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Ear Problems (Earaches, Infections & Earwax)

Earaches, ear infections, swimmer’s ear, earwax, blocked or “popping” ears and a ruptured eardrum — very common, especially in young children, and most get better on their own or with simple care.

Get medical care right away — call your doctor now, or go to urgent care or the emergency room — for:

  • Ear pain with a high fever, a stiff neck or a severe headache. A stiff neck or a very painful headache with a high temperature can be signs of meningitis, which needs emergency care (NHS). Rarely, an ear infection spreads to the bone behind the ear (mastoiditis), which can lead to meningitis or permanent hearing loss if it isn’t treated quickly (NHS). CDC advises seeing a provider for a fever of 102.2°F (39°C) or higher (CDC).
  • Swelling, redness or pain behind the ear, or an ear that starts to stick out — signs of mastoiditis, an infection of the bone behind the ear (NHS).
  • Sudden hearing loss, especially in one ear, sometimes with a “pop,” dizziness, ringing or a full feeling. Treat it as a medical emergency and see a doctor immediately — treatment works best when started early (NIDCD).
  • Drooping or weakness of one side of the face. Get emergency help, as it can be a sign of a stroke; it can also be Bell’s palsy, which needs prompt treatment (NHS). With an ear infection, also get urgent help for new dizziness, vomiting or a change in hearing (NHS).
  • An ear injury — after a blow to the head, bleeding or clear fluid from the ear or new hearing problems (NHS) — or something stuck in the ear. Don’t try to remove it yourself (NHS), and don’t put cotton swabs or anything else inside the ear (NHS).
  • A button battery in the ear (or nose) must be removed right away to avoid permanent damage (Poison Control). Don’t put any drops in the ear until a doctor has examined it (Poison Control).
  • A baby younger than 3 months with a temperature of 100.4°F (38°C) or higher — call right away (CDC, NHS). The NHS adds that a baby under 12 months who may have an ear infection should see a doctor (NHS).

Also contact a provider for fluid or pus draining from the ear, hearing loss, symptoms that get worse, or ear-infection symptoms lasting more than 2–3 days (CDC).

How common are ear problems?

Very common, especially in young children. Five out of six children will have at least one ear infection by their third birthday, and ear infections are the most common reason parents bring a child to the doctor (NIDCD). Adults get ear infections too, but they are less common (MedlinePlus). Children’s eustachian tubes — the small passages that link the middle ear to the back of the throat — are shorter and more level than adults’, so fluid drains less easily, and their immune systems are still developing (NIDCD).

The main ear problems

  • Middle-ear infection (acute otitis media). Infection and swelling behind the eardrum with trapped fluid, often starting after a cold or sore throat. It causes ear pain and sometimes fever (NIDCD). Both bacteria and viruses can cause it (CDC). Babies and young children may rub or pull at the ear, be irritable or restless, go off their food or keep losing their balance (NHS).
  • Fluid behind the eardrum (otitis media with effusion, or “glue ear”). Fluid without infection, often left over after an ear infection. It doesn’t cause fever or pain (CDC). Its most common symptom is temporary hearing loss; children may ask for the TV to be turned up or seem easily distracted (NHS).
  • Swimmer’s ear (otitis externa). An infection of the outer ear canal, usually from water that stays in the ear. The ear hurts when the outer ear is tugged or pressed, and may itch, drain, look red or swell (CDC).
  • Earwax buildup. Wax protects the ears from dirt and germs and normally falls out on its own, but it can build up and block the ear (NHS) — a common, treatable cause of hearing loss (NHS).
  • Eustachian tube problems and airplane ear (barotrauma). When the eustachian tube is blocked, the air pressure in the middle ear can’t even out with the pressure around you (CDC). A cold, sore throat, sinus infection or ear infection can narrow the tube (FAA). On a plane, trouble usually comes during descent: the ear feels full, hearing gradually becomes muffled, and then it hurts (FAA). It is usually not severe, but rarely it can cause dizziness, hearing loss, a burst eardrum or lasting ringing (CDC). Get urgent advice for sudden hearing loss, or hearing loss with earache or discharge (NHS).
  • Ruptured (perforated) eardrum. A hole or tear in the eardrum. Symptoms usually start suddenly after an ear infection, an injury, a loud noise or a sudden change in air pressure, and can include hearing loss, ringing, earache, and clear fluid, blood or pus leaking from the ear. Keep the ear dry and see a provider; it usually heals by itself within 2 months (NHS).
  • Objects in the ear. Don’t try to remove an object stuck in the ear yourself — see a doctor (NHS, NHS).

