The exact cause can be determined only after I clinically examine you. This pain can be neurological in origin due to vascular compression. In hemicranias continua there is localized pain behind the ear. In glossopharyngeal neuralgia there are sudden sharp pains into the ear triggered by swallowing. In impending facial nerve paralysis pain behind the ear is typical and can precede paralysis by a day or so. Sometimes the pain is very prominent and the facial weakness is mild. Do you have any dental cavity or decay? It can also cause referred pain below or behind the ear. I will advise you to see a PCP.After complete clinical examination he will refer you to a specialist for further diagnosis and management. Hope it helps.
Best luck and regards!
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