The fact that the ears are so close to the brain makes any kind of discomfort or pain behind the ear quite worrisome. The pain could mean lots of things and you need to get it checked to understand which kind of pain it is. If the pain is accompanied by fever, then it could be an ear infection which needs to be immediately treated in order to prevent the infection from getting worse. A number of factors like frequency, intensity and severity are all taken into consideration when determining the cause behind the pain.

Causes and Treatments for Pain Behind the Ear

It is very important to diagnose and treat pain behind ear in order to ensure it doesn't progress to something more severe and dangerous. Following is a list of some common causes and respective treatments of pain behind ears:

1. Otitis Media

This virus or bacteria ear infection usually affects the air-filled space behind the eardrum containing the tiny vibrating bones. This condition is more common in children and can lead to pain behind ear due to the accumulation of fluids and inflammation in the middle ear.

Treatment: The condition gets resolved on its own; hence, the treatment for otitis media focuses on monitoring the condition to ensure it doesn't get worse and to manage pain if it gets unbearable. The doctor might prescribe antibiotics for severe cases as leaving it untreated could cause complications.

2. Mastoiditis

The mastoid bone, located behind the ear, is made up of air spaces functioning as drainage for the middle ear. Mastoiditis happens when a bacterial infection affecting the mastoid bone or the middle ear, or when a skin cyst at the centre of the ear blocks drainage. Symptoms associated with mastoiditis include swollen ear lobe, lethargy, irritability, fever, redness or tenderness behind ear, bulging of the ear and drainage.

Treatment: The doctor will prescribe antibiotics and eardrops, and will schedule ear clean-up regularly. For severe cases, a surgical procedure may be required.

3. Swimmer's Ear

As the name suggests, this condition is mostly caused by the remaining water in the ears after taking a swim. It affects the outer canal of the ear that connects the outside of the head and the eardrum. Swimmer's ear can also be caused by damaging of the thin-layered skin lining the ear canal. The lining can be damaged by putting fingers or other objects like cotton swabs in the ear.

Treatment: Sharp pain behind ears caused by this condition is treated with eardrops and OTC pain relievers, such as naproxen and ibuprofen, may be recommended. Immediate medical help is needed in order to prevent deterioration.

4. Temporomandibulur Joint Disorders

The joint that connects the lower jawbone and the temporal bone is called the temporomandibular joint, and the disorder in this joint is caused by a whiplash injury, jaw injury or other bruises.

Treatment: The symptoms may end without any treatment. But if they don't, your doctor will prescribe muscle relaxants, tricyclic antidepressants and pain relievers. Surgery or therapy may be required to replace or repair the joint.

5. Ceruminosis (Too Much Earwax)

Ceruminosis refers to the excessive build-up of wax in the ear canal. Symptoms include itching in the ear, pain behind ear and muffled hearing. Excessive ear wax builds up if the ear canal is to narrow, if the ear glands produce too much ear wax or if the ear wax is pushed in while using ear buds.

Treatment: Special instruments like forceps, suction device or a cerumen spoon along with a wax softening agent are used by a doctor to remove wax.

6. Blocked Eustachian Tube

Sharp pain behind ear can be caused by the blockage of the Eustachian tube due to a sinus infection, flu, a cold, allergies or air pressure changes due to sudden change in altitude.

Treatment: The condition usually goes away on its own. Yawning and chewing gum may also help. To pop open the tube, hold the nose with hands and close the mouth, then lightly blow your nose.

7. Swollen Lymph Nodes

Lymph nodes are small glands located at the back of the ears, groin area and armpits. They usually swell due to viruses, inflammation, infection or even cancer.

Treatment: If the swelling is caused by infections, doctor will prescribe antibiotics. But a proper diagnosis is required to find the underlying cause of the swelling in order to eliminate the chances of any serious conditions.

8. Oral Problem

Sharp pain behind ear is often caused by a tooth infection or a tooth abscess as they cause the lymphatic glands to swell up.

Treatment: In order to treat the earache you will first need to treat the toothache. You can use over-the-counter medicines to relieve pain for the time being, but you will need to visit a dentist as soon as possible to get the tooth checked out. Mouth rinses with warm salt-water are also helpful in temporarily relieving the symptoms.

9. Headache

Because the ear is located so close to the brain, it is quite common for the pain to seep its way to the ears, but the causes are not always the same. Following are some common causes of headaches that are also associated with pain behind ear:

• Ice-Pick Headache: This stabbing pain, although associated with the eyes, can also occur behind the ear too and only last for a few seconds. There is also a variant of the pain, referred to as the "epicrania fugax" that only lasts for a split second and takes a "zig-zag" pattern through the head.
• Hemicrania Continua: This is a one-sided headache that can affect the ears and is often relieved with the help of strong-anti-inflammatory drugs like Indomethacin. It is a chronic pain that usually occurs on a regular basis. In most cases, no underlying cause is identified.

Besides the 2 listed above, there are other kinds of headaches that can cause sharp pain behind ears:

• Cold-stimulus Headache, also known as ice-cream headache
• Cervicogenic Headache
• Primary Yawning Headache
• Headache After Acoustic Neuroma Surgery
• Nummular Headache
• Sudden Unilateral Neuralgiform headache with Conjunctival injection and Tears (SUNCT)