Allergic rhinitis (nasal allergies) occurs when an immune response to an allergen, like pollen, causes inflammation. This can lead to congestion in your sinuses. Because your sinuses are connected to your ears, inflammation can also lead to ear pain.

Both seasonal and perennial allergies can cause ear pain. Seasonal allergies usually come and go based on pollen levels. Perennial allergies are more persistent, triggered by allergens such as pet dander or dust.

Allergies may cause ear pain primarily by affecting the Eustachian tubes, small tubes that connect your ears to your nose, throat, and sinuses. They help equalize the pressure inside your ear.

When allergies or infection cause severe inflammation in your sinuses, known as sinusitis, your Eustachian tubes may become swollen or blocked. Pressure can then build up in your middle ear, leading to discomfort or pain. 

Specific ear problems that can stem from allergies include:

• Increased mucus production: Allergies can make your body produce more mucus, which can clog the Eustachian tubes.
• Fluid buildup: Trapped fluid in the middle ear can cause pressure and pain.
• Ear infections: In some cases, trapped fluid can allow bacteria to grow, leading to a painful middle ear infection.
• Pressure changes: The Eustachian tubes regulate pressure in the ears. When the tubes are blocked, air pressure can build up, causing pain.
• Referred pain: Sinus pain from sinus congestion can sometimes feel like it’s coming from your ears.

Common allergy symptoms, like sneezing, nasal congestion, and itchy eyes, may begin within a few minutes after you encounter an allergen. Ear pain may take several hours to develop.

Allergy-related ear pain may feel like a dull or sharp pain, and you may notice a feeling of fullness or pressure. This sensation can occur in one ear or both.

Allergies that cause ear pain may also affect your hearing, with symptoms such as:

• Distorted hearing
• Muffled sounds
• Tinnitus (ringing or hissing sound in the ears)
• Popping sounds

If you develop an ear infection, you may also notice these ear infection symptoms:

• Severe ear pain
• Fluid draining from the ear
• Hearing loss
• Vomiting or diarrhea
• Fever

The main way to treat ear pain from allergies is to treat your allergies. Along with avoiding any known allergic triggers, treatments for allergies include:

• Saline nasal rinses
• Steroid nasal sprays
• Over-the-counter (OTC) antihistamines or decongestants
• Prescription medications to help change your immune response
• Immunotherapy to help make your immune system less sensitive to allergens

You can also manage ear pain directly with these tips:

• Apply warm or cold compresses to your ear
• Try to clear pressure from your Eustachian tubes by pinching your nose shut, closing your mouth, then gently trying to push air out while you swallow
• Sleep in an upright position
• Use OTC ear drops to relieve pain
• Take OTC oral pain medications, like Tylenol (acetaminophen) or Advil (ibuprofen)

If you develop an ear infection, a healthcare provider may prescribe antibiotic ear drops. Sinus infections may require oral antibiotics. For severe or chronic (long-lasting) ear pain, your provider might recommend surgery to address blockage in your Eustachian tubes.

Never try to clear out your ears or your child’s ears with cotton swabs or water picks. This can damage your eardrum and make the pain worse.

Mild ear pain alongside allergies is usually not a cause for concern, but in some cases, it may require medical attention. Call your healthcare provider right away if you or your child develops:

• Signs of infection, like a high fever or fluid draining from the ear
• Severe pain or pain that wakes you up at night
• Severe pain that stops suddenly, which may signal a burst eardrum
• Swelling or tenderness around the ear
• Dizziness or headache
• Weakness in your facial muscles

Inflammation from nasal allergies can block your Eustachian tubes, cause fluid buildup, and lead to infections. Common ear symptoms include mild ear pain, pressure, and hearing loss.

Treatment focuses on managing allergies with medications like steroid nasal sprays and antihistamines. If your symptoms become severe or last more than a few days, it’s important to contact a healthcare provider.