Patients with swollen and painful sensations behind the ear may have a condition of acute inflammatory infection in the mastoid region. The acute inflammation in the mastoid region is often secondary to acute otitis media, and there may be significant pressure and pain in the bones of the mastoid region. In addition, some patients may have localized sebaceous cysts in the area behind the ear that are secondary to infection, and may also have inflammation and swelling of the local lymph nodes, which are often associated with acute inflammatory infections of the respiratory tract.