Your ear pain may not be from the ear at all. It might be from your TMJ (temporomandibular joint)


A sensation of ear pain is a common reason that many patients seek the advice of an Ear, Nose and Throat specialist. This could be from an outer ear infection such as external blockage with ear wax or with swimmer’s ears situations. Ear pain can also come from middle ear infection, which is more common in children.

However, a large portion of patients that experience ear pain have no ear problems whatsoever. The source of their ear pain may actually be from the jaw bone!

Let us review the anatomy. The visible portion of the earlobe leads to the ear canal, which then leads to the eardrum and the middle ear structures. Directly in front of the ear canal is the joint that controls our jaw bone, namely the mandible. This joint is called the temporal mandibular joint. The front wall of the ear canal is actually the back wall of the joint capsule.

Occasionally, if there are situations with the joint that lead to inflammation and irritation, pain can result. This could be due to arthritic type changes that you might similarly experience in your hip joint, your knee joint or your elbows or shoulders. The pain could be dull and nagging, or it could be stabbing with occasional subtle changes in the position of the jaw. Alternatively, the pain could be coming from the muscles and tendons that regulate the joint and the mandible.

The patients with TMJ dysfunction often complain of ear pain in the absence of any other ear findings such as drainage from the ears, hearing loss, fevers, or any water exposure. They typically have a normal examination of the ear canals, the ear drum and the middle ears, as well as any specific testing done with hearing test.

Conditions that otherwise might lead to worsening of the TMJ problem are varied. It is thought that chewing hard or rubbery foods contributes to over-exercise of the jaw bone area, which then can lead to more wear and tear. Specifically, chewing gum is a redundant motion of the jaw bone, as well as a side-to-side motion rather than a normal chewing, which is up and down motion. Colder weather can affect the joint and basically can “freeze,” the joint, which then leads to worsening of the pain. More people get TMJ dysfunction either during the winter, or again during the summer with too much air-conditioning indoors. Warm compresses help to relieve some of this situation. Stress can also lead to subconscious grinding of the teeth or clenching of the jaw, which once again can give the patient symptoms of TMJ pain.

If you are experiencing ear pain, which is rather atypical in its presentation, it is recommended for you to see a doctor right away to differentiate between ear sources versus non-ear sources for the pain. This could be done by a visit to the ear, nose and throat specialist.

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