Earaches can be very painful, and unfortunately, they most often strike at night—disrupting sleep and adding to the distress. The explanation is a combination of anatomy and pressure. The eustachian tubes are the passageway from the back of the throat to the middle ear. Clogged tubes are the most common cause of earache for children and adults. During the day, you hold up your head, and your eustachian tubes drain naturally into the back of your throat. Also, as you chew and swallow, the muscles of the eustachian tubes contract, opening them and allowing air into the middle ear. But at night when you sleep and your head isn’t upright, the tubes can’t drain as easily. And you’re not swallowing as often, so they aren’t getting as much air. The air already in the middle ear is absorbed, and a vacuum occurs, sucking the eardrum inward. Several hours after you’ve fallen asleep, your eustachian tubes may clog, especially if you have a cold, a sinus infection, or an allergy. Sometimes earache pain signifies a middle-ear infection, called otitis media. This condition is more common in children than adults, because as we grow, our eustachian tubes become narrower, longer, and less prone to plugging up.
Another reason children get ear infections is that the nerves to the area may not be fully developed in some babies, which can affect the eustachian tubes. Also, children in daycare get more colds, which can lead to ear infections. In adults, the stage is set for a middle-ear infection when sinuses get clogged as a result of allergies or a head cold, or when the eustachian tubes become blocked by air pressure during an airplane descent. Even though the usual symptoms of a middle-ear infection are pain and hearing loss, adults and children can get ear infections without pain, says George W. Facer, MD. Once infection hits, the best way to cure it is with antibiotics, although some infections clear up on their own, usually in a week to 10 days.
Other things cause earaches, too. Infections of the ear canal, known as external otitis or swimmer’s ear, can trigger pain. Atmospheric pressure from airplane travel and deep-sea diving can cause ears to ache even if they aren’t infected. Odd things, such as tiny clippings from a haircut, can fall into the ear canal and irritate your eardrum. Then there’s referred pain—a problem that exists somewhere else—that makes your ears tingle. These earaches can originate in your teeth, tonsils, throat, tongue, or jaw. When your ears ache, you need to see a doctor. But until you get there, here are some quick pain stoppers.
25 Earache Remedies
If you have an earache, the pain-reliever acetaminophen is a doctor’s first choice. A dose at bedtime may be enough to let you sleep.
A few minutes upright decreases swelling and starts your eustachian tubes draining. Swallowing once you are sitting up also helps ease the pain. If it’s possible, prop your head up slightly while you sleep to encourage better drainage.
Take A Drink
Swallowing triggers the muscular action that helps your eustachian tubes open and drain. Open tubes mean less pain.
Wiggle Your Ear
Here’s a test to help determine whether you have otitis externa (an external problem like swimmer’s ear) or otitis media (an internal middle-ear infection). Take hold of your outer ear, says Donald B. Kamerer Jr, MD. If you can gently wiggle it without pain, the problem is probably in the middle ear. If moving your outer ear causes pain, then the infection is probably in the outer ear canal.
Take An Herbal Approach
Herbalists commonly recommend garlic and mullein oils for ear infections. Mullein is antimicrobial, and garlic works like an antibiotic. The oils will also migrate past the eardrum and help prevent further infections. You can buy garlic oil, mullein oil, or a combination of the two in most health food stores or drugstores. Apply 2 to 4 drops in the affected ear. Cover the ear with a little wad of cotton to keep the oil from running out. Apply more drops every 6 to 8 hours as needed. Use fresh cotton with each application. Caution: If you suspect that the eardrum may be ruptured or perhaps punctured, never drop fluids into your ear.
Most people know this is one way to open their ears on an airplane flight, but have you considered it at midnight? The muscular action of chewing may open the eustachian tubes. (Try one of these 8 brands of chewing gum that aren't packed with sketchy chemicals.)
Yawning moves the muscle that opens the eustachian tube even better than chewing gum or sucking on mints.
Hold Your Nose
If you’re flying at 32,000 feet when your ears begin to ache, pinch your nostrils shut, suggests the American Academy of Otolaryngology–Head and Neck Surgery. Take a mouthful of air and then, using your cheek and throat muscles, force the air into the back of your nose as if you were trying to blow your fingers off the end of your nose. A pop will tell you when you have equalized the pressure inside and outside your ear.
Don't Sleep During An Airplane Descent
If you must doze off while flying, close your eyes at the beginning, not at the end of the trip, the Academy recommends. Rapid changes in air pressure occur during ascent as well, but ear pain is typically more acute during descent because atmospheric pressure increases as you move closer to the ground. Since you don’t swallow as often when you’re asleep, your ears won’t be able to keep up with the pressure changes during descent, and you might wake up in pain.
Head Off Trouble
Before you get into trouble, use an over-the-counter decongestant. For instance, if you have to fly and you know your sinuses are going to back up and block your ears, take a decongestant or use nose drops an hour before you land. At home, if you have a stuffy head, use a decongestant at night before you climb into bed to help prevent the middle-of-the-night ache.
Avoid Aggravating The Situation
If you’re prone to ear problems when you have a cold or allergies, consider delaying air travel or diving until your head clears. (Here's 7 things you need to know about allergies.)
Try This Fix: A Hot Plate
It may sound odd, but one solution for an aching ear is a hot plate. Lisa Orloff of South Orange, New Jersey, says, “I swear by this for earaches. The heat feels really good as it radiates inward.” Here's how to put the method to work: “Microwave a small ceramic plate or saucer for a couple of seconds. It’s ready when it’s not too hot to the touch to take it out of the oven. Then place the plate gently cupped over the ear that hurts and hold it there.”
