Otitis Media: This is the most common cause of acute ear pain, especially when exacerbated by pressure. It is an infection of the middle ear that can be caused by bacteria or viruses, often following an upper respiratory tract infection. The pain is typically sharp and worsened by pressure changes, such as during air travel or when swallowing.

Otitis Externa (Swimmer's Ear): An infection of the outer ear canal, often caused by bacterial or fungal infections. It is common in individuals who swim frequently or have excessive moisture in the ear canal. The pain can be severe and is exacerbated by manipulation of the outer ear or pressure on the ear canal.
Eustachian Tube Dysfunction: This condition involves the tube that connects the middle ear to the back of the nose and throat. Dysfunction can lead to pressure changes in the ear, causing pain, especially when swallowing, yawning, or experiencing changes in atmospheric pressure.
Earwax Impaction: A buildup of earwax can cause discomfort, pain, and a feeling of fullness in the ear. If the wax is impacted, it can cause significant pain, especially if it is pushed further into the ear canal, which can happen with the use of cotton swabs.

Mastoiditis: A serious infection of the mastoid bone, located behind the ear. It can arise as a complication of untreated or inadequately treated otitis media. Symptoms include severe ear pain, fever, and swelling behind the ear. Mastoiditis requires prompt medical attention to prevent serious complications.
Petrous Apicitis: A rare but serious infection of the petrous part of the temporal bone. It can cause severe ear pain, headache, and neurological symptoms. Prompt diagnosis and treatment are crucial to prevent serious complications, including cranial nerve palsies and brain abscesses.
Temporal Bone Fracture: A fracture of the temporal bone can cause severe ear pain, hearing loss, and other neurological symptoms. It is often the result of significant head trauma and requires immediate medical evaluation.

Ramsay Hunt Syndrome Type 2: A condition caused by the varicella-zoster virus (the same virus that causes chickenpox and shingles) affecting the geniculate ganglion of the facial nerve. It can cause ear pain, facial paralysis, and vesicles in the ear canal.
Glossopharyngeal Neuralgia: A rare condition characterized by sharp, stabbing pain in the back of the throat, tongue, and ear, often triggered by swallowing. It is caused by irritation of the glossopharyngeal nerve.
Temporal Arteritis: An inflammation of the blood vessels, particularly those in the head. It can cause severe headaches, jaw pain, and ear pain, especially in older adults. Prompt diagnosis and treatment with corticosteroids are essential to prevent complications, including vision loss.