Childhood Ear Pain is Common And Can Occur For Many Reasons

Otalgia (ear pain) is quite prevalent among children. It is often the reason for most doctor visits. While 5 out of 6 kids will have an ear infection and subsequent ear pain by the time they are three years old, a kid will most almost certainly get an ear infection before joining the school. It’s simply one aspect of growing up for many children and something for worried parents to have to deal with. 

Often kids with ear pain will be irritable and fussier than usual. In severe cases of otalgia, they may be feverish, struggle to fall asleep, and tug at the ear. Ear pain can occur due to several causes; however, it is easily manageable, and the child will be back to their happy, playful self.

The Common Causes of Ear Pain in Children

There are quite simply a wide number of reasons that a child may be suffering from ear pain. Some of the most common ones include: 

• Fluid Collecting Behind the Tympanic Membrane (Ear Drum) - Otitis media occurring with effusion (fluid) is when the tube that connects the back of the airway to the middle ear is blocked. Once blocked, fluid builds up behind the eardrum. Note that an infection does not cause the condition. Therefore, getting your child antibiotics will not ease their pain. The condition is self-limiting and often resolves in three months. In some cases, the child may experience a mild loss of hearing that is temporary.
• An Infected Ear - In some instances, fluid collects behind the eardrum due to a blocked Eustachian tube. Bacteria or viruses grow in the blocked Eustachian tube and may cause an infection. Acute otitis media is painful and mainly occurs when the child has a viral infection in the upper airway. Otitis media is more prevalent, especially in the cold months and among kids who attend a daycare program.
• Swimmer’s Ear - Otitis externa is a bacterial or viral infection of the external ear. The latter occurs when the skin covering the ear canal is irritated or scratched and becomes infected.
• A Dysfunction of The Eustachian Tube - The Eustachian tube runs from the middle ear to the back of the nose (nasopharynx). The tube is vital in pressure equalization across the eardrum, protecting the middle ear from infection and helps in the clearance of ear secretions. A child with Eustachian tube dysfunction will complain of ear pain, reduced hearing, and a cracking or popping sound in the ear.
• Disorders of the Temporomandibular Joint - Sometimes, a child may get problems affecting the hinge joint connecting the jaw to the skull. In such cases, pain is referred to the ear. Other than ear pain, the child may also experience headaches or severe pain when chewing or opening the mouth. Disorders of the jaw joint are much more common in older children who are over 10.

There are also some simple and relatively minor causes of ear pain. These include: 

• An injury to the ear and ear canal
• Build-up of wax
• The presence of a foreign body in the child’s ear canal

Medical conditions can also play a role. These conditions may cause ear pain: 

• Teething
• Pharyngeal infections
• Sinusitis or inflammation of the sinuses
• An injury on the cervical spine
• Lymphadenopathy

Getting Ear Pain Diagnosed

As a parent, knowing when to seek medical help is vital in the management plan. Seek medical help from a pediatrician or an ear, nose, and throat (ENT) surgeon if:

• The ear pain worsens, is persistent, or is non-responsive to supportive care techniques
• The child has pus or blood draining out of the ear canal
• The child gets a new or a worsening fever
• The ear starts swelling or becoming red

Diagnosing infections will involve collecting a sample of the pus or swabbing the infected area. Treating the infection will entail identifying the organism causing the infection to prescribe the correct antimicrobial agents. Viral infections are self-limiting and therefore only require supportive treatment.

Parents should never attempt to remove foreign bodies from a child's ear without the assistance of an ENT surgeon. Attempting to remove foreign bodies without help may worsen the situation as the parent may damage the child's eardrum.

Helping the Child Handle Pain

Ear pain may worsen when the child lies down. The child should be encouraged to sit or sleep with the head in an elevated position. A warm compress may be effective in dampening the pain. However, caution should be taken not to burn the child's skin.

Over-the-counter painkillers are effective in relieving the pain. However, one must clearly read every label. Some over the counter painkillers should never be given to children. Refrain from inserting anything in the ears (including earbuds).

Antibiotics should only be used when indicated by a physician. Massaging the gums may help the child when they are experiencing teething pain as well. 

Ear pain is relatively common in children. Seeking help from a pediatrician or an ENT surgeon is encouraged. Parents should never self prescribe antibiotics for ear pain or use some over the counter pain killers to manage ear pain in children. Supportive pain management is vital to improve the child's condition.