Why Does My Ear Hurt When I Swallow?

Medically reviewed by Judith Marcin, MD on December 6, 2017Written by Corinne O’Keefe Osborn on December 6, 2017

 

Ear pain comes in many different shapes and sizes. Sometimes it throbs for hours. Sometimes it only hurts when you touch it.

In other cases, it might only show up when you’re doing something that doesn’t involve your ears, such as swallowing. Keep reading to learn more about the common causes of ear pain when swallowing, and how you can treat them.

Ear infections

A common cause of ear pain when swallowing is an ear infection. Most ear infections are caused by a bacterial or viral infection in the middle ear. They usually cause swelling, fluid buildup, and irritation inside your ear, which can cause pain.

Ear infections are common in children, but adults can also get them. When you get an ear infection as an adult, the symptoms may be slightly different than they were during your childhood.

Middle ear infection

Middle ear infections, also called acute otitis media, are the most common. They affect the space behind your eardrum. That air-filled space contains small, vibrating bones that allow you to hear. It’s connected to your throat by a pair of narrow tubes called Eustachian tubes.

Most ear infections are started by another condition, such as a cold, flu, sinus infection or allergies. The Eustachian tubes normally drain fluid from the middle ear. When you’re congested, your Eustachian tubes can clog up. The fluid that accumulates around the blockage can become infected.

The Eustachian tubes are also responsible for maintaining pressure in the middle ear. When you swallow, yawn, or sneeze. the tubes open up to release pressure, which can be painful in an infected ear.

Signs of an ear infection in young children can include:

  • ear pain that gets worse when lying down
  • tugging or pulling at the ear (if it occurs along with other symptoms)
  • crying more than usual
  • more irritable than usual
  • fever above 100° F
  • loss of appetite
  • drainage of fluid from the ear
  • loss of balance
  • trouble sleeping
  • headache

Adults with a middle ear infection may experience:

  • low-grade fever
  • ear pain
  • drainage of fluid from the ear
  • difficulty hearing

Many middle ear infections improve on their own within one week. Certain children may benefit from oral antibiotics, but they’re often unnecessary, particularly in adults.

Swimmer’s ear

Swimmer’s ear is a type of otitis externa or outer ear infection. It’s a different type of ear infection that affects your outer ear. When you swim or take a shower, water can fill your ear canal. This creates a warm, moist environment that’s ideal for bacteria and fungus to grow.

An outer ear infection isn’t always caused by water. Germs can also enter the ear canal through a foreign object, such as your finger. Q-tips and fingernails can injure the delicate lining of the inner ear that protects it from infection. Skin conditions, such as eczema, can also make a person more prone to this type of infection.

Pain from an outer ear infection often gets worse when the ear is tugged or stretched. The pain may become more intense when you’re chewing and swallowing. The pain can radiate throughout the affected side of your face.

Other symptoms of an outer ear infection include:

  • redness and swelling of the ear
  • itching inside ear
  • foul-smelling discharge
  • sense of fullness in ear
  • trouble hearing

This infection usually clears up after 7 to 10 days of medicated ear drops. Over-the-counter pain relievers can help to reduce the pain while you recover.

Nose and throat infections

Although ear infections are a common cause of ear pain, they sometimes begin as nose or throat infections.

Children can develop complications from nose and throat infections because of the activity of their immune system.

Children have small pads of immune tissue called adenoids at the back of their nasal passages near the Eustachian tubes. The adenoids play an important role in the immune system of children. Adenoids are largest during childhood and typically shrink down by early adulthood.

The adenoids work by reacting to germs that enter through the mouth and nose. Sometimes, adenoids can become so large in response to an infection, that they block the Eustachian tubes, leading to middle ear infections.

Tonsillitis

Tonsillitis is inflammation and infection of the tonsils, typically caused by a throat infection. The tonsils are two round pads of immune tissue at the back of your throat.

The main symptom of tonsillitis is a sore throat, but it can also cause:

  • difficulty swallowing
  • tender lymph nodes in your neck
  • swollen, red, or inflamed tonsils
  • white patches at the back of your throat
  • fever
  • headache
  • stomach ache
  • rash
  • bad breath
  • scratchy, muffled voice

The most common cause of tonsillitis is a bacterial infection. The same bacteria that causes strep throat (group A Streptococcus) causes most tonsillitis. Tonsillitis typically responds well to antibiotics.

Peritonsillar abscess

A peritonsillar abscess is a collection of pus around one of your tonsils. It’s usually a complication of untreated tonsillitis. The pain is often quite severe and distinctly worse than a regular sore throat. Only one tonsil is usually affected, which means the pain is worse on one side than the other.

A peritonsillar abscess often causes pain in the ear of the affected side. The pain when swallowing may feel unbearable. You might also have pain when opening your mouth.

Minor surgery is often necessary. Doctors treat the abscess by making an incision or using a small needle to drain the pus. Your doctor may also prescribe a course of antibiotics to treat the underlying tonsillitis and prevent the abscess from coming back.

Other causes

Eagle syndrome

Eagle syndrome is a rare disorder that causes recurring pain in the back of the throat and the face. The throat pain is usually dull and persistent and often radiates to the ear. The pain gets worse when you move your head.

Other symptoms include:

  • trouble swallowing
  • feeling like something’s stuck in your throat
  • ringing in your ears
  • neck pain
  • facial pain

Eagle syndrome is caused by problems with the ligaments and small bones of the neck or skull. It usually requires surgery to correct the problem.

Glossopharyngeal neuralgia

Glossopharyngeal neuralgia (GPN) is another rare condition that can be extremely painful. It involves a nerve of the head and neck known as the glossopharyngeal nerve. GPN is characterized by short, intense episodes of stabbing pain that are often triggered by cold liquids, swallowing, yawning, talking, coughing, or chewing. The pain is often focused around one ear, but can also include the tongue, back of the throat, face, or under the jaw.

GPN episodes usually last about two minutes and are followed by a period of dull aching. Treatment for GPN often involves prescription medications designed to treat neuropathic pain, such as pregabalin and gabapentin. Surgery may benefit those not helped by medications.

Temporomandibular joint dysfunction

Temporomandibular joint (TMJ) dysfunction affects the joint that you use every time you open or close your mouth. The joint is where your jaw bone connects to your skull.

A small disk of cartilage on each side of the joint separates the bones of your jaw from your skull, and allows them to glide easily when you swallow, talk, or chew.

Because you use this joint so often, damage can lead to considerable pain. Many people feel this pain in their ears as well.

Other symptoms of TMJ problems include:

  • trouble opening your mouth wide
  • soreness and discomfort in your jaw
  • locking of the jaw
  • clicking, popping, or grinding noises when opening your mouth
  • chronic headaches and neck pain
  • ringing in the ears

There are several ways to damage the TMJ, including trauma, teeth grinding, and excessive gum chewing. Treatment typically involves lifestyle changes, rest, and nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin).

The bottom line

There are many things that can cause pain in the ear while swallowing. In many cases, it’s likely due to an ear or throat infection. While both of these may improve on their own within a week, you may need prescription medication. If the pain doesn’t go away, contact your doctor to make sure it’s not a sign of another underlying condition.

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