Sharp Pain Behind Ear

Sharp Pain Behind Ear

The bony prominence behind your ears is called the mastoid. Sharp pain behind your ears is almost always caused by inflammation of this bone. This condition is commonly referred to as mastoiditis.  It is a common condition in children that occurs after a bacterial infection of the mastoid bone. This bone consists of airspaces that drain your middle ear of any fluids produced.

When it becomes inflamed due to a spread of infection commonly from the middle ear, also known as otitis media, mastoiditis can develop. The pain that you feel is due to edema and resultant pressure on the bony tissues of the mastoid. Acute inflammation may cause serious health complications as the infection can spread outside the bone.

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It is typically a disease of the young population. However, any age group can be affected. It may be classified as acute or chronic depending on the duration it takes before remission is observed. In chronic mastoiditis, there is an ongoing otitis media and mastoiditis giving rise to the persistent pain. Acute form usually heals in a few days to weeks.

Causes of sharp pain behind the ear

As mentioned above, this condition is usually caused by middle ear infection. Several bacteria are implicated in its pathogenesis. Streptococcus pneumonia, the bacteria that causes pneumonia, is implicated in approximately 22% of cases. Streptococcus pyogenes, a common bacterial infection in children causing sore throat, is isolated in 16% of cases.

In the staphylococcus family, the single most bacteria implicated is the staph aureus in about 7% of cases. Other bacteria include haemophilus influenza which causes common cold and pseudomonas aeroginosa. All these bacterial infections lead to middle ear infection which then spreads to the mastoid bone causing pain.

Several predisposing factors have been identified. These are not causes but if you have such condition, you probability of developing mastoiditis is significantly raised. They include leukemia, which is a cancer of the blood cells, mononucleosis which is caused by infection by the Epstein barre virus, temporal bone sarcoma and Kawasaki disease. A waning immunity and the inappropriate use of antibiotics can also put you at a greater risk.

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Symptoms associated with pain behind ear

Because the major cause of mastoiditis is a bacterial infection, fever in the single most present symptom after pain. You may also become easily irritable and feel weak and tired always. Your ear will also be swollen especially the ear lobe. The area over you mastoid bone will also be tender and red. This is due to the effects of inflammation. In acute cases, your ear will bulge and appear as if it is dropping.

Complications may develop though their occurrence is rare. You may have an accumulation of pus in your mastoid or temporal lobe, commonly referred as abscess.  Infection may also spread to the sinuses giving rise to septic thrombosisi of the lateral sinus. A systemic inflammatory condition may also develop due to the presence of bacteria in the blood. This is called sepsis and it can be life-threatening. Other complications include meningitis, facial paralysis, hearing loss and destruction of the mastoid bone with resultant deformities.

The major cause of this pain as mentioned above is a spread of infection from the middle ear to the mastoid bone. It should be noted that trauma to the bone such as in soccer or other physical activities can also result in this condition. Depending on the cause of the pain, you may or may nor need to see a doctor. In the case of injury to the external ear this pain reduces with time and heal on its own. In most cases there is no need for alarm. However, in children there may be many complication and early diagnosis and treatment is important.

How is mastoiditis diagnosed?

Your doctor will perform several tests that will confirm if you have this condition. The signs and symptoms should guide you to suspect what is wrong with your body. The doctor will look at and inside your ear with a special instrument to see if there is any reddening of the ear lining. Radiological tests done include x-ray and CT scans. Blood tests revealing an increase in neutrophil can be important in diagnosis.

Most of the times mild pain may disappear without treatment. However, if your pain persists even after using drugs, you should see a medical practitioner. Symptoms of middle ear infection should assessed by a doctor immediately.


Persistent mastoiditis is treated by use of oral antibiotics, eardrops and ear cleaning that is done regularly. Rarely is surgery indicated. However, if the symptoms do not subside, you may need surgery so as to minimize the chances of developing complications.

If you are diagnosed with acute mastoiditis, you may be hospitalized so as to be closely monitored by an otolaryngologist, a specialist in ear, nose and throat diseases. Most of the time the infection is systemic and IV or intravenous line will be inserted to enable administration of antibiotics.

Surgery may be necessary so as to drain fluid that has accumulated in the middle ear. This procedure is called myringotomy. This procedure is usually indicated in chronic otitis media patients. Is the inflammation and infection of the mastoid is severe, you may need surgery to remove the bone completely. This type of surgery is called mastoidectomy.

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