Ear pain isn’t always from the ear: it can come with teething or a dental abscess, a sore throat or tonsillitis (NHS), or a jaw-joint problem (temporomandibular disorder, TMD) (NHS). Spinning dizziness from the inner ear is covered in our Dizziness & Vertigo guide. Separate MBHA guides to tinnitus (ringing in the ears) and Ménière’s disease are on the way.

How ear problems are diagnosed

The clinician looks at the eardrum with a lighted otoscope; a red, bulging eardrum points to infection. A pneumatic otoscope puffs air to see whether the eardrum moves, since one with fluid behind it moves less (NIDCD). Tympanometry uses a small, soft plug in the ear that varies the air pressure and measures how flexibly the eardrum moves (NIDCD). Guidelines advise it when fluid is suspected but the diagnosis is still unclear (AAO-HNS guideline, 2016). A hearing test is advised if fluid lasts 3 months or longer (AAO-HNS guideline).

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Pain relief first; watchful waiting for some mild middle-ear infections, with antibiotics when they are needed; ear tubes for repeated infections or long-lasting fluid with hearing problems; antibiotic ear drops for swimmer’s ear; and softening drops, rinsing or in-office removal for blocked earwax. Without insurance: urgent care about $100–$250 for a basic visit, retail clinic about $80–$200+, telehealth about $40–$90. Earwax removal and ear tubes: cost estimate being researched. Strong evidence and national guidelines. Many middle-ear infections clear without antibiotics, most ear infections clear up within a few days, and fluid usually clears within weeks to months.
Chiropractic Some chiropractors offer gentle spinal or neck adjustments for children with ear infections, aiming to help fluid drain. Without insurance, about $90–$200 for a first visit and $55–$100 for follow-ups. Studied, but with little high-quality evidence: reviews find no good evidence to support or refute it. Serious harm in children appears rare, but how often it happens is unknown. Not a substitute for a medical exam.
Acupuncture Fine needles, sometimes at points around the ear. About $125–$230 for a first visit and $90–$185 for follow-ups; community clinics about $50–$90. Very little research: a review found only a few human studies, none in English. We found no good evidence that it treats ear infections.
Herbal medicine Herbal ear drops such as garlic and mullein oil blends for ear pain. Never use any drops if the eardrum may be torn or there are ear tubes. Avoid ear candling. Cost estimate being researched. Two small trials found herbal drops eased ear pain about as well as numbing drops, but most pain went away with time alone. Ear candles don’t work and can burn the ear.
Massage therapy Gentle massage of tight jaw muscles when ear pain comes from the jaw joint, and warmth on a sore ear, for comfort. One national chain’s franchises list about $125–$160 for a 60-minute massage for non-members; memberships about $70–$90 a month. Little research. It may feel soothing, but it doesn’t treat infection, and we found no good evidence that it clears blocked ears.
MBHA Wellness Coach Prevention habits: vaccines, a smoke-free home, breastfeeding and no bottles in bed, dry ears after swimming, nothing in the ear canal, pressure tricks for flying, cold prevention and hearing protection. MBHA coaching cost estimate being researched. These steps lower the risk of ear infections, swimmer’s ear, airplane ear and noise damage. Noise-induced hearing loss is completely preventable.

Approach 1 of 6

Conventional medicine (AMA)

Most ear problems are handled by a primary care provider or pediatrician; persistent or complicated problems go to an ear, nose and throat specialist (otolaryngologist). Treatment depends on which part of the ear is affected.

