Can Migraines Cause Ear Pain (Otalgia)?

Yes, indeed they can – but I did not know that. Earaches without obvious causes, even after extensive testing, might make physicians suspect migraines. At first, I did not make the connection between often stabbing ear pain and my left-sided silent vestibular migraines. I thought of the otalgia as a separate event and blamed it all on allergies and sinus problems.

However, the unexplained ear pain caused me plenty of worry and anxiety. I kept thinking of the substantial Sudden Hearing Loss that upended my life some years ago. What else could possibly happen to my already damaged inner ear and hearing nerve? 

Then, I mentioned the earaches to my primary physician. They were unpredictable. They came and went. They were at times sharp and aggressive. Sometimes they were fleeting. Sometimes they lingered and drove me nuts. Then they went away, and all seemed fine.  

Track the triggers. Keep a diary.

The doctor reviewed the chart and asked all sorts of questions. He felt that these earaches fit into the pattern of migraine symptoms and that it was all connected! He urged me to keep a symptom diary. This would help identify if the ear pain was related to migraine triggers. As Coach Yogi Berra said:” You can observe a lot by just watching.”

Migraine symptoms and triggers differ from person to person. It turns out that for me barometric pressure changes are huge migraine triggers. Upticks in tinnitus are followed by sound and light sensitivities, dizziness, ear pressure feelings – and frequently stabbing ear pain. Rapid and profound pressure changes are sure set-ups for earaches. High pressure is worse than low pressure but often the transition period also becomes problematic.

Ultimately, I was referred to a neurology clinic for an in-depth evaluation and migraine prevention help. While I see improvement, I keep checking the weather map in the local paper and pay attention to our local TV weather forecasts. Where will the highs and lows be? A phone app like the WeatherX Forecast app can help with barometric pressure information.

Migraines are still mysteries

Migraines can be difficult to diagnose.  Researchers recognize them as neurologic disorders with strong genetic ties. Not all migraines are the same. They are not limited to the “classic” type with whopping headaches and auras. However, many patients with classic migraines also report ear pain.

That said, migraines can be atypical and silent – without headaches. They come in different versions and can affect other parts of the body – including the ears. Why this happens is still under investigation. Migraine-related brain inflammation spreading to the ear? Blood flow issues? Migraine-induced changes in brain chemistry? There is plenty more to come on this as research into these elusive conditions expands.

In the end…

Don’t ignore ear pain. Ask your doctor. If no immediate cause is found and tests are negative, it may be a symptom of another underlying condition. Could it be related to migraine? Just a thought!  Watch for triggers. Keep a journal. Who knows? Maybe a lot will be observed by watching!