Earache Health Article

What to expect at your health care provider's office

The doctor will perform a physical examination, which may include examination of the ear, nose, mastoid (bony part behind the ear), and throat. Pain, tenderness, or redness of the mastoid often indicates a serious infection.

During the examination, the doctor will ask questions about the ear pain, such as:

• When did it begin?
• Is it getting better, worse, or staying the same?
• Is the pain constant?
• What other symptoms are also present?
• Is there ear pressure?
• Is there drainage from the ear?
• Are there unusual ear noises?
• Is there a fever?
• Is there pain in the bone behind the ear?
• Is there hearing loss?

Because most ear infections improve within 24 hours of seeing a doctor, physicians are less likely to prescribe antibiotics immediately, often waiting to see if symptoms persist or progress. This strategy has been shown to reduce antibiotic usage.

If antibiotics are prescribed, it is important to take ALL of the prescribed antibiotic on schedule. Ear tubes may be inserted for children who have persistent or recurring ear infections, to re-establish the proper functioning of the middle ear. Inserting ear tubes is a simple and effective surgical procedure.

Prevention

The following steps may help prevent earaches:

• Avoid smoking near children. Smoking has been shown to cause millions of ear infections each year in children.
• Take steps to control allergies. In particular, avoid allergy triggers. Steroid nasal spray may help reduce ear infections. However, over-the-counter sedating antihistamines and decongestants do NOT prevent ear infections.
• Outer ear infections can be prevented by not putting objects in the ear, and drying the ear after bathing or swimming.

References

American Academy of Pediatrics Subcommittee on Management of Acute Otitis Media. Diagnosis and management of acute otitis media. Pediatrics. 2004 May;113(5):1451-65. Review.