My 5 yr old started with sudden onset of pain in ear, has had a cough, runny nose some congestion have given tylenol for pain but not helping? What else can I do to help alleviate pain?

You can call his pediatrician. I know it's Saturday...
Take his temp. Put a heating pad under his ear when he lies down, and put a hat on his head and scarf around his neck when he's up.
He could have pain from congestion in his eustacian tube OR he could have an ear infection. Try the usual drugstore child decongestants for colds, but also be aware of ear infection, totally separate.
Also check his teeth. A back tooth problem can cause ear pain.