Pain in Your Throat and Ears: When and Why To Seek Treatment

We’ve all had that morning. The one where you wake up and your throat is raw. Or where it feels like someone stuffed your ears with cotton.

But what about when it’s both? Your ears ache and your throat is on fire. Or maybe it’s just one ear and one side of your throat. And it won’t let up.

“Typically, if you have pain in your ears and in throat, it’s something that is primarily coming from your mouth or throat,” explains otolaryngologist Micah Timen, MD, an ear, nose and throat specialist. “Usually, when ear pain coincides with a sore throat, the pain in the ear is what is called ‘referred’ pain.”

“Referred” meaning the trouble didn’t start in your ear, but your ear hurts nonetheless.

Pain in your ears and throat can be caused by a number of things, with infections and reflux among the most common.

But Dr. Timen advises that throat and ear pain that lingers more than four weeks should be evaluated by an ear, nose and throat specialist (an ENT, also called an otolaryngologist).

The reason? Lasting throat and ear pain that doesn’t respond to home remedies or medications can be a sign of something much more serious.

We talked with Dr. Timen about the various causes of throat and ear pain and why it deserves your attention.

Throat and ear pain causes

Your throat and ears are intricately connected. And having pain in your throat often triggers referred pain in your ear. Blame your glossopharyngeal nerve (aka cranial nerve IX or Arnold’s nerve), which passes from your brainstem through your ear and then down to your throat.

“Arnold’s nerve gives sensation to the ears and the throat,” Dr. Timen explains. “A lot of people assume that if they have throat pain and ear pain, they must have both a throat infection and an ear infection. In reality, though, that pain is often all coming from one point. But it’s being interpreted by your brain as coming from both areas.”

So, if it’s not necessarily an ear infection, what’s causing your ear and throat pain? Dr. Timen breaks it down.

Teething in babies and kids

First things first, if your baby or toddler is complaining of ear and throat pain (or if that’s the impression you get), the first thing to suspect is teething.

“Teething can cause some mild mouth pain that kids might feel in their ears and throat,” Dr. Timen explains. “It’s common for babies to rub their ears when they’re teething and for older toddlers to have some ear and throat pain when their molars come in.”

Teething shouldn’t cause intense pain or pain that lasts after the tooth erupts. If you suspect your baby is experiencing teething pain, try giving them a cold cloth, teething toys or a dose of a children’s pain reliever.

Infections

Sometimes, throat and ear pain is a symptom of a bacterial or viral infection. Those infections usually come with additional symptoms, too:

• Sinus infections can also include cold-like symptoms and thick yellow or green mucus. Try home remedies, like gargling salt water or using a neti pot for minor symptoms. Seek treatment if symptoms last longer than 10 days.
• Tonsilitis (a tonsil infection) can also include symptoms like fever, difficulty swallowing and red, swollen tonsils or white spots on your tonsils. Try home remedies, such as fever-reducing medications or drinking tea with honey for minor symptoms. Seek treatment for high fevers or symptoms that last longer than four days.
• Strep throat can also include sudden-onset fever and sore throat, headache and nausea or vomiting. Contact a healthcare provider for diagnosis and treatment.
• Abscessed tooth can also be accompanied by a loose tooth, swelling in your jaw and a draining sore in your gums. Contact a dentist or other healthcare provider right away for diagnosis and treatment. Left untreated, the infection can spread beyond your tooth.
• Peritonsillar abscess (an abscess near your tonsils) can also include symptoms like fever or chills, a headache, swelling in your face or neck, and hoarseness. Contact a healthcare provider for diagnosis and treatment.

Chronic acid reflux (GERD)

For some people, throat and ear pain actually starts in their stomach. People with chronic acid reflux (called GERD, short for gastroesophageal reflux disease) may have symptoms that affect their ears and throats.

GERD is a condition that allows stomach acid to flow back up through your esophagus and into your throat and mouth. That acid can cause a sore throat and, for some people, referred ear pain. Other symptoms of GERD include:

• Heartburn.
• Regurgitation.
• Dry cough.
• Bad breath.
• Hoarseness.
• Trouble swallowing.

An occasional bout of acid reflux or heartburn can usually be managed with over-the-counter antacids (like Tums®, Mylanta®, Pepto-Bismol ® or Rolaids ®). But if your symptoms happen twice a week or more, it’s time to talk with a healthcare provider for a long-term solution.

Mouth and throat cancer

This is one you don’t want to think about, but it’s really (really) important to know.

Cancerous tumors in your throat or on your tongue or tonsils can cause throat and ear pain. Usually, but not always, they’ll cause pain on just one side of your throat and in the ear on that same side.

That’s why throat and ear pain that doesn’t go away on its own should be taken seriously — and checked quickly.

“Oral cancers aren’t the most common reason for ear and throat pain, but it’s incredibly important to have a healthcare provider, like an ENT, rule them out, especially if your pain lasts more than about four weeks,” Dr. Timen stresses.

To check for tumors, your provider will use a small endoscope (a thin, flexible instrument with a camera and a light at its tip) to look in your throat. Some providers may get a similar look with a small mirror. The exam only takes a few minutes and is done in the provider’s office.

“If you’re having persistent ear and throat pain that doesn’t go away, you should expect to be checked with a scope. And if your provider doesn’t suggest it outright, I’d recommend you ask for them to look. It’s that important,” Dr. Timen advises.

This is especially true if you are:

• Over the age of 40.
• Smoke cigarettes.
• Drink alcohol.
• Haven’t been immunized against HPV.

Treating sore throat and ear pain

If your sore throat and ear pain comes with cold-like symptoms or a fever, Dr. Timen suggests starting with tried-and-true home remedies for sore throats. That includes things like:

• Gargling salt water.
• Drinking hot beverages, like tea with honey.
• Hot showers (with lots of steam).
• Over-the-counter antihistamines, fever-reducers or pain relievers.
• Plenty of rest and fluids.

If that doesn’t do the trick, a quick visit to your primary care provider may be best. They can check for a bacterial infection that requires antibiotics.

But if your pain lingers, it’s time to take the next step and get to an ear, nose and throat specialist to be absolutely sure you know what you’re dealing with.

Simultaneous pains in your throat and ears can be a passing thing. But finding out what’s causing the pain is important. Just like with a suspicious mole or a new lump on your body, take throat and ear pain seriously. Early intervention can get you feeling better faster.