Why do ear infections hurt so much

Ear infections

Otitis media

Viruses such as flu or herpes viruses as well as bacteria can cause ear infections. An acute otitis media is often preceded by a blocked nose as part of a cold. As a result, the passage between the nasopharynx and the middle ear is not ventilated and the pathogens from the pharynx can be carried away and settle in the middle ear. As a result, the mucous membrane in the middle ear becomes inflamed and produces secretions. A simple viral infection can quickly lead to an additional bacterial infection (so-called superinfection).
In some cases there is already a defect in the eardrum through which germs can penetrate directly into the middle ear via the external auditory canal. There is less of a risk of pathogens being transported to the middle ear via the blood. This can happen, for example, with a scarlet fever disease.

Ear canal inflammation

It is mostly caused by bacteria, more rarely also by viruses or fungi. Often the excessive use of ear swabs is the trigger. The rounded tip of the ear swab simply pushes the physiological ear wax further into the ear canal and sits directly in front of the eardrum. This leads to acute unilateral hearing loss and also harbors the risk of eardrum or ear canal injury. This creates an optimal breeding ground for invading bacteria. If there is also a constriction of the ear canal, e.g. due to bony adhesions, both the removal of the wax and the drainage of water in the ear canal are difficult or impossible. This leads to insufficient ventilation of the ear, as is also the case with frequent use of earplugs or hearing aids, and the development of ear canal inflammation is promoted.

Especially in the summer months with frequent visits to the swimming pool there is an increased incidence of so-called bath otitis. Because the water causes the skin of the ear canal to float up, so that bacteria can easily settle in the moist environment.

Furthermore, the incidence of ear canal inflammation is increased in immunocompromised patients, e.g. in the context of diabetes mellitus.