Most of the conditions causing ear pain can be diagnosed by a medical history and a physical examination. The physician will likely use a hand-held otoscope to inspect the ear canal.

Ear secretions may be collected on a swab for analysis. Usually inflammation and infection of the middle and external ear can be identified visually with the otoscope. Rarely, blood tests such as sedimentation rate or complete blood count may be performed to reveal inflammation or infection.

If a nerve condition such as cranial neuralgia is suspected, tests such as electromyography or nerve conduction studies may be ordered. A tissue biopsy or imaging tests such as a CAT scan (computed axial tomography), MRI (magnetic resonance imaging) bone scan or x-rays may be used to diagnose uncommon conditions such as cancer or malignant otitis externa.

If necessary, a primary care physician can refer a patient to an ear specialist (otologist) or an ear, nose and throat (ENT) specialist (otolaryngologist).