What Causes Pain Behind the Ear?

Feb 10, 2021 Source: Cainiu Health

Dr. Liu Chunqing

Introduction

What Causes Pain Behind the Ear? 1. Facial nerve injury: The mastoid region behind the ear is one of the pathways traversed by the facial nerve, which travels through a very narrow facial nerve canal. 2. Ear inflammation: Clinically, the primary symptom is ear pain, as seen in conditions such as otitis externa or auricular perichondritis. 3. Herpes virus infection: For example, herpes virus infection of the skin over the auricle.

Pain behind the ear is a common neurological disorder affecting the facial nerve. It is typically caused by viral infection, physical compression, or injury to the facial nerve—and is non-contagious. The ear has an abundant supply of sensory nerves, which also interconnect with nerves from adjacent organs. Consequently, ear pain may not only stem from ear-related diseases but can also be referred pain originating from disorders of neighboring structures. So, what causes pain behind the ear? Below, we address this question.

What Causes Pain Behind the Ear?

1. Facial Nerve Damage

The mastoid region (behind the ear) is one location along the course of the facial nerve, which travels through a narrow bony canal—the facial nerve canal. When the facial nerve becomes inflamed and swollen due to viral infection, it may become compressed within this confined space, resulting in pain. Thus, post-cold ear pain behind the ear could signal an early stage of facial palsy—commonly triggered by facial exposure to cold, physical trauma, or viral invasion. Additionally, because numerous nerves surround the ear, prolonged exposure to excessively loud environments may stimulate these nerves, causing periauricular neuralgic pain.

2. Ear Inflammation

Clinically, ear pain is the predominant symptom in conditions such as otitis externa and auricular perichondritis—both more commonly seen in children, often accompanied by visible external ear abnormalities. Acute otitis media may also cause posterior-auricular pain. Typically bacterial in origin, worsening infection may lead to abscess formation and purulent discharge from the ear canal, directly compressing the tympanic membrane and resulting in pain and tinnitus.

3. Herpes Virus Infection

This may result from herpes virus infection of the skin around the ear—such as the auricle—leading to clusters of tiny vesicles. Patients often experience sharp, stabbing, or burning pain in the ear, particularly exacerbated upon touch. In some cases, additional symptoms—including nausea, vomiting, and hearing loss—may occur.

Above are the main causes of pain behind the ear. We hope this information is helpful to you.

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What medication should I take for occasional sharp pain behind the ear every few seconds?

Brief stabbing pain behind the ear occurring every few seconds may be caused by factors such as vascular spasm, neuralgia, or external auditory canal furuncle. Treatment targeting the underlying cause may include calcium channel blockers (e.g., nimodipine tablets, nifedipine sustained-release tablets), neurotrophic agents (e.g., mecobalamin dispersible tablets, oryzanol tablets), and antibacterial analgesic medications (e.g., azithromycin capsules, ibuprofen sustained-release capsules).