Overview

Earwax blockage occurs when earwax (cerumen) accumulates in your ear or becomes too hard to wash away naturally. Earwax is a helpful and natural part of your body's defenses. It cleans, lubricates and protects your ear canal by trapping dirt and slowing the growth of bacteria. If earwax blockage becomes a problem, you or your doctor can take simple steps to remove the wax safely.

Symptoms

Signs and symptoms of earwax blockage may include:

• Earache
• Feeling of fullness in the affected ear
• Ringing or noises in the ear (tinnitus)
• Decreased hearing in the affected ear
• Dizziness
• Cough

When to see a doctor

If you're experiencing the signs and symptoms of earwax blockage, talk to your doctor. Signs and symptoms could indicate another condition. You may think you can deal with earwax on your own, but there's no way to know if you have excessive earwax without having someone, usually your doctor, look in your ears. Having signs and symptoms, such as earache or decreased hearing, doesn't necessarily mean you have wax buildup. It's possible you have another medical condition involving your ears that may need attention.

Wax removal is most safely done by a doctor. Your ear canal and eardrum are delicate and can be damaged easily by excess earwax. Don't try to remove earwax yourself with any device placed into your ear canal, especially if you have had ear surgery, have a hole (perforation) in your eardrum, or are having ear pain or drainage.

Children usually have their ears checked as part of any medical examination. If necessary, a doctor can remove excess earwax from your child's ear during an office visit.

Causes

The wax in your ears is secreted by glands in the skin that lines the outer half of your ear canals. The wax and tiny hairs in these passages trap dust and other foreign particles that could damage deeper structures, such as your eardrum.

In most people, a small amount of earwax regularly makes its way to the opening of the ear, where it's washed away or falls out as new wax is secreted to replace it. If you secrete an excessive amount of wax or if earwax isn't cleared effectively, it may build up and block your ear canal.

Earwax blockages commonly occur when people try to clean their ears on their own by placing cotton swabs or other items in their ears. This often just pushes wax deeper into the ear, rather than removing it.

Diagnosis

Your doctor can determine whether you have earwax blockage by looking in your ear with a special instrument that lights and magnifies your inner ear (otoscope).

Treatment

Your doctor can remove excess wax using a small, curved instrument called a curet or by using suction while inspecting the ear. Your doctor can also flush out the wax using a water pick or a rubber-bulb syringe filled with warm water. If earwax buildup is a recurring problem, your doctor may recommend that you use a wax-removal medication, such as carbamide peroxide (Debrox Earwax Removal Kit, Murine Ear Wax Removal System). Because these drops can irritate the delicate skin of the eardrum and ear canal, use them only as directed.

Alternative medicine

Some people use ear candling, a technique that involves placing a lighted, hollow, cone-shaped candle into the ear, to try to remove earwax. The theory is that the heat from the flame will create a vacuum seal and the earwax will adhere to the candle. However, ear candling is not a recommended treatment for earwax blockage. Research has found that ear candling doesn't work, and it may result in injury, such as burns, ear canal obstructions and even perforations. Talk to your doctor before trying any alternative remedies for removing earwax.

Lifestyle And Home Remedies

If your eardrum doesn't contain a tube or have a hole in it, these self-care measures may help you remove excess earwax that's blocking your ear canal:

• Soften the wax. Use an eyedropper to apply a few drops of baby oil, mineral oil, glycerin or hydrogen peroxide in your ear canal.
• Use warm water. After a day or two, when the wax is softened, use a rubber-bulb syringe to gently squirt warm water into your ear canal. Tilt your head and pull your outer ear up and back to straighten your ear canal. When finished irrigating, tip your head to the side to let the water drain out.
• Dry your ear canal. When finished, gently dry your outer ear with a towel or hand-held dryer.

You may need to repeat this wax-softening and irrigation procedure a few times before the excess earwax falls out. However, the softening agents may only loosen the outer layer of the wax and cause it to lodge deeper in the ear canal or against the eardrum. If your symptoms don't improve after a few treatments, see your doctor. Earwax removal kits available in stores also can be effective at removing wax buildup. Ask your doctor for advice on how to properly select and use alternative earwax removal methods.
Don't try to dig it out
Never attempt to dig out excessive or hardened earwax with available items, such as a paper clip, a cotton swab or a hairpin. You may push the wax farther into your ear and cause serious damage to the lining of your ear canal or eardrum.

