Bug Of The Month: Ear Pain (Otalgia)

Technical Name: otalgia

NickName: ear pain

Causes: ear pain is a symptom that doesn’t always mean ear infection.  The most common causes of ear pain include:

  • Ear infection
  • Ear irritation of ear canal
  • Fluid in ear building up pressure
  • Foreign body in ear canal
  • Pain from the  mouth or neck

To learn more about the anatomy of the ear, click here.

Diagnosis: examination by a doctor will determine the actual cause.

Treatment: for all causes of ear pain, treating the pain early on is the most important factor. The definitive treatment for the pain will be dependent on the actual cause. Here are some considerations:

  1. If a foreign body is present such as a bead, do not go after it, a doctor can remove it for you in the office. However, this is not something always easily done in a pediatrician’s office and may require either an emergency room or visit to an Ear/Nose/Throat specialist.
  2. Ear Canal Infection/Irritation: ear drops are usually prescribed
  3. True middle ear infection: this is also dependent on the cause. If viral, it will clear with time. If bacterial, most will clear with time in older kids and 10-20% will need an antibiotic. The standard of care today is to treat the ear pain for 2-3 days and start an antibiotic at that point if ear pain is persisting. Your pediatrician can guide you more specifically based on your child’s age, ear exam and history. Children under 2 years of age are still treated with antibiotics in the United States.

Other Treatment Issues:

What should I do if my child has ear pain in the middle of the night?

Give Tylenol or motrin and call your doctor for advice the following day. If you have been given ear drops for pain the past, these are ok if you ear is not draining. Never put drops into a draining ear without a doctor evaluating the ear first.

What should I do if my child has ear pain during normal business hours?

If your child is over 2, I’d suggest you give a dose of Tylenol or motrin and gage your child’s response. Knowing that an antibiotic will not be utilized in most case for a few days, you have time to watch and wait. However, if your child appears ill or markedly uncomfortable, if the ear is draining pus or blood, or if high fever is present, call your pediatrician’s office for advice.

Resources for more information:

Antibiotics vs  Waiting from WebMD

Middle Ear Infections (KidsHealth)

Flying With Ear Infections (KidsHealth)

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