Ear Pain Headache
If you have sinus pressure or viral infection in your ear, nose, or throat, it’s not uncommon to experience a headache as well. The ear, nose, and throat are connected and surrounded by hollow sinus cavities in the cheekbones, middle of the forehead, between the eyes, and in the nose.
- When you have sinusitis or tonsilitis, these cavities can fill with mucus and cause sinus pressure headaches.
- The mucus can also leak into the middle ear (the space just behind the eardrum) and cause an ear infection.
- Each of these (often viral) infections can irritate the nerves around the face and head and cause headaches or even migraines.
Now that you know the basics of how headaches happen, you may still be wondering, “Can an ear infection cause a headache?” The answer is yes, ear infections can cause headaches and even fevers. Ear infections are more common in children than in teens or adults.
Ear painFever of 100°F or higherLoss of appetiteIrritabilityLoss of balanceDifficulty sleeping
- 0.1 Is it normal to have ear pain with a headache?
- 0.2 What type of headache is by my ear?
- 0.3 Can ear pain be a migraine?
- 0.4 Can ear problems affect your head?
- 0.5 What is the reason for ear pain in adults?
- 1 How do you relieve ear pain?
What is the cause of ear pain and headache?
TMJ disorder – A doctor or dentist may advise a person to use a mouth guard while sleeping to prevent them from grinding their teeth. If other treatments do not work, a doctor may recommend injections of Botulinum toxin (Botox) for TMJ dysfunction, If other remedies do not help, TMJ surgery may be an option.
ongoing painsevere painother symptoms, such as a fever
Headaches behind the ear can be painful and worrying. Possible causes include occipital neuralgia, mastoiditis, and TMJ pain. Anyone who has ongoing or severe headaches behind the ears or additional symptoms, such as a fever, should seek medical advice.
Is it normal to have ear pain with a headache?
Earaches and headaches are common and can happen on both sides. They often come with other symptoms such as nausea and stress. Severe cases like throat infection and sinusitis can also cause serious head and ear pain on one side or both sides.
Can ear infection cause a headache?
Brain abscess – Another very rare and serious complication of a middle ear infection is a brain abscess. This is a pus-filled swelling that develops inside the brain. Symptoms of a brain abscess can include:
a severe headache changes in mental state, such as confusion weakness or paralysis on one side of the body a high temperature (fever) seizures (fits)
If you suspect that you or someone you know may have a brain abscess, call 999 for an ambulance. A brain abscess is usually treated using a combination of antibiotics and surgery. The surgeon will usually open the skull and drain the pus from the abscess or remove the abscess entirely.
What type of headache is by my ear?
Occipital Neuralgia is a condition in which the occipital nerves, the nerves that run through the scalp, are injured or inflamed. This causes headaches that feel like severe piercing, throbbing or shock-like pain in the upper neck, back of the head or behind the ears.
Osteoarthritis of the upper cervical spine Trauma to the greater and/or lesser occipital nerves Compression of the greater and/or lesser occipital nerves or C2 and/or C3 nerve roots from degenerative cervical spine changes Cervical disc disease Tumors affecting the C2 and C3 nerve roots Gout Diabetes Blood vessel inflammation Infection
Symptoms of occipital neuralgia include continuous aching, burning and throbbing, with intermittent shocking or shooting pain that generally starts at the base of the head and goes to the scalp on one or both sides of the head. Patients often have pain behind the eye of the affected side of the head.
- Additionally, a movement as light as brushing hair may trigger pain.
- The pain is often described as migraine-like and some patients may also experience symptoms common to migraines and cluster headaches,
- Occipital neuralgia can be very difficult to diagnose because of its similarities with migraines and other headache disorders.
Therefore, it is important to seek medical care when you begin feeling unusual, sharp pain in the neck or scalp and the pain is not accompanied by nausea or light sensitivity. Begin by addressing the problem with your primary care physician. They may refer you to a specialist.
- Diagnosis of occipital neuralgia is tricky, because there is not one concrete test that will reveal a positive or negative diagnosis.