1. Middle-ear infections: pain relief first, antibiotics when needed

The 2013 American Academy of Pediatrics (AAP) and American Academy of Family Physicians guideline covers children 6 months through 12 years with uncomplicated ear infections. It sets a strict definition of an ear infection and addresses pain relief, when to watch rather than start antibiotics, which antibiotics to use, and prevention (AAP guideline, 2013). In practice:

  • Treat the pain. A warm cloth on the ear and over-the-counter pain relievers such as acetaminophen (paracetamol) or ibuprofen can help; children under 16 should not take aspirin (NHS, NIDCD). If the eardrum may have burst, don’t put ear drops in unless a doctor recommends them (NHS). We don’t list doses — ask your pharmacist or pediatrician.
  • Watchful waiting or a delayed prescription. For a mild infection, your provider may suggest waiting 2–3 days to see if the body clears it, or give a prescription to fill only if symptoms don’t improve (CDC). CDC’s summary of the AAP guideline says mild cases in one ear in children 6–23 months old, or in one or both ears in children over 2, may be suitable for watchful waiting after a shared decision with the family (CDC). If there is no improvement within 48–72 hours, antibiotics are started (NIDCD).
  • Antibiotics when indicated. Severe infections, or infections lasting longer than 2–3 days, need antibiotics (CDC). MedlinePlus notes that infections in young babies may also need them (MedlinePlus). If prescribed, finish the full course (NIDCD). Antibiotics can cause side effects such as a rash, nausea or diarrhea, and they don’t work against viruses (MedlinePlus).
  • Daily preventive antibiotics are not recommended to reduce repeated ear infections (CDC).

2. Fluid behind the eardrum: wait, watch and check hearing

Most fluid clears on its own. Fluid left after an infection usually disappears within 3 to 6 weeks (NIDCD), and glue ear often clears up within 3 months (NHS). The 2016 ear, nose and throat (AAO-HNS) guideline strongly recommends watchful waiting for 3 months for children who aren’t at extra risk, and recommends against steroids, antibiotics, antihistamines or decongestants for fluid alone. It advises a hearing test if fluid lasts 3 months or more (AAO-HNS guideline, 2016). Children whose speech, language or learning is already at risk need a hearing test whatever the duration (AAO-HNS guideline).

Nasal balloon “autoinflation” — blowing up a balloon through the nose to push air into the middle ear — is a low-cost option. A Cochrane review of 8 small, short trials found it reasonable to consider while waiting for fluid to clear, with no difference in side effects (Cochrane review, 2013), and a 2015 trial in 320 children aged 4–11 found more children had normal ear-pressure tests at 3 months, with better ear-related quality of life (trial, CMAJ). Ask your provider whether it suits your child.

3. Ear tubes for repeated infections or lasting fluid

Ear tubes (tympanostomy tubes) are tiny tubes placed through the eardrum to let air in and fluid drain; the most commonly used tubes stay in place for 6 to 9 months and fall out on their own (NIDCD). They are the most common outpatient surgery for U.S. children. The 2022 AAO-HNS guideline says clinicians should offer tubes for fluid in both ears lasting 3 months or longer with documented hearing difficulties, and for repeated ear infections when fluid is present at the time of assessment — but not for a single bout of fluid lasting less than 3 months, or for repeated infections when the ears are clear. A draining ear with tubes is usually treated with antibiotic ear drops alone, and children with tubes don’t routinely need earplugs or to stay out of the water (AAO-HNS guideline, 2022).

4. Swimmer’s ear: antibiotic ear drops

The 2014 AAO-HNS guideline says uncomplicated swimmer’s ear should be treated first with ear drops, not antibiotics by mouth, unless the infection has spread beyond the ear canal or the person has health factors that call for it. It also stresses checking and treating pain, using drops that are safe for the inner ear when the eardrum may have a hole or there is a tube, and rechecking anyone who isn’t better in 48–72 hours (AAO-HNS guideline, 2014). If the canal is blocked, the clinician may clean it or place a wick to help the drops get in, and should check for factors such as diabetes or a weak immune system that change treatment (AAO-HNS guideline). People with diabetes or a weakened immune system should get urgent advice for ear-infection symptoms (NHS).

