Ear pain following tonsillectomy is a common symptom that most people experience. Here’s why that happens and what you can do to feel better.

A tonsillectomy is a common surgical procedure to remove the tonsils. Sometimes, a surgeon may also remove adenoids at the same time. This procedure is known as a T&A — tonsillectomy and adenoidectomy.

Surgeons usually perform a procedure called tonsillectomy in children and teens. Sometimes adults may also benefit from this procedure. Healthcare professionals may recommend this procedure if your child experiences frequent tonsils infections or if they are swollen and cause obstructive sleep apnea (difficulty breathing during sleep).

Temporary ear pain after a tonsillectomy or T&A is expected. In this article, we’ll explain why your child’s ears may hurt after these procedures.

Ear pain is a common side effect of tonsillectomy procedures. Your child may complain of ear pain for up to 2 weeks after removing their tonsils. Many kids have more intense ear pain than throat pain, even though their throat is affected the most during the procedure.

Even though people feel it in their ears, infection does not cause pain, damage, or inflammation within the ears. Rather, ear pain after tonsillectomy is referred pain (pain that is transmitted to the ears from elsewhere in the body).

The glossopharyngeal nerve, sometimes referred to as cranial nerve 9, sends sensation to the back of the throat, tongue, and ears. It originates in the lower part of the brain stem, in a part called the medulla oblongata.

After a tonsillectomy, nerve pain originating in the throat may travel through the glossopharyngeal nerve into the ears. Another nearby nerve, the vagus nerve, may also transmit sensations of pain up into the ears. In some instances, the pain may not start for several days after the procedure.

While it may last for up to 2 weeks, most children feel relief from ear pain within a few days to a week.

In addition to referred ear pain, common side effects include:

  • difficulty swallowing
  • difficulty speaking
  • hoarse voice
  • bad breath
  • throat pain
  • swollen throat
  • feeling like something is stuck in your throat (caused by swelling)
  • tiredness
  • low-grade, short-term fever
  • snoring
  • nausea and vomiting
  • formation of a scab where the tonsils were removed. When the scab falls off, minor bleeding may occur

More serious complications are rare but can include:

  • infection
  • swollen tongue
  • swelling along the roof of the mouth
  • dehydration
  • postsurgical bleeding
  • problems from the anesthesia

Keeping your child distracted or helping them to relax may be enough to ease their pain. Placing a warm compress on the ear can also feel soothing.

Your child may not need pain medication. But if they do, over-the-counter drugs are usually enough to calm down ear pain after tonsillectomy. Your child may have difficulty swallowing. If so, you may give liquid or easy-melt pain medications.

Do not give your child aspirin, ibuprofen, or adult-dose pain medications. Instead, give child-safe medications like Tylenol (acetaminophen) at the appropriate dose.

If your child’s pain doesn’t respond to OTC drugs, let their doctor know. They may prescribe a different type of medication that will help with pain or inflammation.

Recuperation tips

Even though they’re common, tonsillectomies are still surgeries. Follow the pediatrician’s aftercare instructions, which will include:

  • taking prescribed medications, such as prednisone, antibiotics, or Carafate (to coat the throat)
  • getting plenty of rest
  • avoiding playing sports and strenuous activities
  • staying home from school for around 10 days or until full recovery takes place
  • eating soft, non-chewy foods, like pudding, smoothies, apple sauce, and scrambled eggs
  • drinking plenty of fluids such as water and juice, and using a straw is OK
  • avoiding spitting
  • avoiding environmental irritants, like dust and dander
  • avoiding people who are ill with transmittable viruses like colds, the flu, or COVID-19

If your child’s pain is severe, or keeping them up at night, let their pediatrician know. Also, seek medical advice for:

  • pain that worsens after four or 5 days or doesn’t respond to pain medication
  • fever over 101°F (38.3°C)
  • signs of dehydration
  • heavy bleeding or pus in the throat
  • difficulty breathing

Ear pain after tonsillectomy is common. This side effect may start immediately or several days after the procedure. Let your child’s pediatrician know if the pain is severe or keeps your child from sleeping. They can prescribe pain-relieving medication that best suits your child.