Adult Ear Pain Treatment (Otalgia)
Fast MD-only ear pain evaluation for adults in California by secure online video visit, $49 flat-fee, no insurance required.
Ear pain can come from the ear canal, the eardrum and middle ear space, sinus or upper respiratory congestion, jaw and dental issues, or pressure changes after flying or swimming. TeleDirectMD MDs use a structured evaluation to screen for infection, identify red flags that need same-day in-person care, and provide clear treatment steps when telehealth is appropriate.
- $49 flat-fee visit, no hidden costs
- MD-only care, no mid-level providers
- No insurance required or accepted
- Available for adults in California (and 25+ states)
- Secure, encrypted video visits from home
Online Ear Pain Care by California-Licensed MDs
- Screening for otitis externa and red flags
- Congestion and pressure guidance for eustachian tube dysfunction
- Safe pain control recommendations
- Clear guidance for when you need otoscopy in person
For adults only (18+). You must be physically located in California at the time of your video visit. Sudden hearing loss, severe swelling, facial weakness, severe pain with fever, diabetes with severe ear pain, or swelling behind the ear require urgent in-person evaluation.
What Ear Pain Means and Why the Cause Matters
Otalgia means ear pain. In adults, common causes include otitis externa (swimmer’s ear), eustachian tube dysfunction from viral congestion or allergies, pressure changes after flying, and referred pain from dental or jaw conditions. Middle ear infection (acute otitis media) is less common in adults and often requires an in-person ear exam to confirm.
TeleDirectMD focuses on safe triage and guideline-based decision-making. Some ear pain can be managed with home care and targeted treatment, while other presentations require urgent in-person evaluation for otoscopy, drainage, imaging, or specialty care.
Ear Pain Symptoms and Red Flags
During your visit, the MD will review onset, severity, recent swimming or water exposure, congestion, fever, drainage, hearing changes, dizziness, diabetes or immunosuppression, and any trauma or foreign body concern.
| Symptom | What it suggests | Telehealth appropriate? | Red flag requiring urgent in-person care |
|---|---|---|---|
| Outer ear canal pain, itching, pain when pulling the ear | Otitis externa (often bacterial) | Often yes if mild to moderate | Severe pain, fever, rapidly worsening swelling, diabetes, or immunosuppression |
| Ear fullness with recent cold or allergies | Eustachian tube dysfunction (often viral or allergic) | Yes | Severe headache, high fever, neck stiffness, or neurologic symptoms |
| Ear pain with jaw clicking or tooth pain | Referred pain from TMJ or dental infection | Sometimes | Facial swelling, trouble swallowing, drooling, or severe dental pain with fever |
| Drainage from the ear | Otitis externa, eardrum perforation, or middle ear infection | Sometimes, depends on severity | Bloody drainage after trauma, severe pain, or significant hearing loss |
| Fever with worsening ear pain | Possible bacterial infection | Sometimes | High fever, toxic appearance, severe pain, or swelling behind the ear |
| Sudden hearing loss, new one-sided hearing drop | