Understanding and Managing Headaches Behind the Ear: A Comprehensive Guide

Headaches are among the most common conditions in the world. They come in all shapes and sizes, ranging from mild to severe. Those occurring behind the ear hold significance among the various types of headaches due to their unique characteristics and potential underlying causes. This article will address common concerns, provide valuable information regarding headaches felt behind the ear, and offer practical management solutions.

Understanding the underlying causes of headaches behind the ear is the key to fast relief. While various factors can contribute to these headaches, we will explore typical suspects such as cervicogenic headaches, occipital neuralgia, and temporomandibular joint disorder (TMJ). This will help you narrow in on what you need for immediate relief.

Causes of Referred Ear Pain

Cervicogenic headaches

A cervicogenic headache originates from issues in the cervical spine or neck. Unlike other headaches, which may stem from the head itself, cervicogenic headaches result from referred pain from structures in the neck. These headaches are often described as a dull, aching pain radiating from the skull’s base to the forehead, temples, and even behind the eyes and ears.

– Causes: Tension or muscle strain in the neck and upper spine, poor posture, neck injuries, or whiplash.

– Potential treatment: Physical therapy, chiropractic adjustments, massage therapy, stretching exercises, over-the-counter pain relievers, hot/cold therapy.

Occipital neuralgia

Occipital neuralgia is a condition characterized by recurrent episodes of sharp, shooting, or throbbing pain in the occipital region of the head, which is located at the base of the skull. The pain can be very distressing and may be accompanied by sensitivity to light (photophobia) or sound (phonophobia). Simple neck movements, such as turning the head or brushing the hair, can trigger or worsen the pain. Since there are many nerves that branch from the occipital nerve, pain behind the ears is common. 

– Causes: Irritation, inflammation, or compression of the occipital nerves, neck injuries, diabetes, arthritis, or infections.

-Potential treatments include prescription pain medications, nerve blocks or injections, physical therapy, anti-inflammatory medications, stress reduction techniques, and acupuncture.

Temporomandibular Joint (TMJ) Disorder

TMJ disorder, also known as temporomandibular joint dysfunction, affects the temporomandibular joints, which connect the jawbone to the skull. These joints are located on each side of the face, just in front of the ears, and play a key role in jaw function for activities like talking, chewing, and yawning.

– Causes: Teeth grinding, jaw misalignment, dental procedures, stress, arthritis, or trauma.

– Potential treatment: Dental splints or mouthguards, jaw exercises, physical therapy, stress management techniques, pain relievers, hot/cold therapy, relaxation techniques.

Migraine

Migraine is a neurological condition and produces recurring, moderate to severe headaches that are often accompanied by other symptoms. These headaches are typically pulsating or throbbing and commonly affect one side of the head. Migraine attacks can last a few hours to several days and can disrupt daily activities significantly. One sided facial pain is characteristic of a migraine, and commonly spreads to the ears. 

– Causes: Complex neurological disorder triggered by various factors such as stress, hormonal changes, certain foods, bright lights, or strong odors.

– Potential treatment: Prescription medications (triptans, anti-nausea drugs), preventive medications, lifestyle changes (stress management, regular sleep patterns, healthy diet), relaxation techniques, avoiding triggers.

Tension headaches

A tension headache is a common type characterized by a dull, aching pain and tightness or pressure around the forehead or the back of the head and neck. It often describes a band-like sensation encircling the head, wrapping around into the ears. Tension headaches can be episodic (occasional) or chronic (frequent).

– Causes: Muscle tension, stress, anxiety, poor posture, and lifestyle factors.

– Potential treatment: Over-the-counter pain relievers, stress reduction techniques, relaxation exercises, massage therapy, improving posture, regular exercise, hot/cold therapy, mindfulness techniques.

Trigeminal neuralgia

Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which transmits sensory information from the face to the brain. This debilitatin condition causes intense, often excruciating facial pain that can be triggered by simple everyday actions such as eating, speaking, or even touching the face.

The pain in trigeminal neuralgia is typically sudden, sharp, stabbing, or electric shock-like. It is often triggered by mild stimuli such as a breeze, light touch, or temperature changes, and is frequently limited to one side of the face. The specific areas the pain affects can vary but usually involve the lower face, lips, gums, cheek, ears or jaw.

Trigeminal neuralgia has two main types:

1. Classic trigeminal neuralgia (Type 1): This is the most common form, characterized by sudden, intense, and brief episodes of pain. Routine activities like eating, talking, or brushing the teeth trigger the pain.

2. Atypical trigeminal neuralgia (Type 2): This type involves constant, aching, or burning pain that is less severe but lasts for longer periods. Certain stimuli can still trigger the pain, but it tends to be more persistent.

– Causes: Irritation or damage to the trigeminal nerve, often due to blood vessel compression or nerve inflammation.

-Potential treatments include anticonvulsant medications, nerve blocks, microvascular decompression surgery, nerve ablation procedures, acupuncture, and stress reduction techniques.

Sinusitis

Sinusitis, also known as a sinus infection, is inflammation or swelling of the sinus cavities. These are small air-filled spaces within the facial and skull bones. Sinusitis can occur as an acute infection that lasts a short period (less than four weeks) or as a chronic condition lasting longer than twelve weeks and possibly recurring. Due to the connections between the sinuses and middle ear, referred pain behind the ears is common. 

– Causes: Inflammation or infection of the sinuses, often due to a viral or bacterial infection.

– Potential treatment: Antibiotics (for bacterial infections), decongestants, nasal irrigation or saline sprays, pain relievers, warm compresses, steam inhalation, staying hydrated.

Ear infections or otitis media

Otitis media, commonly known as an ear infection, is an inflammation or infection of the middle ear, the space behind the eardrum. It is a common condition, particularly in children, but it can also affect adults.

– Causes: Infections in the middle ear, often caused by bacteria or viruses.

– Potential treatment: Antibiotics (for bacterial infections), antiviral medications (for viral infections), pain relievers, warm compresses, ear drops, and over-the-counter earache relief products.

Dental issues

Dental issues can cause various pain, often localized to the affected tooth or surrounding areas. The pain experienced can range from mild discomfort to severe agony, depending on the underlying condition. Some common dental problems that can cause pain include:

-Causes: Tooth or gum infections, teeth grinding (bruxism), and dental procedures.

-Potential treatments: Dental treatments or procedures, antibiotics (for infections), mouthguards or splints (for bruxism), stress reduction techniques, and pain relievers.

Nerve compression or impingement

Nerve compression, also known as nerve impingement or pinched nerve, occurs when a nerve is subjected to excessive pressure or irritation, leading to various symptoms and discomfort. This compression can happen at different sites in the body, such as the spine, joints, muscles, or other areas, and it refers to nearby areas.

– Causes: Conditions like cervical radiculopathy, herniated discs, or bone spurs that compress or irritate nerves in the neck.

– Potential treatment: Physical therapy, pain medications, epidural steroid injections, surgery (in severe cases), gentle stretching exercises, heat/cold therapy, posture correction.

Whiplash injury

A common neck injury occurs when the head is suddenly jolted backward and forward in a rapid, whip-like motion, causing whiplash. It most commonly occurs during rear-end car accidents, but it can also occur in other situations, such as contact sports, physical assault, or falls. This can cause referred pain due to muscular strain of the SMC and scalenes, which run directly behind the ear.

– Causes: Sudden jolts or jerking movements of the head and neck, often due to motor vehicle accidents or sports injuries.

– Potential treatment: Rest, neck braces or collars (in some cases), physical therapy, pain medications, heat/cold therapy, gentle neck exercises, massage therapy.

Neuralgia-inducing cavitational osteonecrosis (NICO)

NICO, which stands for Neuralgia-Inducing Cavitational Osteonecrosis, is a condition that affects the bone in the jaw. It refers to the presence of cavitations, which are areas of dead or necrotic bone that can develop in the jawbone, particularly in the areas where teeth were extracted or following dental surgery. NICO is considered a controversial condition within the dental community, and its existence and impact on health are still a subject of debate

– Causes: Areas of necrotic bone in the jaw that can cause pain that radiates to the surrounding area.

– Potential treatment: Surgical intervention to remove the necrotic bone, dental treatments, pain management, jaw exercises, and stress reduction techniques.

Arthritis or degenerative joint diseases

Degenerative joint disease, also known as osteoarthritis, is a condition that affects the joints, causing them to deteriorate gradually over time. It is the most common form of arthritis and typically occurs as people age. However, it can also develop due to joint injury or other factors which can refer pain into the ears. 

In degenerative joint disease, the protective cartilage that cushions the ends of bones within a joint gradually wears down. This can lead to various symptoms and referral pain behind the ear.

– Causes: Osteoarthritis, rheumatoid arthritis, or other conditions that affect the joints in the neck.

Potential treatments include physical therapy, anti-inflammatory medications, pain relievers, gentle exercises, heat/cold therapy, and assistive devices (neck braces, cervical pillows).

Please note that the treatment options mentioned are general suggestions. It’s crucial to consult with a healthcare provider for a personalized treatment plan based on your specific condition and medical history.

Conclusion

In conclusion, headaches behind the ear can be challenging. Still, you can take control of your health by understanding the causes, symptoms, treatment options, and prevention strategies. Seek professional advice, embrace a holistic approach, empower yourself to participate in your care, and prioritize prevention actively. By doing so, you can work towards minimizing the impact of headaches behind the ear and improving your overall well-being.

Click here for a FREE 30-Minute Consultation

*Note: The information provided in this article is for educational purposes only and does not constitute a doctor-patient relationship. Patients are advised to consult their medical provider or primary care physician before trying any remedies or therapies at home.