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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Severe Ear Pain, Have Migraines. On Amoxicillin. Treatment?

I have been having severe ear pain in my left ear for 8 days now. My PCP thought there was some fluid in my ear so she prescribed me amoxicillin . When it got worse she referred me to an ENT . There is no infection in my ear and says it could be due to migraines, which I have been diagnosed with but not bein treated for. He suggested taking sudafed which I started yesterday. The pain is so unbearable when I lay down that my PCP prescribed me ambien so I can get more than 2-3 hours of sleep. Do you have any suggestions?
Wed, 20 Feb 2013
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General & Family Physician 's  Response
Hello,

Thanks for posting on HCM,
What you are presenting is a symptom known as otalgia/earache (ear pain) which could be primary otalgia (ear pain which originates from the ear) or reffered otalgia (which originates from outside the ear). Otalgia is not always associated with ear disease. It may be caused by several other conditions, such as impacted teeth, sinus disease, inflamed tonsils, infections in the nose and pharynx, throat cancer, and occasionally as a sensory aura that precedes a migraine.
From your description your pain, it probably originates from the middle ear and might be caused by
- Mechanical: barotrauma (often iatrogenic), Eustachian tube obstruction leading to acute otitis media.
- Inflammatory / infective: acute otitis media, mastoiditis.
Other causes of secondary/referred otalgia will need to be investigated by a neurologist or an ENT specialist as they follow five major nerve parts and could come as a result of several diseases conditions such as pharyngitis, tonsillitis, trigeminal neuralgia etc.
For now, you will need to take analgesic pain killers ( particularly with antiinflammatory properties like ibuprofen) as it was apparently not included in our treatment.

Hope this helps
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Severe Ear Pain, Have Migraines. On Amoxicillin. Treatment?

Hello, Thanks for posting on HCM, What you are presenting is a symptom known as otalgia/earache (ear pain) which could be primary otalgia (ear pain which originates from the ear) or reffered otalgia (which originates from outside the ear). Otalgia is not always associated with ear disease. It may be caused by several other conditions, such as impacted teeth, sinus disease, inflamed tonsils, infections in the nose and pharynx, throat cancer, and occasionally as a sensory aura that precedes a migraine. From your description your pain, it probably originates from the middle ear and might be caused by - Mechanical: barotrauma (often iatrogenic), Eustachian tube obstruction leading to acute otitis media. - Inflammatory / infective: acute otitis media, mastoiditis. Other causes of secondary/referred otalgia will need to be investigated by a neurologist or an ENT specialist as they follow five major nerve parts and could come as a result of several diseases conditions such as pharyngitis, tonsillitis, trigeminal neuralgia etc. For now, you will need to take analgesic pain killers ( particularly with antiinflammatory properties like ibuprofen) as it was apparently not included in our treatment. Hope this helps