Think You Might Have Otitis Interna? Here’s Everything You Need to Know

If you’ve ever had an inner ear ache, you know how painful it can be.

There are many reasons you might have pain in your inner ear, including an ear infection.

However, when inner ear pain is combined with dizziness and a loss of hearing, you may be experiencing a common condition called otitis interna — also known as labyrinthitis.(1)

Labyrinthitis is a balance disorder affecting the inner ear that most often is caused by a virus. If you are experiencing inner ear pain, dizziness and loss of hearing, then read on to learn everything you need to know about labyrinthitis and how you can seek treatment.

This guide outlines everything you need to know about this perplexing ear and head condition — including;

  • definitions
  • causes
  • symptoms
  • treatment plans
  • and medical outlook

The bad news about otitis interna is that it can return and cause discomfort for patients multiple times throughout their lives. It also can come on very suddenly and without any warning.

The good news is that there is hope and a way forward for getting through the onset of this condition and living a healthy life.


What Is Otitis Interna?

Otitis Interna, also known as labyrinthitis, is a painful balance disorder that generates itself in your inner ear.(2)

There are both bacterial and viral versions of labyrinthitis — but it often is preceded by an upper respiratory infection such as a severe cold, bronchitis or the flu.

More often, labyrinthitis is caused by a virus (3) — but this guide will also explore how labyrinthitis is caused by a bacterial infection. It’s important for a doctor to figure out whether your labyrinthitis is bacterial or viral, as this will affect your treatment plan going forward.

It’s also important to remember that treatment plans for bacterial and viral otitis interna are much like those for other conditions with dual generations.

A virus must be treated with medication. A bacterial infection often has to run its course. But that doesn’t mean you’ll need to be uncomfortable while you wait.



Did you know that your ear is made up of an intricate system of sacs and tubes that doctors call the “labyrinth,” hence the disorder’s whimsical nickname.

These tubes and sacs loop through your ear and contain both hair cells and fluid that work together to control your hearing functions and your balance.

When your inner ear becomes infected by a virus or bacteria that brings on otitis interna, information that your ear is communicating to your brain — such as how to walk or to hear — is disrupted.

Your brain doesn’t know how to function and do what you want it to do because you don’t have the ear functionality and the pathways to make the communication clear.

There are serious conditions and diseases that mimic some of the symptoms of otitis interna, and your doctor will want to rule those out.

Among the diseases and conditions your doctor will want to rule out before diagnosing you with otitis interna are the following:

  • Heart disease
  • Head injuries
  • Brain disease
  • Stroke
  • Side effects from substance (caffeine, alcohol, tobacco)
  • Side effects from prescription drugs



It is very common to notice your inner ear is in pain, that you are losing your hearing or having difficulty hearing and to feel dizzy. If you suddenly feel that you or your inner head is spinning, you may be experiencing a more severe symptom of otitis international — vertigo.

Additional symptoms of otitis interna include:(4)

» Ringing in your inner ear

» Hearing loss

» Vision that is blurred

» A feeling that you are about to fall down

» Vomiting

» Nausea

» A feeling of floating

» Lightheaded-ness

Keep in mind that any of these symptoms can suddenly come upon you.

You may get up from working at your desk and suddenly feel your head spinning. You may be cooking dinner or visiting a friend at a coffee shop when you cannot hear or your vision becomes blurred.

This can be a shocking and frightening feeling, as you may feel out of control of your body. Call 911 or go to the emergency room immediately if you experience any of these symptoms associated with otitis interna.


What are Treatments for Otitis Interna?

The first step in determining a treatment plan with your doctor is to let him, or her, diagnose the cause of your otitis interna.

There are two main causes — viral and bacterial.

Viral labyrinthitis is a more common cause, as mentioned above, but the medical world knows less about it than the bacterial form.

Research has shown that some of the viruses that lead to viral labyrinthitis include:(5)

  • Mumps
  • Measles
  • Hepatitis
  • Chicken Pox
  • Shingles
  • Oral herpes

A good indicator of whether you have viral labyrinthitis, is if only one of your ears is showing symptoms and it goes away in a short amount of time.

If you have the viral version of otitis interna, your doctor will likely prescribe you medication to combat the virus and to reduce inflammation.(6)

He or she also may prescribe an over-the-counter steroid — such as cortisone — to help reduce pain and swelling. From there, you just have to let the virus run its course.

