Treating earache and sore throats

Painful ears and sore throats

Earache

In adults, earache is often associated with an upper respiratory tract infection and, as long as the pain is not too severe, can be treated with oral analgesics. If the pain worsens or persists for more than 72 hours, referral to your doctor is advised.

Earache in children should always be referred to the doctor, as otitis media (middle ear infection) is quite common and if left untreated can lead to more serious problems. Until the doctor can be seen, an oral analgesic can be given.

Topical treatment of otitis media is ineffective and there is no effective anaesthetic ear drop preparation available.

Otitis externa

Otitis externa is inflammation of the external ear canal. It is either localised (often starts as an infection of a hair follicle that can progress to become a boil in the ear canal) or diffuse (swimmer’s ear), a more widespread inflammation of the skin of the external ear canal that can extend to the ear drum. The acute form is usually caused by a bacterial infection, but it can also be fungal or viral. The chronic form may be atopic eczema or a contact dermatitis.

Ear wax

Ear wax (cerumen) is a complex oily fluid secreted by the sebaceous and apocrine glands in the external auditory canal. This combines with the exfoliated skin cells in the ear to form a waxy protective layer. It is normally transported out of the ear canal as a result of jaw movements when chewing and speaking.

However, some people produce an excessive amount of cerumen with high cohesive properties which then forms a plug that affects hearing and causes discomfort. The diagnosis of impacted ear wax needs to be confirmed by examination with an auriscope so you you should see your nurse or GP if you think you have this problem.

Cerumenolytics can be used to soften this wax once a diagnosis has been confirmed and syringing may be necessary to remove the wax. Olive oil and sodium bicarbonate ear drops can be used for softening the wax before syringing.

Otic barotrauma

This is the pain in the ear that some people experience during an aircraft’s descent. The air behind the ear drum and the cabin air pressure (rising during a descent) fail to equalise and pain results. Sucking a boiled sweet can help (many airlines offer boiled sweets just before descent) as can yawning. Valsalva’s manoeuvre (pinch the nose and try blowing out with the mouth closed) can also help some people.