The painful ear.

The painful ear is caused commonly by otitis media, otitis externa and temporomandibular joint dysfunction. Difficulty in visualising the tympanic membrane due to debris in the ear canal can make diagnosis difficult, especially when otitis externa and otitis media co-exist. Another problem is determining the origin of referred pain. Due to the complex innervation of the ear, referred pain can arise from most sites in the head and neck, especially the upper cervical spine, the teeth and the throat.