Ear Pain When Swallowing: Causes, Seriousness, Relief

Ear Pain When Swallowing: Causes, Seriousness, Relief

The average adult swallows about 600 times a day—a reflex you may not think about much until you experience ear pain when you swallow. There are many possible causes of ear pain when swallowing. Your ears contain a complex network of nerves that provide sensation to the ears and other structures in the head and neck.

As a result, ear pain when swallowing can stem from a problem within the ear or with nearby structures, such as the nose, throat, teeth, or jaw. Depending on the cause, ear pain when you swallow may feel like a deep ache, sharp or burning pain, or pressure or fullness in one or both ears.

It’s important to seek medical attention for ear pain, whether it is mild or severe. While most causes are not serious, untreated ear pain can significantly affect your quality of life. But, diagnosis and timely treatment can prevent complications and help you feel better sooner. 

Ear pain when swallowing can develop due to inflammation, injury, or infection affecting the near or nearby body parts, including the nose, throat, teeth, or jaw. Understanding the conditions that cause ear pain when you swallow can help you identify what is causing your pain and discomfort and know when to see a healthcare provider.

Ear Infection

Ear infections are the most common cause of ear pain when swallowing. Most ear infections involve the middle ear—the air-filled chamber behind the ear drum. Ear infections typically develop after an upper respiratory infection (such as the common cold) and cause swelling of the eustachian tubes.

These tubes drain fluids from the middle ear to the back of the throat. But when these tubes become swollen, the fluids can’t drain out and build up in your ear, allowing an ideal space for bacteria and viruses to flourish and cause an infection. 

In addition to ear pain when swallowing, ear infections can cause symptoms such as:

  • A feeling of fullness in the ear
  • Nasal congestion
  • Cough
  • Fever
  • Nausea or vomiting 
  • Fluid leaking out from the ear 
  • Loss of appetite 

Ear infections are most common in children, though adults can get them too. Risk factors for ear infections include allergies, a recent upper respiratory infection, frequent exposure to secondhand smoke, attending daycare centers, and recent changes in climate or altitude.

Throat Infection 

Throat pain when swallowing that radiates (spreads) to the ears is the hallmark symptom of a throat infection. Viruses and bacteria that cause infections, such as the common cold, influenza (the flu), and strep throat, cause inflammation and swelling in the throat, leading to ear pain when swallowing and other symptoms such as:

Risk factors for a throat infection include close contact with someone sick, a weakened immune system, and exposure to irritants such as cigarette smoke or air pollution.

Temporomandibular Joint (TMJ) Disorders

The temporomandibular joints (TMJ) connect the lower jaw bone to your skull on both sides of the head. TMJ disorders are a diverse group of conditions that affect the TMJ joints and surrounding muscles. These disorders commonly cause ear pain, pressure, and fullness—all of which make chewing and swallowing difficult. Common TMJ symptoms include:

  • Jaw pain and stiffness 
  • Neck and shoulder pain 
  • Headaches 
  • Clicking or popping sounds in the jaw 
  • A locking (stuck) jaw or difficulty moving the jaw 
  • Dizziness 
  • Vision problems 

Risk factors for TMJ disorders include a previous jaw injury or dental procedure, an overbite or underbite (misaligned jaw), underlying autoimmune disorders, and teeth grinding or clenching.

Glossopharyngeal Neuralgia

Glossopharyngeal neuralgia (GPN) is a rare neurological (brain-related) condition that causes recurrent episodes of severe stabbing pain in the ears, tongue, tonsils, and throat. The pain tends to affect one side of the face and throat and typically lasts between a few seconds and a few minutes. Irritation or compression of the nerve can trigger bursts of excruciating and stabbing pain.

The following actions may trigger this type of pain:

  • Chewing 
  • Swallowing
  • Yawning 
  • Sneezing
  • Talking 
  • Coughing
  • Laughing 
  • Drinking cold beverages 

GPN is most common in people over age 50, but other risk factors are not well understood. Some evidence suggests that a history of throat infections, head and neck surgery, tooth extractions (removals), and blood vessel abnormalities may contribute to the development of GPN.

Dental Abscess

A dental abscess is a pocket of pus that develops due to a bacterial infection. If you have a chipped tooth or a cavity, bacteria can enter through cracks in the tooth’s enamel, causing an infection. The infection can spread from the tooth to the gums, jaw bones, and sinuses, which may cause ear pain when swallowing or chewing.

Other symptoms of a dental abscess include: 

  • Swollen, sensitive gums near the infected tooth 
  • Bad breath
  • Fever
  • Swollen glands in the neck 
  • Tooth sensitivity, especially to hot or cold foods and beverages 

Poor dental hygiene, smoking, and a weakened immune system increase the risk of developing a dental abscess.

Eagle Syndrome

Eagle syndrome is a rare condition that causes dull, persistent throat and neck pain that may radiate to the ears and cause pain when swallowing. Eagle syndrome develops due to an elongated styloid process (a small bone that anchors tongue muscles) or a hardened stylohyoid ligament (a strong band of tissue connecting muscles to bone).eee

These structures can compress nearby nerves and blood vessels, leading to pain that may feel like dull aches, sharp stabbing, or burning pain.

