As you can see, getting to the bottom of this type of pain is not as straightforward as one may think. While not all causes of pain behind the ears are severe, making an appointment with your healthcare provider is a good idea to rule out more serious conditions, such as an active ear infection, mastoiditis, or occipital neuralgia. 

What are the causes of pain behind the ears?

If you wonder what set of symptoms go hand in hand with pain behind your ears, the answer may surprise you. The symptomology of this condition is very much dependent on the underlying cause of discomfort and the affected tissue. Understandably so, pain stemming from the bone produces very different symptoms than if the issue is with the nerves. Similarly, an inflammation feels different from an acute otitis media (middle ear infection) or a chronic ear infection. 
For instance, pressure-like aching pain is one of the most characteristic symptoms of a middle ear infection. However, the pain triggered by a bone infection behind the ear is most often described as throbbing. In addition, although most are familiar with the painful sensation of toothaches, problems with the teeth or jaw joint can also come with sharp ear pain. 
As mentioned above, pain behind the ears does not typically occur in isolation but with a whole host of other possible uncomfortable symptoms. Some of the most common accompanying symptoms - depending on the diagnosis - are hearing loss, pus-like ear discharge tinnitus (ringing in the ear), throbbing headache, toothache, or jaw pain. 

When should you seek emergency medical attention?

Although not every case of pain behind the ear warrants an emergency visit to the doctor's office, there are specific symptoms you should keep an eye out for. For instance, a high fever may indicate an infection, which means an antibiotic may be necessary to clear it. Other symptoms to be mindful of are excessive ear drainage, stiff neck, neck pain, neurological symptoms, and light sensitivity. 

Common causes of ear pain

Otitis Media
Otitis media is a common problem that many people face at some point during their lifetime. Although this condition primarily affects children, it can occur in adults as well. Otitis media happens when the space between the inner ear and the eardrum gets inflamed and infected. 

One of the possible reasons this infection can develop is Eustachian tube dysfunction. When the Eustachian tube - the canal that links the throat and middle ear - does not function properly, fluid does not drain normally from the middle ear. When drainage doesn't happen as it is supposed to, bacteria and viruses can proliferate and lead to acute otitis media. In addition to acute otitis media, there are two other types of otitis media - otitis media with effusion and chronic otitis media. 
Otitis Externa
Otitis externa also referred to as swimmer's ear occurs when the ear canal gets inflamed. You will likely experience ear discharge, itchy ears, hearing loss, and outer ear tenderness when you suffer from this condition. 

Symptoms of otitis externa can accompany conditions such as allergies and COVID. So how can you prevent otitis externa from developing? 
  • Avoid excessive ear cleaning
  • Be sure to dry your ears after swimming thoroughly
  • If you wear hearing aids, be sure to keep them as clean as possible
Impacted ears
Earwax, also known as cerumen, is a natural substance that fulfills various functions in the ear. One of these functions is to protect the lining of the outer ear canal. Under normal circumstances, manually removing earwax is unnecessary to keep your ears clean, thanks to the ear's self-cleaning abilities. However, if this earwax clearing process does not work properly, earwax can accumulate deep inside the ear canal, sometimes becoming impacted. 

Sticking Q-tips or fingers inside the ear canal is one of the top reasons for ending up with impacted ears. Other reasons are not controllable and include excessive earwax production, a narrow ear canal, drier than usual earwax, or wearing hearing aids.

Significant impaction can lead to symptoms such as pain behind the ear, tinnitus, and hearing loss. 
TMJ Disorder (Temporomandibular Joint Disorder)
The temporomandibular joint is in the front of your ear, where your jaw connects to your skull. TMJ disorders develop as a result of issues affecting this joint and the surrounding muscles. 

Dull, persistent pain near the ear is one of the hallmark symptoms of TMJ disorder. Movement of the mouth and chewing typically worsen the pain. Tinnitus, headaches, and jaw sounds (clicking and popping) are common accompanying signs of the condition. 
Occipital Neuralgia
Occipital neuralgia is a distressing condition when you suffer from severe shooting, stabbing, or electric shock-like pain that spreads through the upper neck and behind the ears. The characteristic pain comes on suddenly and affects only one side of the head, triggered by simple movements. 

The stabbing pain is not the only sign of the condition. People suffering from occipital neuralgia often complain of dizziness, nausea, tinnitus, and tenderness behind the ear.
Mastoiditis is a rare infection of the mastoid bone, which sits behind and below your ear. Mastoiditis typically occurs as a consequence of untreated or unsuccessfully treated acute otitis media. Pain behind the ear is not the only sign of this condition. Fever and headache also go along with it. 

You should seek immediate medical attention if you show signs of mastoiditis. Leaving it untreated can have devastating consequences, such as meningitis, infection of the skull bone, and even paralysis of the facial nerve. 

How to treat pain behind the ear?

Your treatment plan will differ depending on the cause of the pain. For instance, if an ear infection, such as otitis media or otitis externa, is at the root of the pain behind your ear, your doctor will likely prescribe an antibiotic. 

Mastoiditis requires an even more aggressive treatment approach, including IV antibiotics and surgical drainage of the infected fluid.

If your earache is due to impacted ears, over-the-counter earwax-softening drops may be quite effective. Or you may benefit from microsuction from a trained professional. 
TMJ disorders can be a bit complicated to treat. However, many people find relief with a combination of muscle relaxants, nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, and stress management. 

What to expect at the doctor's office

When you arrive at your appointment, your doctor will likely conduct a physical examination of the area of concern, such as your ears, jaws, neck, mouth, lymph nodes, and even the skin around your face. Your physician will try to understand the types of symptoms you experience and may refer you to the lab for blood tests. Imaging tests such as an X-ray may also be needed to determine the cause of the problem. 

Your treatment plan will depend on your doctor's findings and the actual diagnosis you receive. 


As you can see, pain behind the ear can have multiple causes, some of which can be quite serious. Therefore, if you are in discomfort, it's best to seek help from a healthcare professional.
The information contained in this article is for educational and informational purposes only. You should not use the information as a substitute for, nor should it replace, professional medical advice. If you have any questions about your health, you should always consult with a physician or other health-care professional.