- Typically, a physical examination and neurological exam will be done to look for abnormalities.
- If the physical and neurological exams are inconclusive, a doctor may order further imaging to rule out any other possible causes of the pain.
A magnetic resonance imaging (MRI) test may be ordered, which can show three-dimensional images of certain body structures and can reveal any impingement, A computed tomography scan (CT or CAT scan) will show the shape and size of body structures. Some doctors may use occipital nerve blocks to confirm their diagnosis.
Heat: patients often feel relief when heating pads or devices are placed in the location of the pain. Such heating pads can be bought over-the-counter or online. Physical therapy or massage therapy. Oral Medication:
Anti-inflammatory medications ; Muscle relaxants ; and Anticonvulsant medications.
Percutaneous nerve blocks: these injections can be used both to diagnose and treat occipital neuralgia. Botulinum Toxin (Botox) Injections : Botox injections can be used to decrease inflammation of the nerve
Occipital Nerve Stimulation : This surgical treatment involves the placement of electrodes under the skin near the occipital nerves. The procedure works the same way as spinal cord stimulation and uses the same device. The procedure is minimally invasive and surrounding nerves and structures are not damaged by the stimulation. It is an off-label indication for an FDA-approved device.
Spinal Cord Stimulation : this surgical treatment involves the placement of stimulating electrodes between the spinal cord and the vertebrae. The device produces electrical impulses to block pain messages from the spinal cord to the brain. C2,3 Ganglionectomy- This treatment involves the disruption of the second and third cervical sensory dorsal root ganglion, Acar et al (2008) studied the short-term and long-term effects of this procedure. The study found that 95% of patients had immediate relief with 60% maintaining relief past one year.
Patients are encouraged to regularly follow up with their primary care providers and specialists to maintain their treatment. Surgeons like patients to return to the clinic every few months in the year following the surgery. In these visits, they may adjust the stimulation settings and assess the patient’s recovery from surgery.
Evaluation of Occipital Nerve Stimulation in Intractable Occipital Neuralgias Ultrasound Guided Platelet Rich Plasma Injections for Post Traumatic Greater Occipital Neuraliga A Comparison of Dexamethasone and Triamcinolone for Ultrasound-guided Occipital C2 Nerve Blocks A Prospective Controlled Treatment Trial for Post-Traumatic Headaches
Sweet, J.A., Mitchell, L.S., Narouze, S., Sharan, A.D., Falowski, S.M., Schwalb, J.M., Pilitsis, J.G. (2015). Occipital Nerve Stimulation for the Treatment of Patients With Medically Refractory Occipital Neuralgia. Neurosurgery, 77 (3), 332–341. doi: 10.1227/neu.0000000000000872J This systematic review compiles treatment recommendations for the use of occipital nerve stimulation to treat occipital neuralgia. The review found various articles supporting these recommendaitons. Janjua, M.B., Reddy, S., Ahmadieh, T.Y.E., Ban, V.S., Ozturk, A.K., Hwang, S.W., Arlet, V. (2020). Occipital neuralgia: A neurosurgical perspective. Journal of Clinical Neuroscience, 71, 263–270. doi: 10.1016/j.jocn.2019.08.102 This paper investigates the different causes of occipital neuralgia and surgical interventions that have aided in relieving pain. The paper also provides case examples for each cause and corresponding treatment. The paper found that the C2 nerve is the most common site for compression causing the pain. Treatments such as C2 neurectomy and/or ganglionectomy offer the most pain relief for patients. Texakalidis, P., Tora, M.S., Nagarajan, P., Jr, O.P.K., & Boulis, N. (2019). High cervical spinal cord stimulation for occipital neuralgia: a case series and literature review. Journal of Pain Research, Volume 12, 2547–2553. doi: 10.2147/jpr.s214314P This study uses a literature review to support the author’s personal experiences treating occipital neuralgia with spinal cord sitmulation to show the efficacy of the treatment for this condition. The study found that high cervical spinal cord stimulation results in 40-50% success in patients with occipital neuralgia and thus, spinal cord stimulation may be considered as a treatment option.
