Pain Behind Ear: Causes, Treatment, and When to Seek Help

Ear pain does not always mean pain that occurs within the ear or is caused from inside the ear itself.

ear of an infant

The head has many nerves running through and across connecting many parts of the body. Pain behind the ear can be one of many things afflicting a person and may even radiate down the neck. Neck pain can make other parts of your body hurt such as the shoulder, arms, and head.  And the pain in the neck is mostly associated with pain behind the ear. 

You may need to distinguish between actual pain or headaches caused by many different reasons. Pain coming from behind the ear can typically be a result of dental complications, swollen lymph nodes, or Swimmer’s ear. Ear pain does not always mean pain that occurs within the ear or is caused by inside the ear itself. In some cases, this may even cause difficulty in chewing. 

What Could Be Causing It?

Behind the ear is a bony structure called the mastoid.  This area is loaded with nerves and lymph nodes. Any issues within that immediate area such as the jaw, mouth, and neck can lead to pain behind the ear.  Only a proper medical evaluation and medical tests would be needed to help determine the cause.

1. Acquired  Infectious Diseases 

Mastoiditis

An infection of the underlying bone located behind the ear mostly related to an untreated ear infection. This type of infection can spread from the ear to the mastoid bone causing degeneration of the bony tissue located in this part of the skull. Children and adults alike can be affected by mastoiditis. Symptoms to watch out for are head and neck discomfort, swelling and pain, fever, headache, redness around the area and ear drainage

Middle Ear infection 

Otitis media is an infection behind a person’s eardrum that stems from a bad cold or influenza. This Ear infection can be very painful and most sufferers are children more than adults. The build-up of fluids along with ear pressure and inflammation can make a child cranky and feel really sick  Common symptoms are ear pain, tugging and pulling at the ear, difficulty sleeping due to crying and irritability, loss of balance, fever loss of appetite and drainage of fluid from the ear.

Swimmer’s Ear

This is an infection of the outer ear or acute otitis externa that is triggered by getting water in one’s ear canal. Getting water in your ear trapped after swimming can create an environment for bacteria to grow.  Using cotton swabs can also trigger bacteria growth and lead to swimmer’s ear infection that damages the thin layer of the ear canal Symptoms may be mild at first and will worsen if left untreated. Itching may be present and intensifies as the infection progresses, redness, increasing pain, fluid drainage, pus discharge, muffled hearing, fever and swelling of lymph nodes in the neck area. 

2. Underlying Dental Issues 

Dental abscess

Untreated tooth decay can cause a collection of infected debris in the mouth. Symptoms of tooth decay such as pain and swelling in the affected tooth and radiate the pain behind the ear

Jaw clenching

People who get nervous consciously clench their jaws while others do it in their sleep often causing disturbing noises. The repeated clenching  of the jaw and stresses the jaw and causes pain 

Teeth grinding

This is a common issue that people complain about when they share sleeping quarters. Similar to jaw clenching, teeth grinding causes the same disturbing noise when people grind on their teeth while asleep. The constant grinding definitely causes stress on the teeth and jaw and become painful. 

Impacted teeth

When wisdom teeth grow this alone causes pain and can affect nerves behind the ear. If wisdom teeth do not grow properly it causes pain as it tries to come through a blocked path and break through the gums. 

Jaw joint dysfunction

Most often called TMJ or temporomandibular joint, this joint close to the ear causes pain due to the misalignment of the jaw. 

3. Other Causes 

Swollen lymph nodes

Immune cells are stored lymph nodes all over the body including the ones located behind the ear.  When the body is harboring an infection, an autoimmune disease or cancer, lymph nodes become swollen and cause pain. 

Nerve pain

Due to the number of veins running through the skull, certain sicknesses and conditions can cause nerve pain localized behind the ear. 

Wax buildup

When the ear has collected an excess of ear wax in the ear canal expect discomfort and pain behind the ear. 

Cyst

A build of material along with some bacteria under the skin of the ear can cause cystic growths, or commonly pimples that can be really annoying and painful. Do not attempt to pop or excise a cyst in your ear on your own. 

When to Seek Medical Help? 

Once you feel a usual pain behind the ear and cannot pinpoint the cause it is always best to consult your doctor. Taking pain relievers will only temporarily ease your pain and discomfort but will not get to the root cause of pain. The bacterial infection is not something to take lightly and it is best for your health to be treated as soon as possible to prevent further issues.

How To Treat and Relieve the Pain  

Pain behind the ear after being diagnosed by a medical professional can be treated at home. Treatments will vary depending on the cause of the pain :  

  • Over the counter Medications: NSAIDs such as ibuprofen, Tylenol, acetaminophen can help with pain relief and even occurring fever.
  • Heat therapy: Use a heating pad or warm compress to help ease the pain around the affected ear.
  • Drying the Ear: As soon as water enters the ear making sure to immediately drain the ear of the trapped water by gently inserting a soft towel wrapped around your finger and dry inside the ear. 
  • Antibiotics: If there is a bacterial infection, the doctor will prescribe antibiotics to treat the infection and eventually ease the pain 
  • Surgery: In some cases, if a mass has formed that is causing pain, surgery may be required to remove the cause of infection 
  • Biopsy: Depending on your evaluation, a doctor may recommend a biopsy, or simply extracting a small sample of underlying tissue in the area of pain especially if a mass is located and the lymph nodes are swollen
  • Professional ear cleaning: Getting ears cleaned by a medical professional specializing in the ear, nose, the throat will be beneficial in easing the pressure of wax build-up, fluid build-up, and pus discharge. 
  • Mouthguards: When you clench or grind your teeth in your sleep, wear a dental guard to prevent damage to your teeth and stress on your jaw. Your dentist can do a fitting for you to use this protective guard while you sleep. 
  • Dental Surgery or Extraction: If you have tooth decay, the dentist will recommend extraction to prevent further infection and pain.

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