It is normally possible to establish the cause of ear pain based on the history. It is important to exclude cancer where appropriate, particularly with unilateral otalgia in an adult who uses tobacco or alcohol.^{[1] [2]}

• History about the onset, type, characteristics, severity, localization and radiation of pain.
• Any aggravating or alleviating causes of pain.
• Any associated symptoms like tinnitus (ringing sensation in the ears), hearing loss, vertigo (spinning sensation and feeling dizzy), sinusitis, facial pain, myalgias (muscle pain), neuralgias, or arthritis.
• Any toothache or tooth infection.
• Any fever.
• Any cancer risk factors like smoking, alcohol etc.,
• Any recent trauma.
• Any heart burn, difficulty to swallow, or other gut problems.
• Past ear infections or disorders.
• Any heart pain or shortness of breath.

The symptoms of an ear infection in children may include:

• Ear pain
• Fever
• Fussiness
• Increased crying
• Irritability

Many children will have temporary and minor hearing loss during, and right after, an ear infection. Permanent hearing loss is rare, but the risk increases with the number of infections. Adults may complain of only pain and sometimes fever.