5. Earwax: treat only when it causes problems

The 2017 AAO-HNS guideline says clinicians should treat earwax that causes symptoms or blocks the view of the ear, but not wax that causes no problems. Options are softening drops (including water or saline), rinsing (irrigation) or removal with instruments, with extra care for people with a non-intact eardrum, diabetes, a weak immune system or blood thinners; it recommends against ear candling (AAO-HNS guideline, 2017). See Earwax: safe care and what to avoid below.

What it costs

  • Urgent care for ear pain: about $100–$250 for a basic visit without insurance, more with tests or treatment (The Pricer).
  • Retail clinic: a CVS MinuteClinic visit for a minor illness, such as ear discomfort, commonly costs about $80–$200+ without insurance (The Pricer).
  • Telehealth: many basic cash-pay virtual visits cost about $40–$90 (The Pricer).
  • Earwax removal and ear tubes: MBHA cost estimate being researched.

How well it works — what to expect

Most ear infections clear up within 3 days, though symptoms sometimes last up to a week (NHS). Some children keep getting them, sometimes five or six a year (NIDCD), and fluid can linger for weeks or months (NHS). Earwax symptoms should improve as softened wax falls out or is removed (NHS); if symptoms persist after the wax has cleared, the clinician should look for another cause (AAO-HNS guideline).

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic is a licensed health profession; care usually involves hands-on therapy, often spinal manipulation (NCCIH). Some chiropractors treat children’s ear infections with gentle spinal or neck adjustments, on the idea that this helps the eustachian tubes open and fluid drain (review, Medicine). This has been studied, but the evidence is thin.

What the research says

  • 2012 literature review: of 49 articles on spinal manipulation for children’s ear infections, most were commentaries and case reports; only 4 were clinical trials. The authors found limited-quality evidence and concluded there is currently no evidence to support or refute spinal manipulation for ear infections (review, J Chiropr Med).
  • 2016 review of complementary treatments: found only limited-quality evidence and no clear evidence supporting spinal manipulation for ear infections (review, Medicine).
  • 2019 review of manual therapy in children: across 50 studies, the evidence for ear infections was rated inconclusive or unclear; only low back pain, pulled elbow and premature infants had moderately positive findings (systematic review, BMC Complement Altern Med).

Safety for babies and young children

  • A 2020 review found most reported side effects in children under 10 were mild, such as more crying or soreness, though one case report described a rib fracture in a 21-day-old baby. The risk of moderate or serious harm is unknown (rapid review, Chiropr Man Therap).
  • A 2015 review found serious harms after manual therapy in children are rarely reported; most involved high-velocity manipulation and an underlying health problem, so a careful exam beforehand matters (review, J Manipulative Physiol Ther).

See a medical provider first. Ear pain with fever, swelling behind the ear, facial weakness or sudden hearing loss needs medical care, not an adjustment (see the warning box at the top of this page). Babies under 12 months who may have an ear infection should see a doctor (NHS). Before choosing a chiropractor, ask about their education and licensure (NCCIH).

What it costs

Without insurance, a first appointment commonly runs about $90–$200 and a follow-up visit about $55–$100 (The Pricer).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

There is very little research on acupuncture for ear problems. A 2016 review of complementary treatments for children’s ear infections found only a few human studies, none published in English; the other studies it found were in dogs, and may not apply to people (review, Medicine). An earlier review called traditional Chinese and Japanese therapies for ear infections promising but speculative until more research is done (review, Int J Pediatr Otorhinolaryngol).

In short, we found no good evidence that acupuncture treats ear infections, fluid behind the eardrum, swimmer’s ear or blocked ears. If you try it, use it alongside — not instead of — a medical diagnosis, and never delay care for the warning signs above.

Safety

Relatively few complications have been reported, but problems have come from non-sterile needles and poor technique. FDA requires needles to be sterile and single-use, and most states license acupuncturists (NCCIH).

What it costs

Private sessions run about $125–$230 for a first visit and $90–$185 for follow-ups; community clinics about $50–$90 a visit (The Pricer).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

Never put anything in an ear that might have a torn eardrum or ear tubes. With a burst eardrum, don’t put anything in the ear, including ear drops, unless a doctor recommends it (NHS), and ear tubes keep the eardrum open (NHS). Signs the eardrum may have burst include sudden hearing loss, ringing, and clear fluid, blood or pus leaking from the ear (NHS). If a button battery could be in the ear, put no drops in it until a doctor has examined it (Poison Control).

