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Ear Pain: Diagnosing Common and Uncommon Causes
Journal article   Peer reviewed

Ear Pain: Diagnosing Common and Uncommon Causes

Stacie Ann Kasper and Jeffrey D Quinlan
American family physician, Vol.114(3), pp.238-247
09/01/2026
PMID: 42789629

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Abstract

Otalgia, or ear pain, is a common reason for primary care visits. It is categorized as primary (ie, originating from the ear) or secondary (ie, referred from nonotologic sources). A systematic approach guides appropriate management and identifies red flags. Acute otitis media, otitis externa, and eustachian tube dysfunction are common causes of primary otalgia. Temporomandibular joint disorders, dental pathology, and cervical spine pathology are common causes of secondary otalgia. Evaluation should include a focused history and physical examination, with further assessment for concerning or persistent findings. Treatment of benign cases includes targeted therapy for infections or structural abnormalities. Recognizing red flags, such as persistent, severe, or unilateral symptoms, is critical for identifying serious causes.Otalgia, or ear pain, is a common reason for primary care visits. It is categorized as primary (ie, originating from the ear) or secondary (ie, referred from nonotologic sources). A systematic approach guides appropriate management and identifies red flags. Acute otitis media, otitis externa, and eustachian tube dysfunction are common causes of primary otalgia. Temporomandibular joint disorders, dental pathology, and cervical spine pathology are common causes of secondary otalgia. Evaluation should include a focused history and physical examination, with further assessment for concerning or persistent findings. Treatment of benign cases includes targeted therapy for infections or structural abnormalities. Recognizing red flags, such as persistent, severe, or unilateral symptoms, is critical for identifying serious causes.

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