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What is that ache in my ear?

Posted on September 24, 2015

There are many causes for an ear ache.

Unfortunately, we are unable to look inside our own ear to determine the cause.

This blog will discuss possible causes, symptoms and treatments of an ear ache in the external auditory canal.

Ear wax:


Ear wax

Ear Wax


The ear canal will naturally shed wax from the ear. Ear wax (or cerumen) however can completely block the external auditory meatus at which point causes hearing loss.

A build up of wax is more likely to occur in people who insert implements into the ear, those who have narrow ear canals, hearing aid users and older adults. A build up of wax can also be caused by anxiety, stress and dietary or hereditary factors.

Wax impaction is probably the biggest cause of hearing loss in the general population and should be removed before it occludes the ear canal, giving rise to blockage, a water logged sensation and later hearing loss and pain.

Impacted wax may require softening with wax softeners. Wax softeners are available from most pharmacies and to be used as per product instructions. If wax remains after the drops, then removal via micro suction is suitable.

Otitis Externa:


bacterial infection in the ear

Bacterial Otitis Externa


One of the most common infections affecting the ear. It can be reactive (contact allergy) or infective (bacterial, fungal).

Main symptoms include irritation, discharge if chronic and pain if acute. The condition can affect both ears, and there may be some associated mild hearing loss or tinnitus.

Treatment by micro suction and curettage should be first line of treatment to remove debris that may be preventing medicated drops from working. If ear canal is swollen or inflamed, an Ear, Nose and Throat (ENT) Specialist referral is recommended.

Once the ear canal is clear of debris the antibiotics/antifungal/steriod drops (prescribed by a General Practitioner (GP) or ENT Specialist) will treat the infection and reduce swelling. Avoid prolonged use of antibiotic drops as they will become less effective or can cause fungal overgrowth.

Patients should be educated to prevent water from getting in their ears. Swimming should also be avoided until the infection has resolved.

Foreign body:


wax gaurd

wax gaurd


Things often find their way into ears such as cotton tips, match sticks and beads etc. There is a danger of pushing the object further into the canal whilst attempting to remove it.

If you feel like there is a foreign body in the ear, seek an ear examination. For treatment, a GP may use gentle irrigation to flush the item out but it depends on what it is and irrigation must be avoided with co-existent drum defects and in hygroscopic objects such as dried peas.

Aural Care Nurses may remove with instrumentation and direct vision. Insects can be drowned in olive oil but only have the object attempted to be removed once. Referral to an ENT Specialist or to an accident and emergency department will be necessary if the foreign body cannot be removed.

If you have an ear ache or feel like there is something in the ear, whatever you do, do not try to remove it on your own. See a health care professional, like our Clear Ears Nurses who can examine the ear to determine the cause and either treat or refer to the appropriate medical professional.

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