Natural Wisdom

It's cold and flu season again, and that means it's ear infection season too.  3/4 of the patients I've seen this week have had a sore ear, some for the first time, and some as an ongoing complaint.  Treating a painful ear at home is often simple and effective - it's just a matter of knowing why the ear is sore, and when it's safe to self-treat.  Since about two thirds of acute ear infections resolve without any treatment, this is often!

Most adults and older children will recognize when they have a middle ear infection.  The ear feels full and painful.  With a younger child or nonverbal adult, you'll generally see signs such as a red ear, crying or screaming, fever, tugging at the ear or digging in the canal, or non-wax discharge from the ear.  Acute middle ear infections usually come on with a cold or follow closely afterward.

The first thing to do when someone has a painful ear is to look inside to see what is going on.  Sometimes the infection is actually in the canal (otitis externa), rather than behind the eardrum (otitis media).  (This article doesn't cover therapies for otitis externa.)  Sometimes in an intense infection, the eardrum will rupture.  Unfortunately, it so often happens that the pain comes on in the evening or in the middle of the night.  In this situation, it's important not to put any medications INTO the ear canal until someone can take a look inside.  If you feel comfortable using a home otoscope, you can look in there yourself, otherwise call your favorite ND. 

Parents often wonder if their baby or toddler is just teething.  In my experience, if tugging or poking at the ear is the only sign, there is no fever, no screaming, no discharge, and no red ear, and there's a lot of drooling or biting, then teething is the more likely culprit.  If any of the other ear signs are present, though, it's important to check for an infection.

If you haven't looked in the ear, there are still things you can do to ease pain and support the immune response, including homeopathy and hydrotherapy. 

Homeopathy is very effective for ear infections.  Two to three doses of a 30c potency (available at your local health foods store) will usually do the trick, when you get the right remedy.  Several common remedies for earaches include the following:

• For a child or adult with a terribly painful ear that starts around 9 or 10pm, who won't let you even think about touching the ear (except maybe with a warm cloth), and wants to be carried or held even though they are irritable and demanding, think Chamomilla, especially if one cheek is red and the other is pale.
• If the earache comes on at night, there's an associated sore throat, drooling and sick-smelling sweat, think Mercurius, especially with yellow-green discharge from the ear.
• The most frequent remedy for ear infections, both acute and chronic, is Pulsatilla.  The person needing this remedy is weepy and wants to be held tenderly and given lots of affection.  It's often the left ear that is most affected, with a painful full or bursting feeling.  It is worse with heat and better in the open/cool air.
• In a person with a very high fever, red, hot face, cold hands and feet, and an unbearably painful ear (especially the right side), think of Belladonna.  The pains throb, tend to come on around 3pm or after midnight, and are worse with being bumped.  This person may be delirious with fever.

A good book for homeopathic self-treatment is Homeopathic Self-Care: The Quick & Easy Guide for the Whole Family.  If the remedy isn't having any effect after three doses, stop.  If you are having difficulty finding the right remedy, call your ND or homeopath for help.

Two simple hydrotherapy treatments for an ear infection are the onion poultice and warming socks.

• To make an onion poultice, thinly slice an onion and sauté in a small amount of distilled or filtered water until the onions are transparent (clear).  If all you have is tap water, that's okay.  Place the sautéed onion into a cotton cloth (a flat-fold diaper works well) and gather the loose fabric.  This is where you will hold it.  Make sure the poultice is not burning hot before you apply it over the entire outer ear.  Leave it on until it cools and then gently dry the area and go to bed.  For a stronger treatment, make two poultices and do the second as soon as the first cools.  This treatment helps the pain and is antimicrobial.
• The warming sock treatment is useful in any cold, ear infection or sore throat.  It increases the circulation of blood and stimulates immune activity.  The most important part is to be WARM before you start.  Take a warm bath first if there is no significant fever.  Next, take a pair of thin cotton socks and soak them.  Wring them out as much as possible and then apply them to warm feet.  Cover each entire sock with a wool or fleece sock and go to bed.  Kids will often want to take them off at first, but a few minutes of distraction usually gets them to the more comfortable part.  In the morning, the socks will be dry and the feet will be warm.  ***It is very important NOT to do this treatment in a person with impaired sensation or circulation in the feet, such as a diabetic.***   Here is a fun instructional video made by an NCNM student.
  

Once it has been found that there is no rupture of the eardrum, in a person without tympanostomy tubes, it is also possible and helpful to use ear oil drops.  There are many herbal formulations - one of the most common is garlic and mullein in olive oil.  You can find this oil at the health foods store, or make it yourself (ahead of time).  Warm the oil to body temperature before applying 2-3 drops in the painful ear.  You can put a cotton ball in afterward to help keep the oil in, if needed.  The warm oil is soothing and the garlic helps fight the infection.

I often get asked about ear candling for ear infections.  I do not recommend ear candling, as I find no evidence that it is helpful or even does what it's intended to do.  There is also a risk of burns from the hot wax, as well as getting wax into the ear canal.  As you've already read, there are many simple, effective ways to treat ear infections.  Why use an ineffective, possibly harmful, and costly therapy instead?

The best way to treat an ear infection, of course, is to prevent it altogether.  Prevention includes maintaining a strong immune system, drinking plenty of water, and eliminating reactive foods.  Prolonged exclusive breastfeeding is also protective against ear infections in children.  Your naturopathic doctor is well-equipped to give you support with all of these.

One last note, there are other times to seek out medical help (not an exhaustive list):

• Any fever in a baby under 4 months.
• A fever higher than 104°F, especially if the cause is unknown.
• Redness is not confined to the ear, but extends behind the ear.
• There is swelling behind the ear.
  
• An infant or child is listless, unresponsive, dehydrated, or your instinct tells you something is not right.
• Home remedies have not helped.