What could cause an ear ache?

MAny things: Most common cause of ear pain is an ear infection. If infection not present then pressure from sinuses and nasal congestion can cause ear ache. In more extreme cases there can be a tumor deep inside that can only be seen on a scan- other conditions often confused w inner ear pain can be TMJ ( temporomandibular joint disease) it is inflammation btwn the bones of jour jaw and ear-seek eval by dr.