Herbal ear drops (garlic, mullein and similar)

Naturopathic ear drops made with garlic, mullein flower, calendula and St. John’s wort in olive oil have been tested in two small trials from one research group in Israel:

  • 2001: in 103 children aged 6–18 with ear pain from a middle-ear infection, the herbal drops eased pain about as well as numbing (anesthetic) ear drops over 3 days (trial, Arch Pediatr Adolesc Med).
  • 2003: in 171 children aged 5–18, ear pain improved in every group over 3 days. Results were somewhat better with the herbal drops, but the authors noted that pain was mostly (80%) self-limited and could be explained by the passing of time; adding an antibiotic did not seem to help pain (trial, Pediatrics).

A later review notes these drops have been criticized because their claimed anti-inflammatory effects couldn’t be confirmed (review, Medicine), while another says herbal drops may help relieve symptoms during watchful waiting (review, Int J Pediatr Otorhinolaryngol). In short: they may ease pain a little in older children with an intact eardrum, but they don’t replace a medical exam, and they don’t treat swimmer’s ear or a ruptured eardrum. We don’t list doses or recipes — homemade garlic oil in particular hasn’t been tested.

Ear candling: don’t

Ear candling means burning a hollow candle with one end in the ear canal, supposedly to suck out wax. A 1996 study found ear candles create no suction and removed no wax — candle wax was actually left in some ears — and a survey of ear specialists turned up 21 injuries (study, Laryngoscope). The FDA says there is no valid scientific evidence that ear candles work and that holding a lit candle near the face risks severe burns and ear damage; it treats them as unapproved medical devices that can be stopped at the border (FDA import alert). The national earwax guideline recommends against ear candling (AAO-HNS guideline).

Approach 5 of 6

Massage therapy

There is little research on massage for ear problems. It doesn’t treat ear infections or swimmer’s ear, and we found no good studies showing it clears blocked ears.

  • For a blocked, full feeling: we found no good evidence that massage helps. On a plane, swallowing, yawning or tensing the throat muscles usually lets the pressure even out (FAA); see Flying in the Wellness Coach section.
  • Jaw and neck tension: a jaw-joint problem (TMD) can cause pain around the jaw, ear and temple, and the NHS suggests massaging the painful jaw muscles as self-care (NHS). Massage may also give short-term relief of neck and shoulder pain (NCCIH).
  • Comfort: a warm cloth on the sore ear can help relieve earache (NHS).

Safety

The risk of harm from massage appears low, though rare serious problems have been reported, mostly with vigorous techniques (NCCIH). Don’t massage a red, swollen or painful area behind the ear — that needs a doctor (NHS).

What it costs

Prices vary by location. At one national chain, franchise price lists show about $125–$160 for a 60-minute massage for non-members and about $65–$90 for members, whose memberships run about $70–$90 a month (The Pricer). Tips are extra.

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

Many ear problems can be prevented. An MBHA Wellness Coach can help your family build these habits — always alongside your medical care.

Vaccines, hand washing and a smoke-free home

  • Get recommended vaccines, such as the flu and pneumococcal vaccines; the pneumococcal vaccine protects against a common cause of middle-ear infections (CDC). CDC recommends pneumococcal vaccination for all children under 5 and adults 50 and older, among others (CDC), and a flu vaccine every season for everyone 6 months and older, with rare exceptions (CDC).
  • Wash hands often to cut down on colds and flu, and keep sick children apart as much as possible (NIDCD).
  • Children whose parents smoke around them get more ear infections, have fluid in their ears more often and have more ear-tube operations (CDC). A coach can help with a quit plan and smoke-free rules for home and car.

Feeding babies

Dry ears, and nothing in the ear canal

  • Use a swim cap, earplugs or swim molds. Afterward, tilt each ear down, gently pull the earlobe to let water drain, and towel dry; a hair dryer on the lowest setting, held several inches away, can finish the job (CDC).
  • Ask your provider before using ear-drying drops, and never use them with ear tubes, a punctured eardrum, swimmer’s ear or drainage (CDC).
  • Keep cotton swabs, pencils, paperclips and keys out of the ear canal (CDC), and store spare and used button batteries out of sight and reach of young children, with battery compartments secured shut (Poison Control).

