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The Doctors Book of Home Remedies: Earache

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Earache

12 Ways to Stop the Pain

It's a fact. Earaches are worse at night. And it's not just because finding medical help is harder after everyone has gone to bed.

Plugged eustachian tubes (which lead from the back of the throat to the middle ear) are the most common cause of earache for children and adults, explains Dudley J. Weider, M.D., an otolaryngologist at Dartmouth-Hitchcock Medical Center in Hanover, New Hampshire. And the situation is usually aggravated by a cold, sinus infection, or allergy.

During the day, you hold your head up and your eustachian tubes drain naturally into the back of your throat. Also, as you chew and swallow, the muscles of the eustachian tubes contract, opening them and allowing air into the middle ear.

But at night when you sleep, things change. You fall asleep feeling just fine. But those tubes no longer drain naturally. And you're not swallowing as often, so they aren't getting as much air. The air already in the middle ear is absorbed and a vacuum occurs, sucking the eardrum inward. Then about midnight you awaken with the feeling that someone has jammed a hot poker through your ear.

Other things cause earaches, too. Infections, such as swimmer's ear, can trigger pain. Atmospheric pressure from airplane travel and deep-sea diving can also cause ears to ache. Odd things, like tiny clippings from a haircut, can fall into the ear canal and irritate your ears. Then there's referred pain—a problem that exists somewhere else—that makes your ears tingle. Those earaches can originate in your teeth, tonsils, throat, tongue, or jaw.

When your ears ache, you need to see a doctor. But until you get there, here are some quick pain stoppers.

Sit up. A few minutes upright will decrease swelling and start your eustachian tubes draining. Swallowing will help ease the pain. If you can, prop up your head slightly while you sleep to get better drainage, says Dr. Weider.

Turn on the hair dryer. Granddad's trick of blowing smoke from his pipe into painful ears had a basis in fact. It wasn't the smoke that relieved the pain, it was the warmth of the smoke, says Dan Drew, M.D., a family physician in Jasper, Indiana. To do the same trick without putting your lungs in jeopardy, turn your hair dryer to a low, warm setting. Then, holding the dryer 18 to 20 inches from the ear, aim that warm air into your aching ear.

Wiggle your ear. Here's a test to help determine whether you have otitis externa (an external problem like swimmer's ear) or otitis media (middle ear infection). Grab your outer ear, says Donald Kamerer, M.D., chief of the Division of Otology at the Eye and Ear Institute in Pittsburgh, Pennsylvania. If you can wiggle it without pain, the problem is probably in the middle ear. If moving your outer ear causes pain, then the infection is probably in the outer ear canal.

Warm some oil to body temperature. Place a bottle of baby oil or mineral oil in a pan of body-temperature water, says Dr. Weider. Let the oil set in the water until it, too, is at body temperature. Placing a drop or two of oil in the offending ear will help lessen the pain. Caution: Never drop fluids into your ear if you think the eardrum may be ruptured or punctured.

Chew a wad of gum. Most people know this is one way to open their ears on an airplane flight, but have you considered it at midnight? The muscular action of chewing will do the trick by opening the eustachian tubes.

Yawn. Yawning moves the muscle that opens the eustachian tube even better than chewing gum or sucking on mints.

Hold your nose. If you are flying at 32,000 feet when your ears begin to ache, there's help, according to the American Academy of Otolaryngology/Head and Neck Surgery. Pinch your nostrils shut. Take a mouthful of air and then, using your cheek and throat muscles, force the air into the back of your nose as if you were trying to blow your fingers off the end of your nose. A pop will tell you when you have equalized the pressure inside and outside your ear.

Don't sleep during an airplane descent. If you must doze off while flying, close your eyes at the beginning, not the end of the trip, recommends the academy. You don't swallow as often when you're asleep, so your ears won't keep up with pressure changes during descent and they may hurt.

Head off trouble. Before you get into trouble, use an over-the-counter decongestant. For instance, if you have to fly and you know your sinuses are going to back up and block your ears, take a decongestant or use nose drops an hour before you land, Dr. Weider says. At home, use a decongestant at night before you climb in bed with a stuffy head to avoid the middle-of-the-night ache.

Get the squeeze off your face. Like people who fly, scuba divers must be able to equalize the pressure inside their ears with that of the water around them or they can suffer ear trouble. Shallow diving, according to The Physician and Sports Medicine journal, is more likely to cause an earache because "the greatest changes in air volume occur in relatively shallow water [less than 33 feet]." Avoid super snug earplugs and wet suits with tight-fitting hoods that prevent equalization of pressure during descent, recommends Gary D. Becker, M.D., a staff physician at Kaiser Permanente Medical Center in Panorama City, California.

For recreational swimmers, swimming on the surface puts less pressure on the eardrums than swimming under water, says Dr. Drew. He recommends that swimmers not dive deeper than 3 or 4 feet to avoid putting stress on the eardrum.

Avoid the pain. If nothing else seems to work, avoid flying or diving when your head is stuffy.

Count on painkillers. Don't forget, an over-the-counter painkiller (aspirin, acetaminophen, or ibuprofen) will usually buy you time until you can get to a doctor, says Dr. Kamerer.

PANEL OF ADVISERS

Gary D. Becker, M.D., is a staff physician at Kaiser Permanente Medical Center in Panorama City, California.

Dan Drew, M.D., is a family physician in Jasper, Indiana. He is the inventor of the Goggl'Cap, a swim cap-goggle combination.

Donald Kamerer, M.D., is chief of the Division of Otology at the Eye and Ear Institute in Pittsburgh, Pennsylvania. He also is a professor of otolaryngology at the University of Pittsburgh School of Medicine.

Dudley J. Weider, M.D., is an otolaryngologist at Dartmouth-Hitchcock Medical Center in Hanover, New Hampshire.

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