Amy’s Occipital Neuralgia Story Michael’s Story
Patient Pages are authored by neurosurgical professionals, with the goal of providing useful information to the public. Julie G Pilitsis, MD, PhD, FAANS Chair, Neuroscience & Experimental Therapeutics Professor, Neurosurgery and Neuroscience & Experimental Therapeutics Albany Medical College Dr.
- Pilitsis specializes in neuromodulation with research interests in treatments for movement disorders and chronic pain.
- Olga Khazen, BS Research Coordinator Neuroscience & Experimental Therapeutics Albany Medical College The AANS does not endorse any treatments, procedures, products or physicians referenced in these patient fact sheets.
This information provided is an educational service and is not intended to serve as medical advice. Anyone seeking specific neurosurgical advice or assistance should consult his or her neurosurgeon, or locate one in your area through the AANS’ Find a Board-certified Neurosurgeon online tool.
Can ear pain be a migraine?
Discussion – In the current literature, migraine pathophysiology and treatment data have been dominantly produced by neurologists as it was thought to be a purely neurologic disease, but with the light shone from other perspectives, we know that migraine can present with many different symptoms other than headache involving other specialties including otolaryngology,
- It is conceivable for an otolaryngologist presented with migrainous otalgia, to easily miss the diagnosis and attribute the symptoms to a primary ear or sinus condition,
- Many studies documenting common causes for referred otalgia in the clinical setting do not examine migraine as a potential cause,
For example, in a study of origins of referred otalgia in a tertiary setting, 150 out of 450 patients had referred otalgia in which roughly 5% of patients (7 out of 150) had an unknown origin for their otalgia and none was attributed to migraines. Unfortunately, there are no standardized clinical criteria for diagnosing migraine associated otalgia and no easily discernable physical exam or radiologic findings that make the diagnosis of other causes of referred otalgia more straight-forward.
- Headache and dizziness are the only two typical migraine symptoms in the head and neck that are defined by clinical criteria (the IHS for headache and Nehauser’s for vestibular migraine),
- Various other head and neck manifestations can occur outside of the acute headache but are believed to result from the same pathophysiology process of migraines,
These symptoms include sinus pressure, nasal congestion, and runny nose, Referred migraine pain is common throughout the head and neck, and as many as 80% of patients with a “sinus” headache are diagnosed as fulfilling IHS migraine criteria at time of screening,
Otologic symptoms of migraine include ear fullness and pressure, ear pain, sound sensitivity, and tinnitus, Sabra et al. described ear pain and fullness as the most common non-dizzy migrainous ear symptoms. “50 patients (46.3%) presented for an atypical chief complaint out of which 34.2% were ear symptoms (mostly ear pain and fullness) and 14.8% nasal symptoms (mostly nasal congestion and sinus pressure) and 2.7% had an ear and nose atypical chief complaint.” According to Schulz et al.
, 38.2% of patients with positive migraine screening also reported unusual ear sensitivity and 38% experienced ear pressure. Teixido et al. found that 77% of their patients presenting with otalgia had a concordant headache history. All these data show the importance of the study of other manifestations of migraine specially in the head and neck area where they are dominantly innervated by trigeminal nerve.
Migrainous otalgia has been previously described only sparingly throughout the literature. One other paper was identified in our literature review that described the experience of treating patients with referred otalgia with traditional migraine therapy, In agreement with the criteria utilized by Teixido et al.
, we define migraine-associated otalgia or migrainous otalgia as otalgia in the setting of: 1) The absence of primary otogenic problem such as otitis media and secondary otalgia associated with non-otogenic problem such as temporomandibular joint dysfunction, or upper aerodigestive disorder.
- AND 1 or more of the following: 1) IHS defined migraine headaches and its subtypes, 2) triggerability by migraine triggers, 3) response to migraine therapy.
- In our tertiary medical center, migrainous otalgia was found in 64 patients out of 208 patients, which was as common as primary otalgia (n=64).