Preparing For Your Appointment

You're likely to start by seeing your family doctor or a general practitioner. In some rare cases, however, you may be referred to a specialist in ear disorders (ear, nose and throat specialist). As you prepare for your appointment, it's a good idea to write a list of questions. Your doctor may have questions for you as well. He or she may ask:

• How long have you been experiencing symptoms, such as earache or difficulty hearing?
• Have you had any drainage from your ears?
• Have you experienced earache, difficulty hearing or drainage in the past?
• Have your symptoms been continuous or occasional?

What you can do in the meantime

Don't attempt to dig out earwax with cotton swabs or other items — such as hairpins or pen caps. This can push the wax farther into the ear and cause serious injury to the ear canal or eardrum.

Epidural Steroid Injection Success Rates

While the effects of an epidural steroid injection tend to be temporary (lasting from a week to up to a year) an epidural steroid injection can deliver substantial benefits for many patients experiencing low back pain.

• When proper placement is made using fluoroscopic guidance and radiographic confirmation through the use of contrast, > 50% of patients receive some pain relief as a result of lumbar epidural steroid injections.
• Pain relief is more often felt for primary radicular (leg) pain and, less prominently, low back pain.
• The pain relief and control brought on by injections can improve a patient’s mental health and quality of life, minimize the need for painkiller use, and potentially delay or avoid surgery.
Success rates can vary depending on the condition that patient has and the degree of radicular leg pain that accompanies it:
• Recent research reports that lumbar epidural steroid injections are successful in patients with persistent sciatica from lumbar disc herniation, with more than 80% of the injected group with disc herniation experiencing relief (in contrast to 48% of the group that received a saline placebo injection).
• Similarly, in a study focused on a group of patients with lumbar spinal stenosis and related sciatica symptoms, 75% of patients receiving injections had more than 50% of pain reduction one year following the injections. The majority also increased their walking duration and tolerance for standing.
• The minimally invasive approach to this surgery offers our patients a safer and effective alternative to traditional open back surgery and our patients have reported a patient satisfaction score of 96.

ESI: Risks And Side Effects

With few risks, ESI is considered an appropriate nonsurgical treatment for some patients. The potential risks associated with inserting the needle include spinal headache from a dural puncture, bleeding, infection, allergic reaction, and nerve damage / paralysis (rare). Corticosteroid side effects may cause weight gain, water retention, flushing (hot flashes), mood swings or insomnia, and elevated blood sugar levels in people with diabetes. Any numbness or mild muscle weakness usually resolves within 8 hours in the affected arm or leg (similar to the facial numbness experienced after dental work). Patients who are being treated for chronic conditions (e.g., heart disease, diabetes, rheumatoid arthritis) or those who cannot temporarily discontinue anti-clotting medications should consult their personal physician for a risk assessment.

Potential Risks Of Epidural Steroid Injections

As with all invasive medical procedures, there are potential risks associated with lumbar epidural steroid injections. In addition to temporary numbness of the bowels and bladder, the most common potential risks and complications include:

• Infection. Severe infections are rare, occurring in 0.1% to 0.01% of injections. such as Osteomyelitis, a Spinal Infection.
• Dural puncture (“wet tap”). A dural puncture occurs in 0.5% of injections. It may cause a post-dural puncture headache (also called a spinal headache) that usually improves within a few days. Although infrequent, a blood patch may be necessary to alleviate the headache. A blood patch is a simple, quick procedure that involves obtaining a small amount of blood from a patient from an arm vein and immediately injecting it into the epidural space to allow it to clot around the spinal sac and stop the leak.
• Bleeding. Bleeding is a rare complication and is more common for patients with underlying bleeding disorders.
• Nerve damage. While extremely rare, nerve damage can occur from direct trauma from the needle, or from infection or bleeding.

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