Hi, Pain in the ear in spite of painkillers indicate one of the following reasons: - Acute otitis media that is infection with fluid and pressure build up in middle ear cavity with blockage to outflow of fluid - Mastoiditis meaning infection and inflammation in air spaces and bone of ear called mastoid - Blocked nose and runny nose means there was an infection in the nose and may be in sinuses that went to the ear through eustachian tube I would advise you the following: - Consult your doctor, preferably an ENT surgeon for clinical evaluation, examination and ENT endoscopy - Relevant tests of blood - X-ray or better CT scan of nose and mastoids as this alone can tell what is going on in sinuses and mastoid bone - Proper course of an antibiotic - Anti-inflammatory with painkiller properties - Nasal and oral decongestant - See the response and rarely a tympanotomy that is opening up of the ear drum will help to release the pressure and help in resolution well - Remember it takes time for complete resolution hence continue the treatment till cured Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. T. Chandrakant, General Surgeon