Ear aches are a common experience for many people. The causes vary widely, the most frequent being infections in your ear canal or behind your eardrum in your middle ear.
Occasionally, however, a pain in your ear is a fooler. It can turn out to be a pain originating from another tissue or organ via shared nerve pathways that are inflamed. Then it is called a referred pain. In trying to outline the paths of sensations along nerves in your head and neck, you come up with a diagram that resembles an accident in a spaghetti factory. Along some of those nerves, sensations such as pain can follow different pathways than they would normally. This tricks your brain into erroneously perceiving the pain as deriving from a different organ or tissue which is not actually affected. Referred pains can occur in other parts of your body, too.
The most common source of referred ear pain is likely a throat infection or inflammation. Often, you feel little or no pain in your throat, but your ear hurts. Your doctor looks in your ear and says it its fine. Then they look down your throat to find possibly swollen and inflamed tonsils or other signs of your throat being infected, which solves the puzzle of your pain's provenance. The usual nerve that conducts that pain is your glossopharyngeal nerve, or the nerve of Arnold (even if that's not your name).
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Other sources of referred ear pain can be decayed teeth, unerupted third molar, sinus infections, temporomandibular joint problems, trigeminal neuralgia, an excruciating pain in your fifth cranial nerve, and, rarely, various growths including throats cancers.
An acquaintance has recently had that very experience with a long term problem where one ear or both sometimes felt stuffed and achy. He had a thorough ENT workup and was told he had mild hearing loss. But the pain might be coming from his jaw.
So, if a doctor tells you nothing is wrong with your ear when it aches, do not think he or she has a lot of nerve. It might be that the problem needs a different "reference point"
Dr. Frank Bures, a semi-retired dermatologist, has worked in Winona, La Crosse, Viroqua and Red Wing since 1978. He also plays clarinet in the Winona Municipal Band and a couple Dixieland groups.
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