Sometimes, earache and headache occur together. A few conditions can cause this, such as middle ear infections and migraine. The treatment for ear pain with headache depends on what’s causing it.

Ear pain and headache are two common symptoms. When they happen alone, they may be caused by a variety of different medical conditions.

But what does it mean when earache and headache happen at the same time? There are several medical conditions that can cause these two symptoms to occur together.

If you’ve been having concurrent ear pain and headache, there are a few different conditions that may be causing your symptoms. We’ll break down each of these, how they happen, and their other symptoms.

Middle ear infection

Middle ear infections, or otitis media, are caused either by a virus or by bacteria. Swelling from the infection can block the eustachian tubes, which are openings that normalize air pressure in your ears as well as help fluid to drain out.

The swelling and buildup of fluid lead to ear pain. Headache may also occur.

Other symptoms of a middle ear infection are:

In babies and toddlers, symptoms may include irritability, fussiness, or tugging at or rubbing the ear.

Temporomandibular joint dysfunction

Temporomandibular joint (TMJ) dysfunction is when you have pain and other issues with the TMJ joint, which connects your lower jaw to your skull. Injury to your jaw can cause TMJ dysfunction, although the cause is often unknown.

The cranial nerve that passes through the TMJ is the trigeminal nerve. This nerve supplies sensation or signals the brain. Becuse of this, pain from TMJ can also be felt in the ear. Some people with TMJ dysfunction can also experience headaches.

Additional symptoms of TMJ dysfunction are:

  • pain that impacts the jaw and may spread to the face or neck
  • a clicking or popping sensation that happens when you open your jaw and is often painful
  • locking or reduced movement in your jaw
  • noticeable changes in how your upper and lower teeth fit together
  • other ear-related symptoms like dizziness or tinnitus

Migraine

Migraine is a type of recurring headache that involves a pulsing or throbbing pain, often affecting one side of the head. It may be brought on by a variety of triggers, such as strong odors, skipped meals, bright light, or changes in weather.

Some migraine episodes may be preceded by a collection of symptoms called aura. Other common symptoms of migraine can include sensitivity to lights, sounds, or odors, as well as nausea and vomiting.

Because the trigeminal nerve can be involved in migraine, some may also have ear pain. A 2022 review notes that 65% of participants experiencing ear pain without a known cause met the criteria for migraine.

Mastoiditis

Mastoiditis is an infection that impacts a part of a bone located behind your ear. It’s a potential complication of a middle ear infection.

Earache and headache are both potential symptoms of mastoiditis. Others include:

  • swelling or reddening of the skin behind the ear (a symptom that should be evaluated by a doctor)
  • fever
  • lethargy
  • fluid draining from the ear
  • difficulty hearing
  • irritability or fussiness in babies and toddlers
  • tugging at or rubbing the ear in babies and toddlers

Occipital neuralgia

Occipital neuralgia affects the occipital nerves, which run from your neck up to the scalp at the back of your head. It happens due to nerve compression.

Occipital neuralgia involves headache and pain that starts at the base of the skull and spreads to the scalp. This pain has a shooting, burning, or throbbing sensation and can sometimes be felt behind the ear. Other locations include:

  • the upper part of your neck
  • the back of your head
  • your scalp
  • your forehead or behind your eyes

Tinnitus

Tinnitus is when you have a ringing, buzzing, or roaring sensation in your ears. It can be caused by many things, including exposure to loud noises, hearing loss, medications, or chronic health conditions.

Some people with tinnitus also have headaches. Researchers believe the connection between headache and tinnitus is bidirectional, meaning that they contribute to each other.

Depending on the cause of tinnitus, ear pain may also be present. Other ear-related symptoms that can happen with tinnitus include:

  • ear fullness
  • dizziness
  • ear discharge

Acoustic neuroma

An acoustic neuroma is a type of benign tumor that affects the vestibular nerve in your inner ear. These tumors typically have no identifiable cause.

When an acoustic neuroma becomes large, it can rarely lead to headaches and sometimes ear pain. Other symptoms of acoustic neuroma include:

Some medical conditions discussed above can cause a headache and ear pain on only one side. This is because some ear conditions may impact only the left ear or only the right ear.

Examples of conditions that are more likely to affect only one ear (either the right or the left ear) or side of the head include:

  • middle ear infections
  • mastoiditis
  • acoustic neuroma
  • migraine

The conditions that can impact either one or both ears or sides of your head are:

  • TMJ dysfunction
  • occipital neuralgia
  • tinnitus

Some conditions that cause headaches and ear pain may also cause scalp tenderness or pain as well. These include:

  • occipital neuralgia
  • migraine
  • TMJ disorder, due to inflammation of the temporalis muscle

It’s always a good rule of thumb to see a doctor if you have a headache and ear pain that:

  • comes on suddenly
  • is severe
  • is persistent or recurring
  • comes back or gets worse after home care

A doctor can use a variety of tests to help diagnose the underlying cause of headache with ear pain.

In order to diagnose the underlying cause of headache and ear pain, a doctor will first get your medical history. They’ll ask you about things like:

  • the nature of your headache and ear pain, such as:
    • when it started
    • what it feels like
    • how severe it is
    • where exactly you feel it
    • if anything brings on the pain or makes it better
  • whether you’re having any additional symptoms
  • if you have any preexisting medical conditions
  • which over-the-counter (OTC) or prescription medications you’re taking

They’ll then do a physical examination, possibly with a neurological exam (an evaluation of your nervous system). They’ll examine your head and neck and look into your ears to check for discharge or pus as well as signs of inflammation.

Some of the tests that your doctor may order include:

Ear pain and headache can be treated using a variety of approaches. Which one is used can depend on the cause of your symptoms.

Home remedies

Examples of home remedies that may be used for ear and headache pain include:

  • using a warm compress on the affected ear
  • resting in a quiet room
  • applying heat or cold to painful areas of the head or scalp
  • gently massaging tight or painful areas of the head or scalp

Medications

OTC medications like acetaminophen (Tylenol) and non-steroidal anti-inflammatory drugs (NSAIDs) can be used to alleviate pain from an earache and headache.

Other prescription medications that may be used include:

Medical treatment

Some causes of ear pain and headache may need to be treated with medical procedures or other therapies. For example:

  • Surgery, including gamma knife procedure, may be needed to remove an acoustic neuroma that’s become large or is causing severe symptoms. Surgery may also be a part of the treatment of severe mastoiditis.
  • Occipital nerve stimulation may help treat occipital neuralgia that hasn’t responded to other treatments.
  • Persistent tinnitus that doesn’t have a treatable underlying cause may be treated with sound therapies and behavioral therapies.
  • Physical therapy or surgery may be helpful for TMJ dysfunction and occipital neuralgia.

Look below for some answers to frequently asked questions about headaches and ear pain.

Can a blocked ear cause headaches?

Yes. A blocked ear can increase pressure in your ears. As this pressure increases, it can lead to a headache.

When should I go to the ER for ear pain?

Signs that you should go to the ER for ear pain include:

  • severe pain
  • high fever
  • fluid or blood draining from the ear
  • dizziness or issues with balance
  • changes in hearing or hearing loss
  • lethargy

A variety of conditions can cause earache that happens at the same time as headache. A few examples include middle ear infections, TMJ dysfunction, and migraine.

The treatment for ear pain that occurs with headache can depend on what’s causing these symptoms. If you have earache and headache that come on suddenly, are severe, or are persistent, be sure to see a doctor.