Common and usually self-limiting. Whether pulling the ear hurts tells you a surprising amount about the cause.
Assessed by a GMC-registered GP, not a symptom checker
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Tests and referrals arranged where they are needed
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Seek urgent same-day assessment — call 111 or attend urgent care — for:
Babies under three months with a fever need in-person assessment regardless of the cause.
Book a routine consultation — do not simply wait — for persistent one-sided earache in an adult where the ear itself looks normal, particularly with hoarseness, difficulty swallowing, a neck lump, or a history of smoking or heavy drinking. Pain can be referred to the ear from the throat, and that combination warrants ENT assessment.
Earache is one of the commonest reasons people seek same-day care, particularly for children. Most of it is a middle ear infection following a cold, and the majority settle within three days without antibiotics — which is why current guidance favours good pain relief and a short period of watchful waiting for most cases.
There is one question that sorts earache more usefully than any other: does it hurt when you pull the outer ear or press the little flap in front of it? If yes, the problem is in the ear canal — otitis externa. If no, it is more likely behind the eardrum, in the middle ear.
Adults with persistent one-sided earache and a normal-looking ear are a separate matter, and one this page takes seriously.
The old advice — put nothing smaller than your elbow in your ear — remains exactly right.
For most ear infections, painkillers are not a stopgap while you wait for antibiotics — they are the main treatment. Most cases resolve on their own within a few days, and the job in the meantime is to keep the person comfortable.
There is any discharge from the ear, or you suspect a perforated eardrum. Olive oil, wax softeners and over-the-counter drops are for wax in an intact ear, not for an infected or discharging one.
Note that a sudden discharge with immediate relief of severe pain usually means the eardrum has perforated. That sounds alarming and is generally fine — it heals over a few weeks — but it needs a doctor to know about it, and the ear must be kept dry.
Pain when you tug the earlobe or push the small flap at the front, with itching and sometimes discharge, suggests otitis externa — swimmer's ear.
1. Persistent earache in an adult with an ear that looks normal. Ear pain is often referred from elsewhere — the jaw joint, teeth, throat or neck. One-sided earache lasting more than three weeks in an adult, particularly a smoker or heavy drinker, with a normal ear, needs an ENT opinion to look at the throat. This is a recognised presentation of head and neck cancer and it is regularly treated as an ear problem for months.
2. Sudden hearing loss in one ear, with little or no pain. If hearing drops suddenly in one ear over hours or a day — often noticed on waking or on the phone — that is an emergency requiring ENT assessment within days, not weeks. Steroid treatment can restore hearing but only within a narrow window, and it is frequently dismissed as wax or a blocked ear until the window closes.
We cannot look inside your ear. An otoscope is the standard examination for earache, and no video call replaces it. That is a real constraint and worth knowing before you book.
What a remote consultation does well is narrow the cause from the history — which for earache is more informative than people assume — identify who needs urgent care, and treat the cases that do not depend on seeing the eardrum.
Usually not. The majority of middle ear infections — including in children — settle without antibiotics within three days, and the evidence that antibiotics shorten them meaningfully is weak. What genuinely helps is regular, adequate pain relief.
Antibiotics are appropriate for children under two with both ears affected, anyone with discharge from a perforated drum, those who are systemically unwell, symptoms not improving after two to three days, and anyone immunosuppressed. A delayed prescription — collected only if things have not improved in 48 hours — is often the sensible middle course, and we are happy to issue one.
Most acute ear infections improve substantially within three days and resolve within a week. Some hearing muffling can persist for several weeks afterwards as fluid clears, which is normal and does not mean the infection is still there.
Earache lasting more than a week without improving, or hearing that has not returned after six weeks, warrants review.
Yes to both. Cotton buds compact wax against the eardrum, abrade the delicate canal skin, and are one of the leading causes of otitis externa. Ears are self-cleaning; wax migrates outwards on its own.
Ear candling does not work. The waxy residue produced is from the candle, not the ear, and documented harms include burns, canal obstruction and perforated eardrums. There is no reason to use them.
Flying with an ear infection or a blocked ear is uncomfortable and can be genuinely painful, particularly on descent, and carries a small risk of perforation. If you must fly, use a decongestant beforehand, stay awake for the descent, and swallow, yawn or use the valsalva manoeuvre repeatedly.
Do not swim with a discharging ear, a perforated eardrum, or otitis externa — water is what drives outer ear infection.
That usually means the eardrum has perforated, releasing the pressure that was causing the pain. It sounds worse than it is: most perforations heal by themselves over a few weeks with normal hearing restored.
What matters now is keeping the ear completely dry — no swimming, no water in the shower — and having it checked, since a perforation with discharge does warrant antibiotic treatment and a follow-up to confirm it has healed.
Yes — more urgent than almost anything else on this page. Sudden hearing loss in one ear over hours to a day, with or without ringing and dizziness, may be sudden sensorineural hearing loss. It is treatable with steroids, but the window is measured in days, and outcomes are much better the sooner treatment starts.
It is very commonly mistaken for wax or a blocked ear from a cold. If your hearing has dropped suddenly and there is no obvious wax, ask for an urgent ENT referral rather than waiting to see whether it clears.
That is a meaningful finding rather than a dismissal — it means the pain is referred from somewhere else, and the ear shares nerve supply with the jaw joint, teeth, tonsils, throat and neck. The commonest causes are the temporomandibular joint (worse on chewing, often with clicking or teeth-grinding), dental problems, and throat infections.
The exception that must not be missed: persistent one-sided earache in an adult with a normal ear, especially over 45 with a smoking or drinking history, or alongside hoarseness, difficulty swallowing or a neck lump. That needs an ENT opinion to examine the throat.
Honestly, only in part — we cannot look inside your ear, and the appearance of the eardrum is what distinguishes several causes.
What a consultation does well is the history, which does most of the work: outer versus middle ear, whether antibiotics are indicated, correct pain relief dosing, prescribing drops or a delayed antibiotic, screening for the warning signs above, and arranging urgent ENT referral where needed. Where the diagnosis depends on seeing the eardrum, we will say so and direct you to be examined rather than guessing.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 24, 2026
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Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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