What causes sharp, needle-like ear pain?

Nov 28, 2025 Source: Cainiu Health

Dr. Lu Cheng

Introduction

In general, ear pain resembling a needle prick may be caused by excessive ear cleaning, sudden changes in air pressure, external otitis, middle ear infection (otitis media), or ear shingles (herpes zoster). Depending on the specific situation, improvement can be achieved through general care, medication, or surgical treatment. It is important to develop healthy ear habits in daily life, such as avoiding frequent ear picking and prolonged use of headphones, as well as preventing colds to reduce the risk of middle ear infections.

Generally, ear pain that feels like being pricked by a needle may be caused by excessive ear cleaning, sudden changes in air pressure, external otitis, otitis media, or ear shingles. Depending on the specific situation, symptoms can be improved through general care, medication, or surgical treatment. Details are as follows:

1. Excessive Ear Cleaning

Frequently using sharp tools to clean the ears can scratch the skin of the external auditory canal, stimulating nerves and causing needle-like pain. Discontinue ear cleaning, keep the ear canal dry, avoid entry of contaminated water, and minor injuries may heal on their own.

2. Sudden Changes in Air Pressure

During flights or diving, large differences in air pressure between the inside and outside of the ear can compress the eardrum and cause pain. Chewing gum or yawning can help equalize pressure, and pain usually subsides after landing or surfacing.

3. External Otitis

Bacterial infection leads to inflammation of the external auditory canal, causing redness and swelling of the ear canal skin and nerve compression, resulting in needle-like pain. Under medical guidance, ofloxacin ear drops, cefaclor capsules, and ibuprofen sustained-release tablets may be used. Avoid getting water in the ear canal.

4. Otitis Media

Upper respiratory tract infections spreading to the middle ear cause inflammation and congestion of the eardrum, leading to episodic needle-like pain. Follow doctor’s instructions to take amoxicillin-clavulanate potassium tablets, eucalyptus citronellal enteric soft capsules, and dexamethasone tablets. In severe cases, myringotomy (eardrum incision) may be required.

5. Ear Shingles (Ramsay Hunt Syndrome)

Infection of ear-related nerves by the varicella-zoster virus causes neuralgia, manifesting as needle-like ear pain. Under medical supervision, acyclovir tablets, mecobalamin tablets, and gabapentin capsules may be prescribed. Keep the skin around the ear clean and dry.

Maintain healthy ear habits in daily life—avoid frequent ear cleaning and prolonged use of headphones. Prevent colds to reduce the risk of middle ear infections. If ear pain worsens or is accompanied by hearing loss or pus discharge, seek immediate medical attention for accurate diagnosis and treatment.

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