Could you have a middle ear infection without pain?

Maybe: Pain from a middle ear infection often comes from excessive pressure in the ear. If you have a hole in the eardrum you likely wouldn't have pain because the pressure can't build up, but you would likely have a significant amount of drainage from the ear in that case. With a cold you can have a noninfected effusion in the middle ear and these may not be painful (though you can have hearing loss).