Prevent Ear Infections
Ear infections are the most common cause of hearing loss in children, according to the American Academy of Otolaryngology–Head and Neck Surgery. Although you can’t really prevent ear infections, there are some things you can do that may help lower the chances of your child getting them.
Choose child care carefully. Children exposed to large groups of other children are more likely to come into contact with the bugs that cause ear infections. Research has shown that children who attend daycare are more likely to come down with upper-respiratory infections that can lead to ear infection. If your child is prone to ear infections and must attend daycare, you may want to consider a smaller setting such as in-home family daycare.
Breastfeed. The American Academy of Pediatrics cites “strong evidence” from six major scientific studies that breastfeeding protects infants from otitis media. In a study of 306 infants being seen in general pediatric practices, twice as many formula-fed infants as breastfed infants developed ear infections between the ages of 6 months and 1 year. In fact, formula feeding was the most significant factor associated with ear infections, even more important than being in daycare. A study of 237 infants in Helsinki, Finland, showed that 6% of breastfed babies and 19% of formula-fed babies had developed middle-ear infections by the end of their first year. By age 3, only 6% of those breastfed developed an infection compared with 26% of those fed formula. Why the big difference? Researchers believe that breastfed infants have an enhanced immune response to respiratory infections. If you bottle-feed your infant, experts advise holding your baby in your arms during feedings with the head above the stomach level. This semi-upright position will help keep the eustachian tubes from becoming blocked and reduce the risk of ear infections.
Quit smoking. Smoking can push an adult with ear problems toward an infection by littering the air with irritants, which, in turn, lead to eustachian tube congestion. Secondhand smoke, which is also pollutant-filled, can be just as troublesome on children prone to ear problems.
Douse the fire in your wood-burning stove. For the same clean-air reasons that you should quit smoking, put out the fire in your woodstove. Soot and smoke from the fire in your stove load the air with hard-to-breathe and hard-to-tolerate toxins.
Be patient. Some children outgrow ear infections by age 3, says Facer.
Drying-Out Cures for Swimmer’s Ear
All it takes to come down with a stubborn bout of swimmer’s ear is a set of ears and unrelenting moisture. “It’s like keeping your hands in dishwater. The skin gets macerated and leathery,” says Brian W. Hands, MD. “The ears are constantly bathed in water—swimming, showering, shampooing. Then people try to dry the ear with a cotton swab. That takes the top layer of skin off, along with protective bacteria. Then the bad bacteria win.” Swimmer’s ear begins as an itchy ear. Left untreated, it can turn into a full-blown infection. The pain can be excruciating. Once infection sets in, you’ll need a doctor’s help and a round of antibiotics to squelch it. But there are plenty of things you can do to keep the pain from getting worse, and even more to stop it before it starts.
Try an over-the-counter remedy. Most drugstores carry ear drops that can help dry up swimmer’s ear. If ear itchiness is still your only symptom, one of these preparations might be enough to head off infection. Use it each time your ear gets wet.
Soothe away pain with heat. Warmth—a towel fresh from the dryer, a covered hot-water bottle, a heating pad set on low—also helps ease the pain.
Leave your earwax alone. Earwax serves several purposes, including harboring friendly bacteria, says John House, MD. Cooperate with your natural defenses by not swabbing the wax out. Wax coats the ear canal, protecting it from moisture.
Make substitute wax. Since the irritation of swimmer’s ear wears away earwax, you can manufacture your own version using petroleum jelly. Moisten a cotton ball with the jelly, says Hands, and tuck it gently, like a plug, just in the edge of your ear. It will absorb any moisture, keeping your ear warm and dry.
Take a drop. Several fluids are great for killing germs and drying your ears at the same time. If you’re susceptible to swimmer’s ear or if you spend a lot of time in the water, use a drying agent every time you get your head wet. Any of the following homemade solutions works well:
- A squirt of rubbing alcohol.
- Put your head down, with the affected ear up.
- Pull your ear upward and backward (to help straighten the canal) and squeeze a dropperful of alcohol into the ear canal.
- Wiggle your ear to get the alcohol to the bottom of the canal. Then tilt your head to the other side and let the alcohol drain out.
A kitchen solution. Ear drops of white vinegar or equal parts alcohol and white vinegar kill fungus and bacteria, says House. Use it the same way you would rubbing alcohol.
Mineral oil, baby oil, or lanolin. These can be preventive solutions before swimming. Apply as you would the alcohol.
Plug up the problem. Wear earplugs when you swim, shampoo, or shower to keep the water out, says House. Wax or silicone plugs that can be softened and shaped to fit your ears are available at most drugstores.
When To Call A Doctor For Your Earache
If you have ear pain, you need to see a doctor. But if there’s no pain, also make an appointment if you have hearing loss or if your ears stay plugged up for more than a couple of days after a cold. You could already have an ear infection or fluid in the middle ear, says Facer. Left untreated, an ear infection can cause permanent hearing loss. Ten to 14 days of antibiotics is the usual course of treatment.
Panel Of Advisors
George W. Facer, MD, is an otolaryngologist at the Mayo Clinic in Rochester, Minnesota.
Brian W. Hands, MD, is an otolaryngologist with Vox Cura Voice Care Specialists in Toronto.
John House, MD, is a clinical professor of otolaryngologist at the University of Southern California School of Medicine in Los Angeles. He serves as a national team physician for United States swimming, the National Governing Association for Competitive Amateur Swimming that selects the Olympic Team.
Donald B. Kamerer Jr, MD, is an otolaryngologist at Charlotte Eye Ear Nose and Throat Associates in Charlotte, North Carolina.