What is the inner ear?
The inner ear plays an important role in hearing and balance. Viral inner ear infections may be treated with steroids, antihistamines, sedatives and OTC pain relievers.
Your inner ear plays an important role in your hearing and balance. Its primary function is to receive sound waves that come in through the outer ear and go through the middle ear, where the sound makes your eardrum vibrate. These vibrations travel to the inner ear, which transmits them to the brain as nerve impulses.
Your inner ear is a labyrinth of fluid-filled tubes and sacs. It has three main parts:
- The cochlea, a shell-shaped structure that sends sound impulses to the brain
- The semicircular canals, which use your head’s movement to sense your position in space
- The vestibule, which is your primary balance system
Messages run through this system to the brain by way of the vestibulocochlear nerve. This nerve has two branches. One is responsible for hearing and one for balance. An inner ear infection happens when this nerve or the structures around it get irritated or inflamed.
What is an inner ear infection?
Inner ear infections usually develop when a virus attacks the inner ear or the nerve branches that run through it. Most inner ear infections are viral. In some cases, the infection directly affects the labyrinth or vestibulocochlear nerve. In others, a virus like measles, influenza, or mononucleosis affects the entire body including the inner ear.
Bacterial infections are less common. Most of the time, a bacterial inner ear infection happens because of a chronic middle ear infection. Toxins from this infection invade the inner ear structures and nerve. In rarer cases, the bacteria themselves invade the labyrinth from the middle ear or the cerebrospinal fluid that flows in or around the brain.
Symptoms of inner ear infections usually come on quickly. Symptoms can be mild to severe and include:
- Balance problems
- Spinning sensations (vertigo)
- Hearing loss
- Ear pain
- Ear discharge
- Ringing in the ear
- Feelings of fullness in the ear
Different types of inner ear infections cause different symptoms. The two main types of inner ear infections are:
- Neuronitis, which only affects the branch of the nerve that controls balance
- Labyrinthitis, which causes inflammation and irritation of the vestibulocochlear nerve
The primary difference is that labyrinthitis causes hearing-related symptoms, while neuronitis doesn’t. Your treatment will depend primarily on whether you have a viral or bacterial infection.
Remedies for inner ear infections
Do you need antibiotics?
If you have a bacterial inner ear infection, you may need an antibiotic. However, most inner ear infections are caused by viruses, not bacteria. Antibiotics aren’t effective against viral infections. For viral infections, your doctor will suggest treatment options to control your inflammation and help with your symptoms.
What treatments can help?
If you have a viral inner ear infection, your doctor may prescribe a steroid treatment to reduce inflammation or antiviral medication to attack the virus.
You may also take medications to control symptoms of nausea, vomiting, dizziness, and vertigo. Your doctor may suggest over-the-counter medications like diphenhydramine (Benadryl) or prescribe something like lorazepam (Ativan) or diazepam (Valium). Over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help to relieve discomfort.
What are some inner ear infection home remedies?
Besides medication, there are steps you can take at home to ease the symptoms of an inner ear infection. For example:
- Keep your head upright as much as possible. Sitting or standing can help to drain the ear.
- Apply a warm compress to the affected ear to relieve pain.
- Avoid smoking and drink as little alcohol as possible.
- Reduce your stress levels, since tension can worsen symptoms.
For labyrinthitis, specifically, to combat dizziness and nausea, you can try:
- Resting in a dark, quiet place
- Drinking plenty of water, especially if your nausea leads to vomiting
- Keeping your vision focused in one place instead of glancing around at your surroundings
- Going for walks as soon as you feel you can, with someone for support until you get your balance back
Risks and outlook
How long will it last?
Some people have no symptoms after the active inner ear infection is gone. Other people develop chronic symptoms. These may include:
Some people develop a condition called benign paroxysmal positional vertigo (BPPV) after recovering from an inner ear infection. BPPV is a chronic condition that causes dizziness or vertigo when the head moves.
Also, a condition called Ménière’s disease can develop in people who have had inner ear infections. Ménière’s disease causes chronic hearing problems, dizziness, and discomfort in the ear. Symptoms may start years after the initial infection.
Moving forward and recovering
With prompt treatment, most people recover from inner ear infections in just a few weeks. If you do have ongoing symptoms, your doctor can perform hearing and balance tests to find out what might help.
People with chronic dizziness or balance issues may improve with vestibular rehabilitation. This type of physical therapy uses specialized exercises to help your body adapt. Mechanical aids may help with hearing loss.
Whether you think you have a new or chronic ear infection, talk to your doctor. Different infections respond to different courses of treatment.