For an earache caused by a cold, the pain is usually due to pressure and fluid buildup behind the eardrum. Oral pain relievers like ibuprofen or paracetamol are the most effective options to reduce discomfort and inflammation. To relieve the pressure, a generic nasal decongestant spray (such as oxymetazoline) can help open the passage to the ear, but use it for no more than three days. Avoid over-the-counter ear drops, as they cannot cross the eardrum to relieve internal pressure. Applying a warm compress to your ear can also provide soothing relief. If you develop a high fever or fluid drainage, please consult a doctor.