Other symptoms of this condition include: 

  • Difficulty swallowing
  • Feeling like something is stuck in your throat 
  • Tinnitus (ringing in the ears) 
  • Neck and facial pain affected one or both sides
  • Worsening pain during certain activities, such as turning the head, yawning, or swallowing

People who undergo throat surgery (such as a tonsillectomy) have an increased risk of developing Eagle syndrome. 

Less Common Causes

Other possible causes of ear pain when swallowing include: 

  • Barotrauma: Changes in altitude or pressure during air travel, scuba diving, or swimming to the bottom of a swimming pool can affect the eustachian tubes and cause ear pain that may worsen when you swallow food or saliva
  • Chronic sinusitis: Long-term inflammation in the sinuses can affect the ears’ eustachian tubes, causing ear pain when swallowing
  • Thyroiditis: Inflammation of the thyroid gland can cause pain that radiates to the ear when swallowing
  • Tumors: Tumors in the throat can cause ear pain, often with other symptoms such as difficulty swallowing, unexplained weight loss, and hoarseness

If you’re experiencing ear pain when swallowing, it’s important to see a healthcare provider if the pain persists for more than a few days, is severe, or happens repeatedly. You may also consider seeking care from a provider if you ear pain occur alongside additional symptoms, such as:

If you decide to seek care, understanding the diagnostic process can be helpful. Your healthcare provider will likely learn about your medical history, perform a physical examination, and order diagnostic tests.

Primary care providers (PCPs) can diagnose many causes of ear pain but they may refer you to an otolaryngologist (ENT), a doctor with special training in diagnosing and treating conditions that affect the ear, nose, and throat, depending on your symptoms. 

Medical History 

Your healthcare provider will begin by reviewing your medical history and asking about your symptoms. They may ask you: 

  • What does your pain feel like?
  • Which activities improve or worsen the pain?
  • Is your pain constant, or does it come and go?
  • Do you have any underlying health conditions that affect your ears?
  • Are you experiencing additional symptoms alongside ear pain when swallowing?

Physical Examination 

Once your provider learns more about your symptoms, they will conduct a physical exam to examine your ears using an otoscope—a tool with a light that helps visualize the inside of the ear and eardrum. They will also assess your nose, throat, mouth, jaw bones, and neck to look for signs of inflammation, infection, or other abnormalities.

Diagnostic Tests

Depending on your symptoms, your healthcare provider may order one or more of the following tests to identify the cause of ear pain when swallowing:

  • Audiometry: Assesses how well you hear sounds to help identify hearing loss related to ear problems
  • Throat swab: Collects a sample of mucus or cells from the back of the throat to help identify the presence of bacteria and diagnose bacterial infections like strep throat
  • Imaging tests: Uses technology like computed tomography (CT) and magnetic resonance imaging (MRI) scans to identify nerve compression, tumors, and structural abnormalities and help pinpoint the source of ear pain
  • Blood tests: Check for signs of infection or inflammation in your body

If you receive a diagnosis for ear pain when swallowing, your exact treatment plan will depend on the underlying cause of your pain and the severity of your symptoms. For mild cases, home remedies may be enough to relieve pain. However, moderate and severe pain may warrant additional medical treatments.

Home Remedies

Some at-home treatments may offer pain relief for some causes of ear pain. These include:

  • Over-the-counter pain relievers: Medications like Tylenol (acetaminophen) or Advil (ibuprofen) can help reduce pain and inflammation
  • Warm compress: Applying a warm water bottle or cloth to the affected ear may temporarily relieve ear pain
  • Hydration: Drinking plenty of fluids helps thin mucus and promote drainage 
  • Ear drops: Over-the-counter ear drops may soothe ear pain
  • Chewing gum: Chewing a piece of gum may help reduce ear pressure
  • Jaw exercises: Gentle jaw exercises may help relieve TMJ-related pain

Medical Treatments

Some causes of ear pain when swallowing may require medications or therapies. Depending on your diagnosis, treatment may include:

  • Antibiotics: Help eliminate infections like ear infections, strep throat, and dental abscesses 
  • Decongestants: Relieve congestion caused by ear and throat infections 
  • Antiseizure medications: Ease nerve pain that may be causing ear pain when swallowing
  • Physical therapy: Creates a personalized physical therapy program to help reduce your pain and improve the function and mobility of your jaw if you have TMJ
  • Surgery: Treats nerve compression (e.g., glossopharyngeal neuralgia) or a severe dental abscess causing ear pain

Ear pain when swallowing can occur from ear problems, such as an ear infection, or issues with nearby structures, such as dental abscesses and TMJ disorders. If your pain affects your daily life, seeing a healthcare provider can help you get a proper diagnosis and timely treatment. Depending on the cause of your pain, your healthcare provider may recommend home remedies, medications, or therapies that relieve pain and improve your quality of life.

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