Pain behind the ears can stem from diverse origins, from common issues to conditions requiring prompt medical attention. This discomfort often arises from the intricate network of nerves, muscles, and bones in the head and neck. Understanding potential causes is crucial for effective management and addressing serious conditions.
General Headache Categories
Common headache types, while typically associated with broader head pain, can sometimes manifest with discomfort radiating to the area behind the ears.
Tension headaches are characterized by a dull, aching sensation and a feeling of tightness or pressure across the forehead, sides, or back of the head. This band-like pain can extend to the neck and occasionally be felt behind the ears due to muscle tension, stress, or poor posture.
Migraines, known for their intense, throbbing pain, often affect one side of the head and can be accompanied by sensitivity to light or sound. While commonly felt around the eye or temple, migraine pain can sometimes radiate to the back of the head or be perceived as pain behind the ear.
Cluster headaches, a severe and rare type, typically cause excruciating, sharp pain concentrated around or behind one eye. This intense pain can also spread to the side of the head, including the region near the ear.
Specific Medical Conditions
Beyond general headache patterns, several distinct medical conditions can specifically cause pain behind the ear.
Occipital Neuralgia
Occipital neuralgia occurs when the occipital nerves, which run from the top of the spinal cord through the scalp, become injured or inflamed. This condition results in piercing, throbbing, or electric shock-like pain that typically starts at the base of the skull and radiates to the scalp, often extending behind the ears. The pain can be sudden and sharp, sometimes triggered by light touch or neck movement.
Mastoiditis
Mastoiditis is an infection of the mastoid bone, located directly behind the ear. It commonly develops as a complication of an untreated middle ear infection. Symptoms typically include persistent throbbing ear pain, redness, and noticeable swelling behind the ear, often causing the ear to protrude. Fever, ear discharge, and headache are also frequent indicators.
Temporomandibular Joint (TMJ) Disorders
Temporomandibular Joint (TMJ) disorders affect the jaw joint, located just in front of the ear. These disorders can lead to pain and tenderness in the jaw, ear, and temple region, often worsening with jaw movement, chewing, or talking. Clicking or popping sounds and difficulty opening the mouth fully are also common.
Ear Infections
Ear infections, such as otitis media (middle ear infection) or otitis externa (outer ear infection), frequently cause ear pain that extends behind the ear. Middle ear infections affect the space behind the eardrum, often causing pain that radiates to the surrounding areas, particularly in children. Outer ear infections affect the ear canal and can also cause discomfort.
Dental Issues
Dental issues can cause referred pain behind the ear. Problems like an impacted wisdom tooth, dental abscess, or severe tooth decay can irritate nerves connected to the ear, causing pain that radiates from the jaw or teeth. Teeth grinding, known as bruxism, can also contribute to jaw and ear discomfort.
Cervical Spine Issues
Cervical spine issues, including muscle strain, pinched nerves in the neck, or degenerative conditions like arthritis in the upper spine, can cause referred pain. This pain may originate in the neck and radiate upwards to the base of the skull, extending behind the ears. Poor posture, especially from prolonged device use, often contributes.
Giant Cell Arteritis (GCA)
Giant Cell Arteritis (GCA), also known as temporal arteritis, is an inflammatory condition affecting the arteries, especially in the head. While it often causes a severe headache around the temples, jaw pain, and vision changes, it can also present with broader head pain, requiring immediate medical evaluation due to potential vision loss or stroke.
Parotitis
Parotitis is the inflammation of the parotid glands, the largest salivary glands in front of and below the ears. This condition typically causes swelling and pain in the cheek and jaw area, which can extend discomfort behind the ear, often accompanied by fever.
Recognizing Urgent Symptoms
While many causes of pain behind the ear are not severe, certain symptoms indicate a more serious underlying condition requiring immediate medical attention.
A sudden onset of very severe pain, especially if it is the “worst headache of your life,” should prompt urgent medical evaluation.
Other symptoms signaling a potential medical emergency include:
High fever
Stiff neck
Changes in vision (like double vision or sudden vision loss)
Weakness or numbness
Difficulty speaking
Any pain developing after a head injury, even if initially mild
Understanding Diagnosis and Relief
Diagnosis
Diagnosing the cause of pain behind the ear typically begins with a thorough medical history and a physical examination. A healthcare professional will inquire about the pain’s nature, duration, and any accompanying symptoms. This assessment helps narrow down potential causes and guides further diagnostic steps. Depending on the suspected cause, imaging studies such as X-rays, CT scans, or MRI scans may be recommended to visualize the bones, soft tissues, or nerves in the head and neck.
Relief
Relief strategies for pain behind the ear depend on the underlying diagnosis. For many common causes, over-the-counter pain relievers like ibuprofen or acetaminophen can manage discomfort. Applying warm or cold compresses to the affected area can provide temporary relief. Rest and avoiding activities that aggravate the pain are often beneficial. Lifestyle adjustments, such as improving posture, managing stress, and addressing dental hygiene, can help reduce symptoms and prevent recurrence.