Pain at the back of the ear may be boils behind the ear, neuralgia behind the ear, lymphadenitis behind the ear, etc., and you should consult a doctor in time to find out the cause. 1. Boils behind the ear: mainly due to blockage of hair follicles behind the ear, secondary infection; or patients with localized unclean skin in the ear; drinking too much alcohol, eating too much spicy and irritating food and other factors. Some patients may also be affected by adverse mental and emotional factors, or recent irregular work and rest, repeated exertion, staying up all night, resulting in decreased immunity, endocrine dysfunction, etc. can lead to boils behind the ear. 2. Post-auricular neuralgia: Post-auricular neuralgia may be caused by inflammation and infection of the local nerve. Migraines, which are often caused by lack of sleep, can also involve pain in the blood vessels behind the ear. 3. Lymphadenitis behind the ear: The most common cause of lymphadenitis behind the ear may be inflammation of the external ear canal, auricle or throat, which stimulates the lymph nodes to produce inflammation. This condition includes pharyngitis, tonsillitis, apical abscess and other oral diseases, all of which can cause an inflammatory reaction in the lymph nodes in the area behind the ear, leading to pain behind the ear. There may be other causes of pain behind the ear, and you should seek medical attention to have your doctor identify the specific cause and treat it accordingly if necessary.