What causes ear pain without any external injury?

Ear pain without external injury may result from prolonged ear pressure, sebaceous cysts near the ear, herpes zoster, or ear canal disorders.

1. Prolonged Ear Pressure

Maintaining the same lateral sleeping position, wearing masks or eyeglasses for extended periods, or other activities that chronically compress the ear may impair local blood circulation, leading to chronic ischemia of the affected tissue. In such cases, patients typically experience ear pain despite the absence of external trauma.

2. Sebaceous Cyst Near the Ear

The area around the ear contains numerous hair follicles. When these follicles become obstructed, sebaceous cysts may develop near the ear, potentially becoming infected and causing localized pain. This often manifests as ear pain without any visible external injury.

3. Herpes Zoster

Herpes zoster affecting the auricle commonly causes pain near the ear. If the infection involves surrounding cranial nerves (e.g., the facial or vestibulocochlear nerve), severe pain may occur—sometimes involving the entire ear.

4. Ear Canal Disorders

Conditions such as otitis externa, otitis media, or bullous myringitis can cause ear pain—either localized near the ear or involving the entire ear—despite the absence of external trauma.