Why does my ear hurt when I have a sore throat, and what should I do?

Generally speaking, the throat refers to the pharynx. Throat pain accompanied by ear pain may be caused by factors such as pressure changes, excessive voice use, improper sleeping posture, acute pharyngitis, or otitis media. Treatment options include general treatments and medications, as directed by a physician. The specific causes are analyzed as follows:

1. Pressure Changes

During rapid ascents or descents while flying in airplanes, using elevators, or diving, the surrounding air pressure changes quickly, while the pressure balance between the middle ear and the outside becomes disrupted. Because the ear and throat are connected via the Eustachian tube, pressure differences can cause dysfunction of the Eustachian tube, resulting in ear fullness, pain, and possibly throat pain due to pressure impact and associated nerve reflexes. During flights, frequent actions such as chewing gum or swallowing saliva can help open the Eustachian tubes and balance pressure.

2. Excessive Voice Use

Speaking loudly, shouting, or singing for extended periods can cause throat muscle fatigue, congestion, and swelling, leading to throat pain. Additionally, nerves in the throat and ear are interconnected; excessive voice use causing throat nerve tension can result in referred ear pain via nerve reflexes. It is recommended to plan voice use appropriately, avoid prolonged and strenuous vocalization, rest periodically, and stay hydrated to keep the throat moist.

3. Improper Sleeping Posture

Long-term compression of the ear or neck during sleep can impair ear blood circulation and nerve conduction, potentially causing ear pain. Neck compression may also affect nerve supply to the throat, causing throat discomfort. Maintain proper sleeping posture, choose a pillow with suitable height and firmness, and avoid prolonged lateral or prone sleeping positions that compress the ears and neck.

4. Acute Pharyngitis

Acute pharyngitis is often caused by viral infections such as influenza virus or adenovirus, although bacterial infections such as streptococcus or staphylococcus may also be responsible. Inflammation of the throat can cause referred ear pain through nerve reflexes, and the inflammation may spread to involve the Eustachian tube, causing Eustachian tube inflammation and subsequent ear pain. Symptoms may also include fever and fatigue. Medications such as Watermelon Frost Throat Lozenges, Lanqin Oral Liquid, and Amoxicillin Capsules may be used under the guidance of a physician.

5. Otitis Media

Otitis media often results from upper respiratory infections such as the common cold or influenza, where bacteria or viruses spread to the middle ear through the Eustachian tube. It can also occur due to eardrum perforation or the spread of external ear infections. Middle ear inflammation irritates the ear nerves, causing pain, and the inflammation can travel retrogradely through the Eustachian tube to affect the throat, potentially causing throat pain, especially when swallowing, which may intensify ear pain. Patients may also experience symptoms such as hearing loss and tinnitus. Patients may use medications such as Cefuroxime Axetil Tablets, Erythromycin Enteric-coated Tablets, and Prednisolone Acetate Tablets under a physician's recommendation.

Maintain good ear hygiene by avoiding frequent ear cleaning and keeping water out of the ears to ensure the external auditory canal remains clean and dry. Additionally, maintain healthy lifestyle habits, regular sleep patterns, balanced nutrition, avoid excessive fatigue, and enhance overall immunity.