Ear pain, or otalgia, is a very common problem presented to ENT doctors. However, ear pain is not to be confused with pressure or fullness of the ear, which is associated with eustachian tube dysfunction.
There are two types of otalgia – primary and referred. Primary otalgia is associated with pain that originates from the ear itself, and referred otalgia is pain that originates elsewhere, possibly due to dental issues or other conditions. Referred otalgia is the most common, especially in adults.
Most causes of primary otalgia can easily be diagnosed or ruled out with a quick exam. The most common sources of primary otalgia include:
- Otitis externa/ “swimmer’s ear” – inflammation or infection of the external auditory canal
- Otitis media – middle ear infection
- Mastoiditis – inflammation of the mastoid air cells in the temporal bone
- Auricular infections – infection of the ear cartilage
Referred otalgia can have many sources. Since many areas of the body share dual innervation with the ear, damage to these areas may be perceived as ear pain. Typical causes of referred otalgia include TMJ dysfunction, cervical arthritis, and dental origins. Depending on the patient’s history and exam, a cervical X-ray may be obtained to evaluate for arthritic changes in the neck. A dental exam should also be considered to rule out any dental disorders.
TMJ dysfunction is one of the most common causes of referred otalgia. Signs and symptoms of TMJ disorders may include:
- Pain or tenderness in your jaw
- Pain in one or both of the temporomandibular joints
- Aching pain in and around your ear (referred otalgia)
- Difficulty chewing or pain while chewing
- Aching facial pain
- Locking of the joint, making it difficult to open or close your mouth
TMJ disorders can also cause a clicking sound or grating sensation when you open your mouth or chew. But if there’s no pain or limitation of movement associated with your jaw clicking, you probably don’t need treatment for a TMJ disorder.
In some cases, the symptoms of TMJ disorders may go away without treatment. If your symptoms persist, your doctor may recommend a variety of treatment options. The majority of patients have relief with conservative management including heating pads, NSAID’s, maintaining a soft diet, and avoiding excessive use of the jaw. If the patient has continued pain, an oral appliance may be beneficial.
If you are experiencing persistent ear pain and would like more information, please visit us at NAENTA.