 [ Symptoms ] i have been experiencing sharp lancing pain behind my right ear in the mastoid area [ Disease ] if you mean your pain is in the same area behind the ear then pilates has nothing to do with aggravating this pain unless you are suffering cervical vertebral lesion that has been triggered with the exercises done in your pilate class i recommend rest local analgesic cream or gel plain xray of the cervical area massage and myofacial release can help you in this case