Sore Throat & Ear Pain: Meaning, Causes & Treatment

Key takeaways:

• A sore throat that comes with ear pain is usually due to a viral or bacterial infection.
• Some causes of sore throat and ear pain will resolve on their own with at-home care and rest.
• If your sore throat and ear pain persist, worsen, or come with other symptoms, consult a doctor.

Experiencing a sore throat and ear pain can be an uncomfortable experience. You might be wondering if you have an infection that requires medication, a virus, or something else entirely. However, experiencing these two symptoms together is more common than you think.

What can cause these two nagging symptoms to show up in tandem? More importantly, is there anything that can be done to quickly resolve these symptoms? We’ll explore some of the more common causes, give advice on home remedies, and list symptoms that should warrant a call to your primary care doctor.

Common causes of a sore throat with ear pain

There are a few common causes that are responsible for simultaneous sore throats and earaches. Let’s break them down.

Mononucleosis

Infectious mononucleosis, also known as “mono,” is most frequently caused by the Epstein-Barr virus (EBV). Anyone can develop a mononucleosis infection, but it is most common among teenagers and young adults.

Symptoms may include sore throat, extreme fatigue, fever, swollen lymph nodes in the neck and armpits, and a rash.

Your doctor may note a swollen spleen and liver during the physical exam. Infectious mononucleosis resolves in two to four weeks for most individuals, although fatigue may persist for several more weeks. Strenuous contact sports can put you at an increased risk of experiencing a ruptured spleen, so you should avoid contact sports until you make a full recovery.

Strep throat

Strep throat is a bacterial infection that affects the throat and tonsils. Anyone can develop a strep throat infection, but it is most common among children five to 15 years of age. The most common strep throat symptoms include red and swollen tonsils, fever, pain with swallowing, small red spots on the roof of the mouth, and swollen lymph nodes localized to the front of the neck.

Less frequently, strep throat may be associated with a headache, abdominal pain, nausea and vomiting, and a rash known as scarlet fever. Ear infections, sinus infections, and abscesses may occur if the infection-causing bacteria spreads to other parts of the body.

Ear infections

One of several types of ear infections might be causing your ear pain. Ear infections can be viral or bacterial, meaning some cases may resolve with only supportive care while others may require treatment with antibiotics.

Middle ear infections, which are referred to as acute otitis media, are infections of the inner and middle ear. Swimmer’s ear, known as acute otitis externa, is an infection of the ear’s outer portion.

Ear pain and fever are two common symptoms of ear infection. Fluid can sometimes build up in the middle ear without an infection. In these cases, the ear may feel painful or clogged, but you will not develop a fever or other infectious symptoms.

Treatment options for sore throats with ear pain

Your doctor will treat your sore throat and ear pain based on the underlying cause. A physical exam, blood test, or throat swab can usually pinpoint the cause.

Over-the-counter medications

Acetaminophen, ibuprofen, or other over-the-counter medications can help with pain relief and fever reduction. Your doctor will review the recommended dosage and frequency of each drug with you. Decongestants may help if you have fluid buildup in your sinuses or behind your ear drums.

Antibiotics

If a bacterial infection (such as strep throat) is causing your symptoms, your physician will prescribe antibiotics. It is important to let your physician know if you have allergies to any antibiotics.

Conversely, if symptoms are caused by Epstein-Barr or another virus, antibiotics will not be useful, and the virus will resolve on its own. Additionally, it is important to avoid penicillin antibiotics when you have infectious mononucleosis because this medication can cause rashes if taken during this viral infection.

Supportive care

Get plenty of rest and stay hydrated. Home remedies such as honey, throat lozenges, and gargling salt water can provide some pain relief by soothing sore throats. Sleeping with a humidifier to lubricate the throat may also be helpful.

What can it mean if your ears only hurt on one side?

Ear pain localized to one side may be due to an acute infection such as a middle ear infection or swimmer’s ear. It may also indicate an earwax buildup or a perforation of the eardrum on that side. Conditions that are not related to the ear, such as dental pain, throat infections, abscesses, and swollen lymph nodes in the neck, may cause pain in one or both ears.

