Earaches and Ear Infections

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Earaches and Ear Infections

Turn Down the Pain

Women doctors agree: The term earache is a commonly used yet unscientific term for a whole range of problems that run the gamut from minor annoyances to serious infections.

At the minor end is simple ear discomfort, says Jo Shapiro, M.D., instructor of otology and laryngology at Harvard Medical School and associate surgeon of otolaryngology at Beth Israel Deaconess Medical Center and Brigham and Women's Hospital, both in Boston.

"Annoying but uncomplicated achy ears are usually the result of a cold. The eustachian tube (the pencil-size canal that leads from the back of your nasal passages to your ear) becomes congested. Since there is less air in the middle ear, it creates a negative pressure, sometimes associated with fluid accumulation," says Dr. Shapiro. "Because of this, you won't feel sharp pain, but you will feel discomfort or pressure or have muffled hearing."

Ear pain can also occur when the eustachian tube becomes inflamed or congested from a cold, allergy or sore throat.

HELP FOR SIMPLE EARACHES

If you have an earache, you want relief, and you want it fast. Here's what to do.

Warm 'em up. "Heat is excellent for earaches," says Jennifer Derebery, M.D., assistant clinical professor of otolaryngology at the University of Southern California in Los Angeles. "Heat promotes blood flow and marshals infection-fighting white blood cells in the area." She recommends using a hot-water bottle, a hot towel or a heating pad, warmed to a comfortably hot level and wrapped in a towel. Keep the heat on your ear for 20 minutes or until the pain goes away, whichever comes first.

Reach for the hot sauce. "Food that is so spicy that it makes your nose run can ease earaches associated with congestion," says Evelyn Kluka, M.D., director of pediatric otolaryngology at Children's Hospital in New Orleans. "Try a good hot-and-sour soup or, better yet, an authentic New Orleans gumbo loaded with hot peppers."

What Women Doctors Do No More Ear Pain Donna Jean Millay, M.D. In the hills of Vermont, below-zero winter temperatures can cause painful earaches. But that doesn't stop Vermonters from venturing out. When Donna Jean Millay, M.D., assistant professor of otolaryngology at the University of Vermont and staff physician at Fletcher Allen Medical Center, both in Burlington, goes outdoors, here's what she does to keep her ears warm and pain-free. "I'm a runner," says Dr. Millay. "But I avoid hats when I run, because they make me too hot. "So when it's chilly, I roll up a cotton bandana and tie it around my head, covering my ears. When it's really freezing, I wear a fleece headband to cover my ears." Once home, Dr. Millay says, she rubs her hands together, then places one on each ear to warm them up after her run.

Humidify your nose. "Use a plain saline nasal spray, available over the counter, several times a day when your nose is congested. It will reduce the congestion caused by a cold or allergies, thereby reducing your ear discomfort," says Dr. Kluka.

Breathe away an ache. According to Effie Chow, R.N., Ph.D., a certified acupuncturist and Qigong master who teaches the Chinese healing discipline Qigong at the East/West Academy of Healing Arts in San Francisco, Qigong's deep-breathing techniques are effective for earaches and other pain, because they oxygenate the body, strengthen the immune system and open blockages.

"Breathe in deeply from your diaphragm, not your chest, bringing air in through your nose," says Dr. Chow. "Imagine the area right behind your naval to your upper chest area as an accordion, and fill it with air through your nose. Keeping your lips closed, expand the accordion. Then exhale, collapsing the accordion, and allow the air to escape through your lips. Continue this exercise until you feel relaxed and the pain eases." Dr. Chow suggests that this breathing be done from time to time over a 24-hour period.

TIPS FOR AIRBORNE ACHES

When your eustachian tubes are congested, changes in air pressure--during aircraft landings, scuba dives or even rapid trips in high-rise elevators--can hurt your ears. Excess mucus prevents your middle ear from equalizing the pressure. A vacuum forms, sucking the eardrum inward and stretching the eardrum. Sounds are muffled or blocked, and you feel discomfort. If you have a cold and must fly, try these tips.

Try the Frenzel maneuver. Pinch your nose and push your tongue against the back part of the roof of your mouth, says Laura Orvidas, M.D., senior associate consultant and instructor in the Department of Otorhinolaryngology at the Mayo Clinic in Rochester, Minnesota. That will work a little air through your eustachian tubes without damage.

Yawn or chew (or both). To clear that full-ear feeling during takeoff or landing, force yourself to yawn, says Dr. Orvidas. Or quietly chew on a stick of gum.

When To See A Doctor See your doctor as soon as possible if your ear pain is: * Severe * Accompanied by drainage or discharge from your ear * Accompanied by a fever of 102°F or higher * Not accompanied by a cold * Not caused by water in your ear Symptoms that may require emergency treatment include: * Sudden change in hearing * Sudden onset of dizziness * Inability to concentrate * Muscle weakness on the same side of your face as the affected ear "Any one of these four symptoms could mean that your infection has spread and is more aggressive than usual," says Donna Jean Millay, M.D., assistant professor of otolaryngology at the University of Vermont and staff physician at Fletcher Allen Medical Center, both in Burlington. "See your doctor--or visit an emergency room--immediately." Also, people with diabetes need immediate attention when their ears ache.

Pretreat with a decongestant. One hour before flight time, take a decongestant like Sudafed, says Dr. Orvidas. Follow package instructions.

Or, use a decongestant spray. "A spray or two in each nostril of Afrin or Neo-Synephrine reaches the exact area that you want to decongest," says Dr. Orvidas.

Dr. Kluka advises using nasal spray when you're in the terminal, about 20 minutes before boarding the plane, then again once you board your flight.

EARACHE OR EAR INFECTION?

Most ear infections start with an earache, says Dr. Shapiro, but not all earaches are ear infections. If you have an infection, it's time to see Ye Olde Family Physician. "She will prescribe antibiotics. Many people ask if antibiotics are really necessary. I tell them that the ear is close to many delicate structures, including the brain. An untreated infection can spread and cause problems, including mastoiditis--an infection of the bone tissue surrounding the ears. Antibiotics eliminate ear infections--and potentially serious problems--safely and rapidly," says Dr. Shapiro.

To ease discomfort until you see the doctor, here's what you can do.

Try an OTC painkiller. To ease severe ear pain and reduce fever, take ibuprofen or acetaminophen according to package instructions, says Donna Jean Millay, M.D., assistant professor of otolaryngology at the University of Vermont and staff physician at Fletcher Allen Medical Center, both in Burlington.

Decongest. A decongestant like Sudafed, taken according to package instructions, relieves congestion and discomfort, says Dr. Millay.