Ear Pain in Children

Ear pain, or otalgia, is one of the most frequent reasons children are brought to the doctor—at home and especially during travel. Whether it appears during a flight, after a swim, or following a cold, ear ache can disrupt family trips and cause real concern. While most causes are mild and self-limiting, some require medical attention.

Our clinic in Tel Aviv sees many children and adults visiting from abroad with ear-related complaints. Understanding the causes, warning signs, and treatment options can help reduce anxiety and avoid complications.

Anatomy of the Ear – Why Does It Hurt?

The ear consists of three main parts:

1. Outer ear – including the auricle and external auditory canal

2. Middle ear – an air-filled cavity behind the eardrum

3. Inner ear – involved in balance and hearing

Pain may originate in any of these parts, or be referred from nearby areas (jaw, throat, teeth, neck). In children, ear pain is especially common due to their narrower eustachian tubes and frequent upper respiratory infections.

Common Causes of Ear Pain in Children

1. Acute Otitis Media (AOM) – middle ear infection

• Cause: Often follows a cold or nasal congestion. Viruses or bacteria migrate from the nasopharynx to the middle ear.

• Symptoms: Sudden, sharp pain; fever; irritability; disturbed sleep; temporary hearing loss; in some cases, ear discharge if the eardrum perforates.

• Diagnosis: Confirmed by otoscopic examination showing a bulging, inflamed tympanic membrane.

• Treatment:

  • Pain relief: paracetamol or ibuprofen.

  • Observation: Many cases improve within 48–72 hours, especially in children over 2.

  • Antibiotics: Given when the infection is severe, in children under 6 months, or if symptoms persist beyond 2 days.

2. Otitis Media with Effusion (OME) – fluid without active infection

• Cause: Often post-viral. The eustachian tube fails to drain fluid properly.

• Symptoms: Muffled hearing, sensation of fullness in the ear, speech delays in toddlers. No fever or acute pain.

• Treatment: Usually resolves spontaneously within 4–6 weeks. Monitoring is key.

• When to refer: If fluid persists beyond 3 months or affects hearing/speech.

3. Otitis Externa (Swimmer’s Ear) – infection of the ear canal

• Cause: Water trapped in the ear, especially in humid climates or after swimming.

• Symptoms: Pain when touching the outer ear, itchiness, swelling, possible discharge, feeling of blockage.

• Treatment:

  • Ear drops with antibiotics and steroids.

  • Avoiding water in the ear until healed.

  • In severe cases, wick placement or oral antibiotics may be required.

Less Common But Serious Conditions

Mastoiditis - A bacterial infection of the mastoid bone behind the ear

usually a complication of untreated AOM.

• Signs: Redness, swelling, and tenderness behind the ear, fever, protruding ear.

• Requires urgent evaluation and IV antibiotics, sometimes surgery.

Cholesteatoma

• Abnormal skin growth in the middle ear that can erode nearby structures.

• Signs: Chronic ear discharge, hearing loss, sometimes dizziness.

• Managed by ENT specialists, may require surgical removal.

Barotrauma

• Pressure-related pain, typically after airplane travel or diving.

• Signs: Sharp pain during descent, sometimes hearing loss or popping.

• Prevention: Use nasal decongestants before flight, encourage swallowing during take-off/landing.

Referred Ear Pain

• Sometimes the ear is normal, but pain is "referred" from other sources like:

  • Throat infections (e.g., tonsillitis)

  • Dental issues

  • Temporomandibular joint (TMJ) disorders

  • Sinus infections

When to See a Doctor in Tel Aviv

You should seek medical evaluation promptly if your child experiences:

• High fever (>38.5°C / 101.3°F)

• Persistent or worsening pain after 48 hours

• Ear discharge (especially pus or blood)

• Redness, swelling, or tenderness behind the ear

• Hearing loss, imbalance, or dizziness

• Pain after head trauma

• Ear symptoms in a child under 6 months

• Recurrence of symptoms despite previous treatment

• Ear pain that interferes with eating, sleeping, or general behavior

Our family clinic in Tel Aviv offers same-day appointments, experienced evaluation, and child-friendly care – in English.

At-Home Supportive Care

While waiting for a visit, or for mild symptoms:

• Use pain relief (paracetamol or ibuprofen) by weight and age.

• Apply a warm compress to the ear for comfort.

• Keep the child hydrated.

• Encourage swallowing or chewing gum if in flight.

• Avoid inserting anything into the ear, including cotton swabs.

Prevention Tips

To reduce the risk of ear infections while traveling:

• Dry ears thoroughly after swimming or bathing.

• Avoid using cotton swabs or fingers in the ear canal.

• Use ear plugs for swimming if advised.

• Treat colds promptly to prevent eustachian tube blockage.

• Maintain up-to-date vaccinations – especially pneumococcal and flu.

• Avoid passive smoke exposure.

• Consider nasal saline sprays during flights or dry weather.

About Our Clinic

Our Tel Aviv-based family clinic is well equipped to diagnose and manage all common pediatric ear complaints.

We are located in central Tel Aviv, within walking distance from major hotels and public transportation.