptoms become more severe or frequent.

Prevention

You may be able to prevent ear problems.

  • Teach your children to blow their noses gently. Remember to do this yourself also.
  • Keep soap and shampoo out of the ear canal. These products can cause itching, which can be mistaken for an ear infection because of the need to scratch or pull at the ears.
  • Do not put cotton swabs, bobby pins, or other objects (especially if they are sharp) in the ear canal.
  • Limit your contact with others who have colds, when possible.
  • Protect your ears from sunburn and frostbite.
    • Apply sunscreen to your ears and wear a hat that shades the ears in the summer.
    • Wear a hat that covers the ears in the winter.
  • Limit or avoid exposure to loud noises such as music, power tools, gunshots, and industrial machinery.
  • Wear protective earplugs or earmuffs if you can't avoid loud noises.
    • Avoid the prolonged use of earplugs. They can cause irritation, itching, and can plug the ear with wax.
    • Do not use wadded-up tissue or cotton balls. These do not protect adequately against loud noises (especially the more dangerous high frequencies) and they may become lodged in the ear canal.
  • Avoid exposing children to cigarette smoke, which is linked with more frequent ear infections. If you smoke and are unable to stop, smoke outside, away from children.
  • Stop smoking. Smoking irritates the mucous membranes that line the nose, sinuses, and lungs, and it may contribute to inflammation or infection of the ear. See the topic Quitting Smoking.
  • If ear pain appears to be related to a problem with your jaw, see the topic Temporomandibular (TM) Disorders for tips on relaxing the muscles in this area.
  • Take good care of your teeth. Daily brushing and flossing, along with regular dental checkups, helps prevent tooth decay, infections, and other dental problems that can lead to referred ear pain.
  • If you wear hearing aids, be sure to follow the manufacturer's recommendations carefully for cleaning and storing them.
  • For tips on how to prevent swimmer's ear, see the topic Ear Canal Problems (Swimmer's Ear).

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

  • Do you have ear pain?
    • When did the pain start?
    • What were you doing when the pain started?
    • Does the pain come from the inside or the outside of your ear?
    • Has the pain been constant, or does it come and go?
    • Does anything make the pain better or worse?
  • Have you ever had this type of ear problem before? If yes, what was the diagnosis and how was it treated?
  • What other symptoms do you have? Do you have a fever, runny nose, cough, congestion, or jaw discomfort?
  • Do you suspect a hearing problem? Be prepared to describe your symptoms.
    • Do you have hearing loss or ringing in the ears (tinnitus)?
    • Does your hearing problem affect just one ear or both ears?
  • Do you use hearing aids?
  • Have you had a recent injury to the ear?
  • Do you have any other symptoms in your eye, teeth, jaw, facial muscles, or neck that might suggest referred pain?
  • Do you have drainage from the ear? If yes, what does it look and smell like?
  • Have you had problems with earaches or ear infections in the past?
  • Have you been swimming or had other recent exposure to water, such as through surfing, kayaking, or scuba diving?
  • Do you regularly use a hot tub or home spa?
  • Have you recently traveled by plane?
  • What home treatment measures have you used? Be sure to include nonprescription and prescription medicines you have tried.
  • Do you have any health risks?

Credits

By Healthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical Reviewer H. Michael O'Connor, MD - Emergency Medicine
Current as of June 4, 2014

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