Why Do My Ears Hurt During a Cold?

Ear pain is a common and uncomfortable symptom during a cold. This discomfort can range from a mild ache to a more intense sensation. Understanding why involves exploring the connection between the ear and the respiratory system, how a cold affects it, and when discomfort might progress to an infection.

The Ear’s Connection to a Cold

The middle ear, located behind the eardrum, is connected to the back of the throat and nose by a narrow passage known as the Eustachian tube. This tube typically remains closed, opening briefly when a person swallows, yawns, or chews.

The Eustachian tube helps equalize air pressure between the middle ear and the outside environment, ensuring the eardrum can vibrate properly for hearing. It also allows fluid and mucus to drain from the middle ear into the back of the throat. This connection explains why inflammation in the nose and throat during a cold can directly impact the ears.

How Colds Cause Ear Discomfort

A cold triggers inflammation and increased mucus production in the respiratory passages. This inflammation can extend to the Eustachian tubes. As the lining of the nasal passages and throat swells, it can narrow or block the opening of the Eustachian tubes.

When blocked, the Eustachian tube cannot equalize pressure or drain fluid from the middle ear. This blockage creates negative pressure in the middle ear as air is absorbed. The pressure imbalance pulls the eardrum inward, causing pain, fullness, or a “plugged” sensation, along with muffled hearing. Fluid and mucus can also accumulate behind the eardrum, contributing to discomfort and pressure.

Beyond Discomfort: When a Cold Leads to Ear Infection

Fluid accumulation and altered pressure within the middle ear create an environment conducive to microorganism growth. This warm, damp space with trapped fluid becomes an ideal breeding ground for bacteria or viruses, which can then lead to an ear infection.

The pain from an ear infection is often more severe and persistent than the pressure-related discomfort. It can be accompanied by symptoms such as fever, swelling, and sometimes a discharge of fluid from the ear. While the initial ear pain from a cold usually improves as the cold resolves, an ear infection will persist and may require medical attention.