- This high rate of migrainous otalgia can be due to the difficulty of diagnosis of such cases in the community by the primary care providers or general otolaryngologists and the resultant higher rate of referring to higher level of care.
The female to male ratio in our migrainous otalgia group was 4.8:1 which was lower than this ratio in Teixido et al.’s study (12:1) and was greater than the reported 3.3:1 ratio in the adult migraine population, though none of these differences reached a significant level ( χ 2 =1.1431, p -value=0.285 and χ 2 =1.3489, p -value=0.245, respectively).
According to Olsson, “if a patient has migraine, but also has significant cochlear and/or vestibular dysfunction, the migraine syndrome and the peripheral organ must both be treated.” Our study is among the earliest to evaluate treatment outcomes in patients with otalgia and migraine headaches by using migraine therapy.
We propose treatment of migraine associated otalgia with migraine therapy. Our study reveals that otalgia of unknown source in patients with history of migraine can be successfully treated with traditional migraine therapy. Our results echo the findings of Teixido et al.’s study which showed 92% of 26 patients showed more than a 50% reduction in symptom scores with migraine treatment.
- In our study, 87% had significant improvement and 57% of patients experienced complete resolution of their earache after treatment.
- Our sample size was modestly larger at thirty patients even after excluding thirty four patients due to inadequate follow-up.
- Based on our experience, we created a treatment algorithm ( Fig.1 ).
To follow this algorithm, one should be aware of the side effects and contraindications of these medications. For example, propranolol is not recommended for diabetic and asthmatic patients and those with heart failure. As with any retrospective chart review, a limitation is reliance on correct documentation and diagnosis tracking in the electronic medical record.
Another limitation in our study is patient loss to follow-up. We had sixty four patients with unexplained otalgia who met IHS criteria for migraine and only thirty patients who had sufficient follow-up were analyzed for the efficacy of the treatment. However, the mean age and gender distribution were not statistically different between the treatment study group and all migrainous otalgia group which made this loss of follow up less detrimental.
The other limitation was having more than one reason for otalgia in some patients where detailed history, physical exam and response to the different treatments were used to determine the main reason of otalgia. Due to markedly common presentation, it is necessary to explore the frequency of stress symptoms, bruxism, and recurrent neck pain in patients with secondary otalgia This project is an introduction to a cohort research project to study the migrainous otalgia and the outcome of the treatment.
What does an ear infection headache feel like?
Ear problems – A dull, aching pressure on the side of the head, face, or jaw may indicate an ear infection or a vestibular migraine, Symptoms that usually accompany ear-related problems include:
pain in the ear, jaw, or templedizziness or vertigo trouble hearing tinnitus, or a ringing in the earsvision problemsfluid discharge from the ear
Can ear problems affect your head?
Ear conditions – What it feels like: Dull but constant pressure in the temples, ears, jaw, or side of the head. Ear conditions can affect one or both sides of the head. What it is: Ear infections and earwax blockages are common ear conditions that can cause head pressure with ear pain. Causes:
ear barotrauma ear infectionsearwax blockage labyrinthitis ruptured eardrum outer ear infection (swimmer’s ear)
What is the reason for ear pain in adults?
Causes – The eustachian tube runs from the middle part of each ear to the back of the throat. This tube drains fluid that is made in the middle ear. If the eustachian tube becomes blocked, fluid can build up. This may lead to pressure behind the eardrum or an ear infection.
Arthritis of the jawShort-term (acute) ear infectionLong-term (chronic) ear infectionEar injury from pressure changes (from high altitudes and other causes)Object stuck in the ear or buildup of ear waxHole in the eardrumSinus infectionSore throatTemporomandibular joint syndrome (TMJ)Tooth infection
Ear pain in a child or infant may be due to infection. Other causes may include:
Ear canal irritation from cotton-tipped swabsSoap or shampoo staying in the ear
How do you relieve ear pain?
Warm compress for an ear infection – A warm compress can help reduce ear pain. Just a soak a washcloth in warm water, wring out the excess water and then hold it against the infected ear for up to 20 minutes. If the compress seems to help with the pain, reapply the compress throughout the day.