What causes otalgia (ear pain) in the external auditory meatus (ear canal) due to stretching from wearing earplugs (hearing protection devices)?

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Last updated: May 12, 2025View editorial policy

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From the Guidelines

Pain in the ear canal from wearing earplugs is typically caused by pressure and stretching of the sensitive skin lining the ear canal, and managing this pain involves using appropriate analgesics and taking measures to reduce pressure on the ear canal. This discomfort occurs because earplugs, especially those that are too large or inserted too deeply, can exert pressure against the ear canal walls, causing the skin to stretch 1. The ear canal is lined with thin skin over bone with minimal subcutaneous tissue, making it particularly sensitive to pressure and irritation.

To manage this pain, first try using smaller earplugs or a different type that fits your ear canal better. Silicone or foam earplugs that expand gently may cause less pressure than rigid types. If you must wear earplugs regularly, give your ears breaks whenever possible to allow the tissue to recover. For existing pain, over-the-counter pain relievers like acetaminophen (500-1000mg every 6 hours as needed) or ibuprofen (400-600mg every 6-8 hours with food) can help reduce discomfort, as they are effective for mild to moderate pain 1.

Some key points to consider when managing ear canal pain from earplugs include:

  • Using appropriate analgesics at adequate doses to achieve comfort and prevent pain from becoming severe 1
  • Assessing the severity of discomfort regularly to adjust treatment as needed 1
  • Considering non-pharmacologic therapies, although their effectiveness is unproven 1
  • Avoiding the use of topical anesthetic drops unless necessary and with caution, as they may mask progression of underlying disease 1

If you notice persistent pain, discharge, or hearing changes, consult a healthcare provider as these could indicate an infection or injury that requires medical attention.

From the Research

Ear Canal Pain from Stretching due to Wearing Ear Plugs

  • The available studies do not directly address the issue of ear canal pain from stretching due to wearing ear plugs.
  • However, a study on stretching stenoses of the external auditory canal 2 discusses the use of ear stretching tunnels or ear stretchers to solve external auditory canal stenosis, which may be relevant to the context of ear canal stretching.
  • The study found that the use of ear stretchers was effective in solving external auditory canal stenosis with the least discomfort for the patient and the lowest cost.
  • Other studies focus on the treatment of chronic suppurative otitis media (CSOM) using topical or systemic antibiotics 3, 4, or the use of topical or oral antibiotics for children with acute otitis media presenting with ear discharge 5.
  • A study on bacitracin 6 discusses its use as a topical antibiotic, but does not address the issue of ear canal pain from stretching due to wearing ear plugs.
  • There is limited evidence available to directly answer the question of ear canal pain from stretching due to wearing ear plugs, and further studies are needed to address this issue.

Possible Causes of Ear Canal Pain

  • Acquired stenosis of the external auditory canal may be caused by a variety of insults, including previous surgery or radiotherapy 2.
  • The use of ear plugs or ear stretchers may cause stretching or stenosis of the external auditory canal, leading to pain or discomfort.
  • However, the available studies do not provide direct evidence on the causes of ear canal pain from stretching due to wearing ear plugs.

Treatment Options

  • The use of ear stretchers or ear stretching tunnels may be effective in solving external auditory canal stenosis, but its application to ear canal pain from stretching due to wearing ear plugs is unclear 2.
  • Topical or systemic antibiotics may be used to treat CSOM or acute otitis media, but their effectiveness in treating ear canal pain from stretching due to wearing ear plugs is unknown 3, 4, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Stretching stenoses of the external auditory canal: a report of four cases and brief review of the literature.

Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale, 2015

Research

Topical antibiotics for chronic suppurative otitis media.

The Cochrane database of systematic reviews, 2020

Research

Topical versus systemic antibiotics for chronic suppurative otitis media.

The Cochrane database of systematic reviews, 2021

Research

Bacitracin.

Cutis, 2005

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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