Ear pain when swallowing is often caused by a sore throat, ear infection, or Eustachian tube problems. See a doctor if it persists.
Common causes
- Sore throat or tonsillitis. The throat and ear share nerves (referred pain).
- Ear infection (otitis media).
- Eustachian tube dysfunction from colds or allergies.
- Temporomandibular joint disorder (TMJ).
- Dental problems and wisdom teeth.
- Swollen lymph nodes.
Home care
Rest, fluids, warm compress and pain relievers.
See a doctor if
Pain lasts more than 2 days, there is fever, drainage, hearing loss or severe pain.
Rare
Swallowing pain with ear pain that persists for weeks, especially in smokers, needs evaluation for throat problems.
Children
Ear infections are common, so call the pediatrician.
Why swallowing can cause ear pain
The Eustachian tubes connect the middle ear to the back of the throat and open when you swallow to equalize pressure. Because the throat and ear share nerves, mainly the glossopharyngeal and vagus nerves, pain from the throat can be felt in the ear. This is called referred pain. Tonsil, throat and ear problems often cause an earache with swallowing.
Common causes
- Sore throat, strep throat or tonsillitis, where ear pain from swallowing is common.
- Middle ear infection (otitis media), with pressure, muffled hearing and sometimes fever.
- Eustachian tube dysfunction, with a feeling of fullness and popping, often with colds and allergies.
- Peritonsillar abscess, a pocket of pus near the tonsil, with severe one-sided throat pain, trouble opening the mouth and a muffled voice.
- Temporomandibular joint (TMJ) disorders.
- Dental problems, like an impacted wisdom tooth or abscess.
- Swimmer’s ear (otitis externa), which hurts when pulling the ear.
- Acid reflux irritating the throat.
Home care
- Use a warm compress on the ear.
- Take acetaminophen or ibuprofen as directed.
- Gargle with warm salt water and drink warm fluids.
- Use throat lozenges for sore throat.
- Chew gum or yawn to open the Eustachian tubes.
- Avoid inserting cotton swabs or objects into the ear.
See a doctor if
Pain lasts more than 2 days, there is fever above 102 F, fluid or blood draining from the ear, hearing loss, severe pain, swelling behind the ear, trouble swallowing or breathing, or drooling. Strep throat requires antibiotics to prevent complications such as rheumatic fever, and a rapid test can confirm it.
Rare causes
Persistent unexplained ear pain on one side with throat symptoms for several weeks, especially in smokers or heavy drinkers, can be an early sign of throat or tongue cancer and needs examination. Glossopharyngeal neuralgia is a rare nerve condition causing sharp stabbing pain in the throat and ear on swallowing.
Children
Children get ear infections more often because their Eustachian tubes are shorter and more horizontal. About 5 in 6 children have at least one ear infection by age 3. Pulling at the ear, fussiness, trouble sleeping and fever are signs. Call the pediatrician if you see these.
Eustachian tube and referred pain
The Eustachian tube connects the middle ear to the back of the nose and opens when swallowing to equalize pressure. When it is blocked by a cold, allergies or infection, pressure builds and ear pain follows. Sore throat and tonsillitis refer pain to the ear through the glossopharyngeal nerve, so swallowing hurts both. Temporomandibular joint disorders and dental infections can mimic ear pain. Chewing gum, yawning and decongestants can open the tube. A nasal steroid spray helps allergic cases. See a doctor for fever, discharge, hearing loss, severe pain or pain lasting over 2 days. Children get ear infections more because their tubes are shorter and flatter.
Based on data from the American Academy of Otolaryngology and the American Academy of Pediatrics
