Ear Infection: Causes, Symptoms, Treatments

Ear infections are a common problem and inflict discomfort, muffled hearing, and ear pain on millions of people each year. Children are especially vulnerable to ear infections, with approximately 9 million kids seeing doctors for infection-related ear pain annually. So how do you get an ear infection, and what treatment is available?

9 million

kids seeing doctors for infection-related ear pain annually

How Do You Get an Ear Infection?

Our ears connect to the back of our throats through tiny openings called Eustachian tubes. Eustachian tubes help control air pressure in the middle ear, so the pressure in the ear remains the same as air pressure in the surrounding environment.

Certain factors can block the Eustachian tubes, creating a warm, moist, and enclosed environment in which bacteria and other microorganisms can grow. Colds, flus, allergies, and sinus infections can inflame tissue surrounding the Eustachian tubes, temporarily blocking the tube’s access to the throat. Other causes of middle ear infections include:

  • Adenoid problems
  • Environmental toxins
  • Exposure to cigarette smoke
  • Postnasal drainage

Impacted ear wax is a common cause of ear infections.  In the case of earwax blockages, the infection may irritate the ear canal skin.

Risk Factors for Ear Infections

Children have smaller Eustachian tubes that tend to be more horizontal than adult tubes, two factors that increase the chances of Eustachian tube blockages and subsequent infections.

Adults are less likely to develop ear infections, but anyone can develop a middle ear infection at any age. High-risk groups include:

  • People with asthma or other chronic respiratory diseases
  • People with family histories of ear infections
  • People with palate abnormalities
  • People with weak immune systems
  • Tobacco smokers or people, especially children, who live with smokers

Types of Ear Infections

Types of ear infections include:

  • Swimmers ear (Otitis externa): Infection of the ear canal skin, typically caused by fluid buildup in the ear or impacted ear wax.
  • Middle ear infections: Infection of the portion of the ear behind the eardrum.


Medical professionals recognize several types of middle ear infection, including:

  • Acute otitis media: A single ear infection that does not recur.
  • Recurrent otitis media: A series of up to three ear infections over 12 months.
  • Otitis media with effusion: Fluid left trapped behind the eardrum after an ear infection. Remaining fluid can affect hearing and increase the risk of further ear infections.
  • Chronic otitis media with effusion: Fluid caused by ear infections remains in the ear for extended periods of time or returns over time. 
  • Sinus ear infection: A common condition that occurs when the nasal passages and sinuses become infected, leading to inflammation and fluid buildup in the middle ear.


Ear Pain and other Symptoms of Ear Infections

Ear infection symptoms in adults are slightly different from the symptoms seen in children. For adults, the symptoms can include:

Ear pain may be sharp and sudden or experienced as a dull, continuous earache. Some adults experience a sharp “stabbing” pain followed by drainage from the ear canal.


Children, especially young children, may have difficulty communicating their symptoms and the cause of their discomfort. Watch for signs such as:

  • Crying when lying down – this is the main indicator 
  • Fevers
  • Irritability or restlessness
  • Loss of appetite
  • Poor sleep
  • Tugging at the affected ear
  • Vomit and dizziness

Ear Infection Complications

Most ear infections resolve without any long-term complications. Chronic ear infections, however, can cause problems such as:

  • Facial nerve paralysis
  • Mastoiditis (bacterial infection of the mastoid, the bone behind the ear)
  • Meningitis
  • Perforated eardrums
  • Permanent hearing loss
  • Speech or developmental delays in children due to temporary or permanent hearing loss

Ear Infection Treatment

Ear infection treatment depends on the cause of the infection. If it’s caused by bacteria, your doctor may prescribe antibiotics. Viral ear infections cannot be treated with antibiotics and are usually left to resolve on their own.

Your doctor may suggest over-the-counter pain medication to reduce fever and ease ear pain. Acetaminophen or ibuprofen are most often recommended. Hot compresses or low heat from heating pads may also provide ear pain relief.

Do not use aspirin to treat ear pain in children. Children who take aspirin have an increased risk of Reye’s Syndrome, which causes dangerous brain and liver swelling.

In cases of chronic otitis media with effusion, where fluid is trapped behind the eardrum, doctors may suggest a particular type of ear infection treatment called a myringotomy. A small hole is made in the eardrum, and a tube inserted to drain excess fluid. This also allows aeration of the tube which can then heal without the body continuing to produce antibodies. A myringotomy reduces ear pain while reducing the risk of future ear infections.

Remember, ear infections are only one cause of temporary hearing loss, muffled hearing, and ear pain. If you experience any of these symptoms, see your doctor or a licensed hearing care professional. 

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