Ear pain and a sore throat can appear at the same time, particularly during a cold or throat infection. In some cases, the problem starts in the ear. In others, the ear itself is healthy, and the pain travels from the throat.
If you have ear pain and a sore throat, an ear, nose and throat (ENT) specialist may examine both areas, even when one symptom feels more noticeable.
Why can throat pain be felt in the ear?
The ear and throat are connected through a network of sensory nerves, which carry information such as pain to the brain. Some of the same nerves supply both areas. This means the brain can sometimes interpret throat pain as coming from the ear. This is known as ‘referred pain’, meaning pain felt somewhere other than its actual source.
The middle ear, which is the space behind the eardrum, is also connected to the back of the nose by the Eustachian tube. This narrow passage helps balance pressure in the ear.
Sometimes, swelling and mucus caused by a cold or another infection affecting the nose and throat can block this tube, creating pressure or discomfort.
Common causes of ear and throat pain
Tonsillitis is a common cause. This is inflammation of the tonsils, the two small pads of tissue at the back of the throat. Alongside a sore throat and painful swallowing, tonsillitis can cause earache, a high temperature and swollen glands in the neck.
Other possible causes include:
- A viral sore throat or cold – may inflame the throat and affect pressure in the middle ear
- A middle ear infection – can cause pain alongside fever, reduced hearing or a feeling of fullness
- Quinsy – a collection of pus beside a tonsil that can cause severe one-sided throat pain, referred ear pain and difficulty opening the mouth
- Irritation elsewhere in the head or neck – including dental problems and jaw joint conditions
How can you tell where the pain is coming from?
Pain that becomes worse when you swallow, together with a red or inflamed throat, may suggest that the throat is the source.
Ear discharge, reduced hearing or marked pressure inside the ear may point towards an ear condition.
However, symptoms can overlap. An examination is often needed to check the ear canal and eardrum, as well as the mouth, tonsils, throat and neck. An ENT specialist can assess both areas and identify the likely cause.
When to seek an ENT specialist
Arrange an assessment if the pain is persistent, keeps returning or is mainly on one side. You should also seek medical advice if you experience:
- A neck lump
- Ongoing hoarseness
- Unexplained weight loss
- Difficulty swallowing
- Ear pain when the ear itself appears normal
- Symptoms that are getting worse rather than improving
Most causes are not serious, but persistent or one-sided symptoms may need further investigation.
Call 999 or go to A&E if:
- You are struggling to breathe
- You cannot swallow
- You are drooling because you cannot swallow your saliva
- Your symptoms are severe or worsening quickly
Get specialist support for ear and throat pain
Ear and throat pain can have several possible causes, particularly when symptoms continue, return or affect one side more than the other.
Mr Wale Olarinde, an experienced ENT specialist and head and neck surgeon, can examine your ears and throat to identify where the pain is coming from and recommend the most appropriate treatment.
Book a consultation with ENT Sheffield for a specialist assessment and personalised advice.