When patients experience a throbbing pain behind the ear, it is often due to factors such as excessive mental tension, anxiety, lack of sleep, repeated fatigue, or staying up late, which cause peripheral neuralgia in the ear. In addition, some patients may have acute inflammation of the external ear canal or acute otitis media, which can be further diagnosed by specific examination of the inner ear canal, often related to excessive forceful ear digging, repeated water ingress in the ear, or respiratory infectious diseases. Other patients may have a viral infection of the nerve surrounding the ear, which can lead to further viral herpes and often a more severe degree of pain behind the ear.