This page deals with acute earache (pain of less than 72 hours' duration). Longer term earache always needs a medical opinion but you can treat it in the same way until you do get to see a doctor (soon).
Earache is one of the most common reasons for children being taken to see the doctor at night. Unfortunately, the symptoms often do not begin in earnest until the patient is lying down or has been asleep for a while, and when they do, everyone is at a low ebb!
Adults can also suffer from earache, and when they do, the causes and treatment are usually the same.
Most earache is caused by congestion related to a viral infection. Occasionally, pain is caused by impacted wax, ear canal infections or even by insects in the ear canal. Follow the link to find out why we get earache...
All earache can initially be treated with painkillers as described on our pain in children and pain in adults pages. Pain which does not settle in about two hours is a good reason to see a doctor at night.
First of all, sit the patient upright as this often helps a lot. Give painkillers and see if the pain reduces. Once the pain has settled (it may take an hour or two) it often does not return and if it does, it is usually much less severe.
Most patients will be pain free within 24 hours. 97.5% are pain free within 3 days. Generally speaking, antibiotics do not help earache to go away any faster and they often have unpleasant side effects.
When to see a doctor:
If the pain does not settle quickly with painkillers, see a doctor the same day.
We are always happy to see you if you, or a member of your family has earache.
We can examine the ears to determine the likely cause of the pain, advise on painkillers and provide prescription medication for pain if necessary.
All children under two years, all children with pain lasting over 72 hours and all patients with a discharge from the ear should see a doctor the day after the onset of pain.
All children (and most adults) who have earache with a temperature over about 37.5 celsius should see a doctor the day after the onset of pain as antibiotics are occasionally useful.
Remember that this cannot be a full list. Please do not hesitate to call for an appointment if you have any concerns. We do everything we can to see all children on the same day you request an appointment.
Scottish Intercollegiate Guidelines Network give definitive evidence based guideline on earache management for doctors.