Ear Pain: Symptoms and Possible Causes Explained

Ear pain with an abnormal feeling in the ear canal?

Hello Doctor, my ear has been intermittently painful for the past few days.
The pain feels deep, not like a surface pain, and there are no bumps or anything when I touch the outside with my finger.
Today, it feels itchy inside, and when I inserted my pinky finger, I noticed that the ear canal on the right side is shallower, almost like the hard bone inside the ear is protruding outward, making it difficult to insert my finger.
When I open my mouth, it doesn't move, and pressing down causes some pain.
Recently, I've also experienced swelling in the muscles at the back of my neck, soreness while sleeping, and swelling on the right side of my face.
I'm not sure if the neck issue is due to the long hours of studying recently.
Thank you, Doctor.

Niming, 10~19 year old female. Ask Date: 2021/06/20

Dr. Ji Zhaoyun reply Otolaryngology

Hello, the issues you mentioned may be due to the following possibilities:
1) Otitis Media:
a) Acute Otitis Media: Often occurs alongside upper respiratory infections (such as colds) and sinusitis.
In severe cases, there may be discharge from the ear.

b) Chronic Otitis Media with Acute Exacerbation: This usually occurs when there is a pre-existing perforation in the eardrum, which can become inflamed due to unclean water or improper ear cleaning.

Treatment options include using ear drops combined with oral medications (such as antibiotics and anti-inflammatory pain relievers) for mild cases; hospitalization is required for severe cases.
If hearing is affected, it is advisable to seek medical attention promptly.
2) Temporomandibular Joint Disorder (TMJ): This condition affects the joint located in front of the ear and often presents with ear pain.
It is commonly caused by poor bite habits and can be managed with medication and adjustments to biting habits.
3) External Auditory Canal Inflammation (Otitis Externa)
4) Neck Muscle Strain
If symptoms persist, it is best to consult an Ear, Nose, and Throat (ENT) specialist.

Wishing you peace and good health.

Director of ENT Department, Taichung Hospital, Ministry of Health and Welfare, Chi Chao-Yun.

Reply Date: 2021/06/20

More Info

Ear pain can be a complex issue, often stemming from various underlying causes that may not be immediately apparent. Based on your description, it seems you are experiencing a combination of symptoms that could be related to several conditions affecting the ear, neck, and possibly even the jaw. Let’s break down your symptoms and explore potential causes and recommendations for further evaluation.

Symptoms Overview
1. Deep Ear Pain: The sensation of pain deep within the ear, rather than on the surface, can indicate issues within the ear canal, middle ear, or even referred pain from other areas such as the jaw or throat.

2. Itching in the Ear: This could suggest irritation or inflammation in the ear canal, possibly due to an allergic reaction, infection, or even the presence of earwax buildup.

3. Shallow Ear Canal: The feeling that the ear canal is shallow and that there is a bony protrusion could be anatomical. Some individuals have variations in ear canal shape that can affect how sound is perceived and how infections manifest.

4. Neck Pain and Swelling: The swelling in the right neck muscles and associated pain could indicate a muscular issue, possibly exacerbated by prolonged periods of studying or poor posture. However, it could also suggest lymphatic involvement, especially if there is an underlying infection.

5. Facial Swelling: Swelling in the face, particularly if localized, may indicate an infection or inflammation that could be affecting nearby structures, including the ear.

Possible Causes
1. Eustachian Tube Dysfunction: This condition occurs when the tube that connects the middle ear to the back of the throat becomes blocked or does not function properly. This can lead to pressure changes in the ear, causing pain and discomfort.

2. Otitis Externa or Media: Infections of the outer ear (otitis externa) or middle ear (otitis media) can cause significant pain. Symptoms may include itching, discharge, and hearing changes.

3. Temporomandibular Joint (TMJ) Disorder: Issues with the jaw joint can lead to referred pain in the ear, as well as neck and facial discomfort. This is particularly relevant if you have been clenching your jaw or grinding your teeth, which can occur during periods of stress or concentration.

4. Muscle Strain: Prolonged studying or poor posture can lead to muscle strain in the neck, which may contribute to pain that radiates to the ear.

5. Allergic Reactions or Sinus Issues: Allergies can lead to inflammation in the ear and sinuses, causing discomfort and a feeling of fullness in the ear.

Recommendations
1. Consult an Ear, Nose, and Throat (ENT) Specialist: Given the complexity of your symptoms, it would be beneficial to see an ENT specialist. They can perform a thorough examination, including otoscopy to check for infections or structural issues in the ear.

2. Posture and Ergonomics: Evaluate your study environment. Ensure that your workspace is ergonomically sound to reduce strain on your neck and shoulders. Taking regular breaks to stretch can also help alleviate muscle tension.

3. Warm Compresses: Applying a warm compress to the affected ear and neck area may provide relief from pain and discomfort.

4. Hydration and Humidification: Staying well-hydrated and using a humidifier can help if your symptoms are related to dryness or allergies.

5. Pain Management: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage pain and inflammation.

6. Monitor Symptoms: Keep track of your symptoms, noting any changes or patterns, especially in relation to activities or dietary factors, which can be helpful for your healthcare provider.

In conclusion, while ear pain can be distressing, understanding the potential causes and seeking appropriate medical evaluation can lead to effective management and relief. Given your symptoms and their duration, it is advisable to seek a comprehensive evaluation from a healthcare professional to rule out any serious conditions and to receive tailored treatment.

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