Diagnosing a sore throat with ear pain

To diagnose a sore throat with ear pain, your doctor will first want a detailed history of your symptoms. They will likely examine your ears, throat, lymph nodes, and surrounding structures. In many situations, the suspected diagnosis can be identified based on history and the physical examination alone.

If strep throat is suspected, your doctor may take a throat swab to confirm an underlying bacterial infection. They may also order blood tests if they suspect infectious mononucleosis.

When to go to the doctor or emergency room for a sore throat and ear pain

Deciding where to go when seeking medical care depends on how severe your symptoms are and how long you’ve been experiencing them.

You should see a doctor if:

• You have throat pain when talking or swallowing.
• You have ear pain, drainage from the ear, or sudden loss of hearing.
• You have swollen lymph nodes in your armpits or neck.
• You have symptoms that last more than a week.

You should go to the emergency room if:

• You have difficulty breathing.
• You have difficulty swallowing.
• You experience drooling or are unable to fully close your mouth.
• You experience a high fever that does not respond to over-the-counter medication.

Questions to ask your doctor about a sore throat with ear pain

• Are my symptoms a sign of a potential infection?
• How will you diagnose the cause of my sore throat and ear pain?
• What can I do to manage my symptoms at home?

Frequently asked questions: sore throat and ear pain

You may be wondering what conditions you might have based on the nature and duration of your symptoms. Below are answers to some common questions patients have when they experience throat and ear pain.

What if you’re experiencing throat and ear pain without a fever?

Throat and ear pain without a fever may still be due to an infectious cause. However, it is important to consider other causes of these symptoms, including allergies, acid reflux (GERD), noninfectious fluid in the ear, and laryngitis.

What if you’ve had a sore throat and painful ears for weeks?

Pain that persists for weeks may indicate an underlying chronic condition. If bacterial infections do not resolve with the use of antibiotics and viral infections do not resolve on their own with supportive treatment over the course of 7-10 days, you should call your doctor. They may want to examine you or refer you to an ear, nose, and throat (ENT) specialist.

What can you do if your ears are completely clogged?

If your ears are completely clogged, it may be due to a buildup of earwax. You should avoid using Q-tips and consider trying an over-the-counter earwax removal kit.

Other possible causes of clogged ears include fluid behind the eardrum due to sinus congestion or an ear infection. Decongestants may help in either case. Please consult a healthcare provider if the symptoms do not improve after a few days or with the use of over-the-counter methods.

What can it mean if it only hurts when you swallow?

Pain with swallowing is often a sign of inflammation in the throat. Viral infections, bacterial infections, acid reflux, allergies, and post-nasal drip are a few causes of throat inflammation. Seeing your doctor or healthcare provider can narrow down the possible cause of your symptoms.

Final thoughts to ease the ache

Dealing with a sore throat and ear pain is never enjoyable and can be frustrating when there are so many potential causes. Understanding the common culprits and the symptoms to watch out for can help you make an informed decision on when to seek medical attention.

While some causes may resolve on their own with supportive measures, don’t hesitate to consult your healthcare provider if the pain doesn’t go away.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Jennifer Nadel, MD.

Sources

Centers for Disease Control and Prevention (CDC). “About Infectious Mononucleosis (Mono).” CDC, 9 May 2024, www.cdc.gov/epstein-barr/about/mononucleosis.html.

Centers for Disease Control and Prevention (CDC). “About Strep Throat.” CDC, 18 Apr. 2024, www.cdc.gov/group-a-strep/about/strep-throat.html?CDC_AAref_Val=www.cdc.gov/groupastrep/diseases-public/strep-throat.html.

Centers for Disease Control and Prevention (CDC). “Ear Infection Basics.” CDC, 23 Apr. 2024, www.cdc.gov/ear-infection/about/.

Centers for Disease Control and Prevention (CDC). “Sore Throat Basics.” CDC, 24 Apr. 2024, www.cdc.gov/sore-throat/about/index.html.