Flying

  • Swallow or yawn now and then as the plane descends, and stay awake for landing, since we swallow less often while asleep. Give babies a bottle or pacifier, and let small children chew gum. If that doesn’t work, try the Valsalva technique — close your mouth, pinch your nostrils shut and blow air into your nose — early, before the ears become painful (FAA).
  • If you have an ear, nose or sinus infection or bad congestion, consider postponing the flight or ask your provider about a decongestant (CDC). Forcing air into the ears during a cold may carry the infection into the middle ear (FAA). More travel tips are in our Air & Motion Sickness guide.

Colds and stuffy noses

Ear infections often begin after a cold, sore throat or other respiratory infection; when the eustachian tubes are swollen or blocked with mucus, fluid may not be able to drain (NIDCD). The NHS also advises treating conditions that affect the ears, such as eczema (NHS). See our Allergies guide and Common Cold guide.

Protecting your hearing from noise

Noise-induced hearing loss is the only type of hearing loss that is completely preventable. Long or repeated exposure to sounds at or above 85 decibels can damage hearing — loud headphones, concerts, lawn mowers, fireworks and guns are common culprits. Wear earplugs or earmuffs, move away from noise you can’t reduce, protect young children’s ears, and get your hearing tested if you notice changes (NIDCD). MBHA coaching cost estimate being researched.

Another approach

Earwax: safe care and what to avoid

Earwax is not dirt. It protects your ears from dirt and germs, and it usually falls out on its own (NHS). Wax that causes no symptoms doesn’t need treatment (AAO-HNS guideline).

Signs of a blockage

Hearing loss, earache or a feeling that the ear is blocked, ringing or buzzing (tinnitus), or dizziness (NHS).

Do

  • For a blockage, softening drops — olive oil, almond oil (not if you’re allergic to almonds) or ear drops from a pharmacy — can help the wax fall out on its own; a pharmacist can advise (NHS). Clinicians may also use water or saline to soften wax (AAO-HNS guideline).
  • If you wear hearing aids, expect your clinician to check your ears for wax at visits (AAO-HNS guideline).
  • See a provider if symptoms haven’t cleared after 5 days, or if your ear is badly blocked and you can’t hear anything. A clinic can flush the wax out with water, suck it out (microsuction) or scrape it out with a very small tool (NHS).

Don’t

Another approach

Children’s ear infections

Signs to look for

Most ear infections happen before children can say “my ear hurts.” Look for tugging at the ear, fussiness and crying, trouble sleeping, fever, fluid draining from the ear, clumsiness, or not responding to quiet sounds (NIDCD). Young children may also be off their food (NHS).

Caring for your child at home

Rest, extra fluids and over-the-counter pain or fever medicine as directed help (CDC), and a warm cloth on the ear can ease the pain (NHS). A child with a high temperature, or who doesn’t feel well enough for normal activities, should stay home until they feel better (NHS). Call your pediatrician for the warning signs at the top of this page, or if earache lasts more than 2–3 days, your child becomes generally unwell, fluid comes from the ear, their hearing changes, or a child under 2 has earache in both ears (NHS).

Hearing and speech

Fluid behind the eardrum commonly causes temporary hearing loss; if it lasts a long time, it can affect a child’s speech development and progress at school (NHS). If fluid lasts 3 months or longer, ask about a hearing test (AAO-HNS guideline).

Another approach

A note on hearing loss

Hearing loss from fluid behind the eardrum or a burst eardrum is usually temporary (NHS, NHS), and earwax build-up can be treated with ear drops or removed (NHS). Gradual hearing loss with age is common: about one in three U.S. adults aged 65–74 has hearing loss, and nearly half of those over 75 have difficulty hearing (NIDCD). If you find TV, parties or group conversations hard to follow, consider a hearing check. Over-the-counter hearing aids are available for adults with mild to moderate hearing loss, and a primary care doctor, ENT or audiologist can help with more complex problems (NIDCD). Sudden hearing loss is different: see a doctor immediately (NIDCD).

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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