Some Basics...

• There are many causes of ear pain.
• In adults, swimmer's ear (otitis externa) is more common than a middle ear infection (otitis media).
• Ear pain and stuffiness can occur during air travel. This happens because of rapid changes in air pressure.

Causes

Pain can comes from the ear itself. Causes of this type of ear pain include:

• Ear pressure during travel: Nearly everybody experiences ear pressure or pain during air travel. It mostly happens on take-off and landing. The medical term for this is barotitis media.
• Otitis media: This is a middle ear infection. It is more common in children than adults.
• Otitis externa: This is also called swimmer's ear. It is an infection of the external ear canal. Swimmers and people who use Q-tips are more likely to get it.

Ear pain can also be caused by a disease outside of the ear. The ear shares nerves with other parts of the mouth and face. As a result, even though the ear is hurting, the problem can be from something else. Causes of this type of pain include:

• Severe toothache
• TMJ syndrome
• Tonsillitis

Pain Scale

• None: No pain. Pain score is 0 on a scale of 0 to 10.
• Mild: The pain does not keep you from work, school, or other normal activities. Pain score is 1-3 on a scale of 0 to 10.
• Moderate: The pain keeps you from working or going to school. It wakes you up from sleep. Pain score is 4-7 on a scale of 0 to 10.
• Severe: The pain is very bad. It may be worse than any pain you have had before. It keeps you from doing any normal activities. Pain score is 8-10 on a scale of 0 to 10.

1. What You Should Know:
   • Ear pain can be primary or referred. There are many causes of ear pain.
   • You can treat mild ear pain at home.
   • Here is some care advice that should help.
2. Pain Medicines:
   • You can take one of the drugs listed below if you have pain.
   • They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.
   Acetaminophen (Tylenol):
   • Regular Strength Tylenol: Take 2 pills (650 mg) every 4-6 hours. Each pill has 325 mg of acetaminophen.
   • Extra Strength Tylenol: Take 2 pills (1,000 mg) every 8 hours. Each pill has 500 mg of acetaminophen.
   • Do not take more than (3,000 mg) of this drug per day.
   Ibuprofen (Motrin, Advil):
   • Motrin and Advil: Take 2 pills (400 mg) every 6 hours. Each pill has 200 mg of ibuprofen.
   • A second choice is to take 3 pills (600 mg) every 8 hours.
   Naproxen (Aleve):
   • Aleve: Take 1 pill (220 mg) every 8 hours. Each pill has 220 mg of naproxen.
   • A second choice is to take 2 pills (440 mg) every 12 hours.
   Extra Notes:
   • Use the lowest amount of a drug that makes your pain feel better.
   • Your doctor might tell you to take more than what is shown above. That is because your doctor knows you and your health problems.
   • Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old. Acetaminophen is in many OTC and prescription drugs. It might be in more than one drug you are taking. Be careful how much you take. Too much of this drug can hurt the liver.
   • Caution- Acetaminophen: Do not take it if you have liver disease.
   • Caution- Ibuprofen and Naproxen:
     • Do not take ibuprofen or naproxen if you are pregnant.
     • Do not take these drugs if you have stomach problems or kidney disease.
     • Do not take these drugs for more than 7 days without checking with your doctor.
   • Read all package instructions.
3. Cold Pack: For pain, put a cold pack on the outer ear for 20 minutes. You can also use a wet washcloth. This will help with the pain as the drugs start to work. Some people like to use heat instead of cold for 20 minutes.
4. Avoid Earplugs: If pus or cloudy fluid is draining from the ear, wipe it away. Avoid plugging your ear with cotton. Pus can cause infection or more ear pain in the ear canal.
5. How It Is Spread: Ear infections are not contagious. They cannot be spread to other people.
6. Call Your Doctor If:
   • You get worse

1. What You Should Know:
   • Ear pain and stuffiness can occur during air travel.
   • It happens because of rapid changes in air pressure. The change in pressure stretches the ear drum. This causes pain. The medical term for this is barotitis media.
   • There are many things you can do to help ear pressure and pain.
   • Here is some care advice that should help.
2. Treatment for Ear Pain - During Take Off:
   • Chew gum, or
   • Yawn, or
   • Swallow, or
   • Swallow while pinching nose.
3. Treatment for Ear Pain - During Landing: 
   • Take a small breath, pinch off your nose. Try to gently blow out and force air through your pinched-off nostrils.
   • You should feel a slight clicking or popping in your ears as air moves into the middle ear.
4. Prevention: Using a nasal decongestant about 1 hour before take-off may help. These drugs shrink the swollen nasal passages. They open up the tube between the nose and ear. This helps bring ear pressure to normal. They can be taken as pills or as a nasal spray.
   • Pseudophedrine (Sudafed): Sold OTC in pill form. Normal adult dose is two 30 mg tablets every 6 hours.
   • Phenylephrine nasal drops (Neo-Synephrine): Sold OTC. Blow your nose to clean out the mucus before using. Spray each nostril once. Wait one minute and then spray a second time. Read all package instructions.
   • Do not take these drugs if you have high blood pressure, heart disease, or an enlarged prostate.
   • Do not use these drugs for more than 3 days.
   • Read all package instructions.
5. Call Your Doctor If:
   • Pain does not go away
   • You get worse