Constant Pain? Why Your Middle Ear Is Infected + Medically Approved Next Steps

If you're dealing with constant ear pain, pressure, or muffled hearing, a middle ear infection could be the cause. This condition—also known as acute otitis media—is common in both children and adults. While it can be uncomfortable and frustrating, most cases are treatable and improve with the right care.

Here's what you need to know about why middle ear infections happen, what symptoms to watch for, and what medically approved steps you should take next.

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What Is a Middle Ear Infection?

A middle ear infection occurs when the space behind your eardrum (the middle ear) becomes inflamed and filled with fluid. This usually happens after a cold, sinus infection, or upper respiratory infection.

The middle ear connects to the back of your throat through a small canal called the Eustachian tube. When this tube becomes swollen or blocked, fluid gets trapped behind the eardrum. Bacteria or viruses can grow in that trapped fluid, leading to infection.

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Why Does a Middle Ear Infection Cause Constant Pain?

The pain from a middle ear infection happens for a few key reasons:

• Fluid buildup creates pressure behind the eardrum
• Inflammation causes swelling and irritation
• The eardrum stretches due to trapped fluid
• In severe cases, pus may accumulate

Because the middle ear is a small, enclosed space, even a little swelling can feel intense. That's why the pain can seem constant or throbbing.

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Common Symptoms of a Middle Ear Infection

Symptoms can range from mild to severe. The most common include:

• Persistent ear pain (sharp, dull, or throbbing)
• A feeling of fullness or pressure in the ear
• Muffled or reduced hearing
• Fluid draining from the ear (in some cases)
• Fever
• Headache
• Trouble sleeping due to discomfort

In children, you might also notice:

• Tugging or pulling at the ear
• Irritability
• Difficulty feeding
• Trouble balancing

If symptoms develop suddenly after a cold, a middle ear infection is often the cause.

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What Causes a Middle Ear Infection?

Most middle ear infections are caused by:

• Viruses (such as those that cause colds or flu)
• Bacteria that grow in trapped fluid
• Allergies that cause nasal swelling
• Sinus infections
• Enlarged adenoids (more common in children)

Risk factors include:

• Recent upper respiratory infection
• Smoking exposure
• Seasonal allergies
• Being around others who are sick
• Young age (children's Eustachian tubes are shorter and more easily blocked)

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Is a Middle Ear Infection Serious?

In most cases, a middle ear infection is not dangerous and clears within a few days to a week.

However, untreated or severe infections can lead to complications such as:

• Temporary hearing loss
• Ruptured eardrum
• Spread of infection to nearby tissue
• Chronic ear infections

These complications are uncommon but possible. That's why ongoing or worsening symptoms should not be ignored.

If you're experiencing persistent ear pain and want to understand whether it could be an Ear Infection, a free AI-powered symptom checker can help you assess your symptoms and determine the right next steps before your doctor visit.

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Medically Approved Next Steps

1. Manage Pain First

Pain control is the first priority.

Doctors commonly recommend:

• Acetaminophen (Tylenol)
• Ibuprofen (Advil, Motrin)

These reduce both pain and inflammation. Always follow dosing instructions carefully, especially for children.

A warm compress placed over the ear may also help relieve discomfort.

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2. Watchful Waiting (When Appropriate)

Not every middle ear infection requires antibiotics.

In many cases—especially mild ones—doctors recommend watchful waiting for 48–72 hours because:

• Many infections are viral
• The body often clears the infection on its own
• Avoiding unnecessary antibiotics prevents resistance

However, this approach is usually only appropriate if:

• Symptoms are mild
• There is no high fever
• The patient is otherwise healthy
• Pain is manageable

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3. Antibiotics (When Needed)

Antibiotics may be prescribed if:

• Symptoms are severe
• Pain is intense
• Fever is high
• Symptoms last more than 2–3 days
• The patient is very young
• There are signs of bacterial infection

If prescribed antibiotics:

• Take the full course
• Do not stop early, even if you feel better
• Follow up if symptoms don't improve within 48–72 hours

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4. Monitor for Warning Signs

While most middle ear infections resolve without serious issues, seek urgent medical care if you notice:

• Severe headache
• Stiff neck
• Swelling behind the ear
• Facial weakness
• Persistent high fever
• Dizziness or balance problems
• Ear drainage with worsening pain

These symptoms could signal a more serious complication and require immediate evaluation.

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How Long Does a Middle Ear Infection Last?

• Pain often improves within 1–3 days
• Fluid may remain behind the eardrum for several weeks
• Hearing may feel muffled until fluid fully clears

If hearing problems last longer than a few weeks, follow up with a healthcare provider.

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Can You Prevent Middle Ear Infections?

While you can't prevent every case, you can reduce risk by:

• Washing hands frequently
• Avoiding close contact with sick individuals
• Managing allergies
• Staying up to date on vaccinations (including flu vaccine)
• Avoiding cigarette smoke exposure
• Treating sinus infections promptly

For people with repeated infections, a doctor may refer you to an ear, nose, and throat (ENT) specialist. In some cases, small tubes may be placed in the eardrum to prevent fluid buildup.

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When Should You Speak to a Doctor?

You should speak to a doctor if:

• Pain is moderate to severe
• Symptoms last more than 2–3 days
• There is a high fever
• Hearing loss is significant
• Symptoms keep returning
• The infection occurs in a baby or toddler

Any symptom that feels severe, worsening, or unusual should be evaluated. If you suspect a serious complication or life-threatening issue, seek urgent medical care immediately.

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The Bottom Line

A middle ear infection is a common cause of constant ear pain, pressure, and temporary hearing changes. Most cases improve with proper care, whether through watchful waiting or antibiotics when necessary.

The key is to:

• Manage pain appropriately
• Monitor symptoms carefully
• Know when to seek medical help
• Follow your doctor's instructions closely

If you're unsure whether your symptoms match an Ear Infection, using a free online symptom checker can provide clarity and help you prepare for a more informed conversation with your healthcare provider.

Above all, don't ignore persistent or worsening symptoms. Speak to a doctor about anything that could be serious or life threatening. Early evaluation helps ensure the best outcome and protects your hearing long term.