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Outer ear pain with side sleeping - a different suggestion
Susanne_DPT posted:
It's surprising to see in all of these discussions no mention of related neck pain and only slight mention of jaw pain. I too am a sufferer of the bilateral ear pain at night with side sleeping. However, I can usually predict when my episodes are going to be the worst - that is when my upper cervical vertebrae (spinal bones of the neck) and cranium are off. I know these are out when I have limited rotation or extension of the head. Also, when I look in the mirror my head tilts to one side. I'm also afflicted with right TMJ issues and when this is bad, then so increases the frequency of the ear pain.

What is a common thread in these discussions is that change in position (i.e., sitting up) will usually reduce the pain within 20 minutes or so. Changes in position usually indicates a musculoskeletal issue, not an endocrine issue that many people are looking at (see comments on pregnancy and fibromyalgia). Yes, the nerves are talking, rather, screaming at us, so they are definitely involved. But entrapment, impingement or straight irritation of nerves can occur when the bones are not well positioned. The suggestion of pulling on the ear is also indicative of a musculoskeletal issue, and not an organic pathology, since this affects the fascial system and attachments around the ear/cranium/cervicals.

My hypothesis is that when we sleep on our sides there is a slight shearing that occurs between the cranium & the vertebrae, which irritates the nerve that supplies the cartilage to the ear. I have not seen this anywhere in the literature, however, so have no evidence to support this hypothesis.

What I do know, is that when I see a practitioner who helps with my alignment (for me this includes seeing a physical therapist who is an expert in manual work, or a massage therapist who does good jaw, neck and cranial work, or a chiropractor who can adjust the AO joint) that my symptoms are usually relieved for a while.

Good luck to all my fellow sufferers of this enigmatic condition. I wish you all relief and pain free sleep.
Rod Moser, PA, PhD responded:
There are many causes of "referred" ear pain. Because of the nerve pathway, problems in the mouth, throat, lymph nodes, salivary glands, teeth, and yes, even the cervical spine, can cause pain to be referred to the ear area. There can be dozens of different causes. It is up to a medical practitioner to determine if a particular ear pain is a problem within the ear, or originating by a referred route. It is possible that a person can have more than one cause of ear pain.

Ear pain should never be taken lightly, nor should a discoverable cause by assumed to be the only cause. The same goes for therapy. Since people have an amazing ability to heal themselves, and pain has an annoying tendency to "come and go", it would also be presumptious to attribute improvement (or worsening) of any symptom to the last therapeutic intervention.

I am pleased that massage, manipulation, and/or chiropractic adjustments have worked for you, please keep in mind that it is just YOU. In no way, would an identical treatment regime have similar results in someone else.

I thank you for your contribution to this on-going discussion.

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