The good news is that with anti-viral medication, you could begin to feel a little better almost immediately.

In addition, your doctor may prescribe medication to help address the issues associated with dizziness, vertigo and vomiting.

With bacterial labyrinthitis, bacteria will somehow enter your inner ear from a middle ear infection.

The ear produced toxins that move to the inner ear and cause pain and inflammation.(7)

Bacterial labyrinthitis also can be caused by infections in the bones that are around the inner ear.

Again, toxins are produced as a result and the inner ear becomes inflamed.

Finally, a more uncommon and a more severe form of bacterial labyrinthitis is when bacteria gets into the tube and sac system — the labyrinth — of the inner ear.(7) Bacterial meningitis often is the culprit in this latter case.

Your doctor will likely prescribe you medications that help you feel more comfortable as the disease runs its course — similarly to the viral version, such as cortisone for swelling and medications for vertigo and vomiting.

In addition, in both cases, you can also go to physical therapy to learn exercises that can help you walk and balance better.

This can help to accelerate your recovery but remember every case of otitis interna is different, so be patient with yourself and keep up with your exercises and treatment plan.


What is the Outlook on Recovery for Otitis Interna?

Otitis interna comes on suddenly and puts a patient out for several weeks and sometimes several months. The good news is that the majority of people affected by otitis interna do recover completely from it.

Now, that doesn’t mean it won’t return.

While most people recover, many experience having the condition and vertigo again. That can be frustrating and unnerving, especially because you could turn your body or head ever so slightly and bring upon a bout again.

However, doctors recommend continuing to keep up with physical therapy and living a well-balanced life of healthy eating, drinking and exercise to try to mitigate some of those occurrences. It also is good news that many people report a second bout with Otitis interna being less severe the first occurrence.

If it does return, you’ll want to ask your doctor to dig a little deeper into your medical history and reports to try to figure out if there is a long-standing, underlying cause that may be bringing the condition back.

This is often the cause with long-standing viruses in your body that do not have a cure and can remain latent in your body until they decide to flare up again — which is the cause of oral herpes, for example.


When Should You See a Doctor?

There is never a wrong time to see a doctor when you are experiencing otitis interna.

But, there are more severe times than others.

For example, the first time you experience otitis interna, you actually may be scared — especially if you have been feeling energetic and healthy, and all of a sudden you lose your sharp vision or you can’t hear well. Know your body and pay attention to it. If something like this happens to you, get assistance and go see a doctor immediately.

You should always call 911 or go to the emergency room if you begin to vomit regularly. Vomiting leads to dehydration and also leads to being wary of eating and drinking.

You want to find out the cause of the vomiting before you get into a state where you are sicker than before because your body is not hydrated properly.

Finally, if you experience any of these systems while driving a car or operating machinery, you need to stop immediately and call 911.

Otitis interna can lead to complications beyond just your ear and head because it actually can put you at physical risk of hurting yourself and others.

At the end of the day, call a doctor when you are in pain!

The only way you’ll get to the bottom of what is causing your condition is to see a trained doctor who can look into your medical history, diagnose your otitis interna as either viral or bacterial and plan your treatment plan.


Is It Time to Intervene?

Left untreated, labyrinthitis can lead to long-term and extended pain and discomfort.

Individuals who do not treat labyrinthitis find that they need to stay in bed because of severe dizziness and vertigo — and that alone can lead to missing work and being unable to participate in key events in your life.

Keep mind that most otitis interna can be treated and you can recover from it. But, if you experience it multiple times, you really need a doctor to look into deeper causes that may run in your medical history.

Remember, getting started with your labyrinthitis treatment plan can be easy. Here are a few precautions to take:

» Move slowly if you are feeling dizzy so that you don’t lose balance.

» Clear the high-trafficked areas so that furniture or cords that you could trip upon are removed.

» Rest if you feel dizzy. Close your eyes and try to relax in a dark room.

» Stay on a healthy eating and drinking diet by avoiding caffeine and alcohol and drinking water to stay hydrated.

» Avoid driving if you fee dizzy.

» See your doctor regularly — and especially if your symptoms get worse. Your doctor can prescribe medication to address your labyrinthitis.


(3)Clinical Decision Making for Adult-Gerontology Primary Care Nurse Practitioners, Joanne Thanavaro,Karen S. Moore