Why does tonsillitis cause ear pain?

Viral tonsillitis is an acute inflammation of the tonsils, caused by pathogenic microorganisms that affect the body by finding a suitable habitat for their replication. Common cold viruses are the ones that normally cause this type of tonsillitis, characterised by a sore throat and fever, which normally does not exceed 39°.

If you are wondering how long viral tonsillitis lasts, it can be said that symptoms normally disappear spontaneously within 72 hours; paracetamol can help relieve sore throat and fever, the characteristic symptoms of this disorder. 

Particularly common in colder season, this condition is often transmitted in crowded places. However, it resolves after a few days.

Can tonsillitis cause ear infection? 

Yes, it can and one of the main symptoms of tonsillitis is earache. This is because the tonsils are located at the transition point between the mouth and pharynx, close to the ears. Therefore, when they become inflamed, the entire area may be affected by pain, including the ears. This type of earache is called reflex otalgia because it is not the auditory system that is attacked by the virus or bacteria, but rather the throat. When considering treatment, it is important to consult a doctor rather than relying on self-treatment.

Otalgia refers to inflammation of the ear and is normally understood as an illness that is caused by inflammation of the outer, but often also the inner ear. There are two different types of otalgia: bilateral and reflex otalgia. 

• Bilateral otalgia is pain that affects both ears: the cause is a disorder affecting the auditory system and can be of various kinds. 
• Reflex otalgia, on the other hand, is an intense pain in the ear that has causes unrelated to ear infections, such as those caused by tonsillitis or, more generally, all infections of the oral cavity. The latter cause inflammation so severe that it also affects the areas where the cranial nerves that are responsible for the increased sensitivity of the outer and middle ear are located. The affected nerve is the 9th cranial nerve, glossopharyngeal.

In severe cases of tonsillitis, the disorder can complicate and lead to mastoiditis, a bacterial infection that normally follows acute otitis. To treat it, antibiotic therapy is required, administered under medical indication. 

Mastoiditis is a very painful and debilitating disorder, so it is always a good idea to treat tonsillitis early and avoid unpleasant repercussions on the body in general.

Medications for tonsillitis vary depending on the cause of the disorder. 

In the case of viral tonsillitis, treatment is based on paracetamol, in doses appropriate for fever and pain. Normally, however, after a peak in the first 72 hours, it regresses spontaneously and disappears in 7-10 days. In some cases, the doctor may also indicate taking NSAIDs (non-steroidal anti-inflammatory drugs), such as acetylsalicylic acid and ibuprofen. On the other hand, if the tonsillitis is viral, antibiotics must not be taken under any circumstances, whereas they are necessary in the case of bacterial tonsillitis. The antibiotics normally used are broad-spectrum ones. If close infections occur, the antibiogram will give a useful indication of the antibiotic to be used.

If tonsillitis is viral, it is essential to help the immune system defend itself. This may involve implementing all the good practices used for fever and other viral infections, such as 

• avoid temperature changes;
• washing hands often;
• ventilate rooms to avoid contagion of the virus;
• drink small sips of water often to moisturise the tonsils, or infusions and herbal teas based on honey, lemon, ginger, mallow and echinacea; 
• disinfect the throat by gargling with a mouthwash or with salt and bicarbonate.
• Eating fresh food can also help soothe the pain.

Good practices can help, but it is always best to consult with a physician to evaluate the most effective  to treat the disorder.