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Mastoid pain is most commonly caused by musculoskeletal pain in the surrounding areas; given the mastoid's location behind the ear, it is liable to experience referred pain from the neck and jaw. Physical impact to the area can also cause lingering pain, especially if the blow is enough to damage the bone. Direct causes of pain include mastoiditis and sensory neuralgia, particularly in the ear area.
Individuals usually experience pain in the mastoid process after overexertion of the jaw and neck muscles. In most cases, the discomfort tends to fade with a few minutes of rest. Lingering pain can be treated by directly addressing the source of the pain; neck cramps, for example, can be remedied by applying a hot compress and allowing the muscle to relax.
Although relatively rare because of the bone's location, it is not unheard of for mastoid pain to be caused by direct physical impact. This most commonly happens during falls or in physical confrontations. In most cases, the impact is not enough to damage the area of bone, and the pain fades with time. Fractures are possible, however, and will require immediate medical attention to prevent any further complications, as is the case with all cranium fractures. Breakage in the other portions of the temporal bone — the petrous, tympanic portion, and the squama temporalis — can result in referred pain throughout the general area.
Mastoiditis, an inflammation of the mastoid bone, is one of the more common medical causes of pain. The condition might be caused by middle-ear infections from a variety of bacteria, including Hemophilus influenzae, pneumococcus, and certain strains of Staphylococcus. Healthcare professionals recommend that patients get immediate treatment in order to prevent the infection from spreading further and, in most cases, antibiotic medication is enough to eliminate the bacteria. If the infection develops an abscess, the mastoid will have to be cleaned and drained; worst-case scenarios involve surgical removal of the bone and any other infected tissue.
Neuralgia in sensory nerves associated with the ear can also cause mastoid pain. The varying causes of neuralgia include nerve pressure, physical damage to the nerve or its surrounding area, and nerve cell degeneration. Nerve pressure is commonly caused by blood clots or swelling from the surrounding area; in rare cases, the pressure might be caused by a nearby tumor. The nerves can receive direct damage from powerful enough blows to or near the ear. The nerves can also degenerate in varying degrees, from demyelinization to congenital nerve deterioration.