Brief Answer:
Ear drum retraction or infection of the drum

Detailed Answer:
Hi. Thank you for writing to HCM.

A sharp stabbing pain is indicative of an infection or due to intermittent stretch of the ear drum. This can be due to many things and needs to be evaluated and treated accordingly.

Ear infection is usually associated with fever. If on pressing the tragus cartilage (small tag of cartilage at the start of the ear canal) your pain worsens then this signifies otitis externa or outer ear infection. You will need to see an ENT for a prescription of antibiotics, anti-inflammatory medications and antibiotic ear drops.

If it is ear wax then your ear will block typically after a bath after water enters the ear. It may also cause pain and blockage of the ear when sleeping on the same side of the wax build up. It is unlikely that you have ear wax since blockage or reduced hearing is not a complaint. But, if it is (confirmed by an ENT) you will need wax dissolving ear drops. It is recommended to not use any wax dissolving ear drops until the presence of wax is confirmed.

If it is a stretch of the ear drum due to eustachian tube (ET) dysfunction the the pain must worsen or improve on performing the toynbee's or valsalva procedure. You can learn these after an online search. If it is indeed ET dysfunction then you will need an ENT evaluation for a nasal endoscopy to examine the ET region for mucus plugs or infection. Also you may need nasal decongestants, mucolytics and anti-allergy measures. Stretch of the eardrum can also be due to accumulation of fluid in the middle ear or otitis media. Accompanied decreased hearing may be present. This can be diagnosed by an ENT examination and a tympanometry test. Treatment may involve evacuating the fluid or antibiotic management.

If it is an infection of just the drum then it can be diagnosed only after an otoscopic or endoscopic visualisation by an ENT. A red drum is suggestive of this infection and treatment is ear drops, antibiotics and anti-inflammatory medications.

Based on such a wide variety of differentials and the difference in management approaches, it is my opinion that you see your physician or an ENT to identify the right cause and treat accordingly.

Hope this helps. Do let me know if you have any further questions.

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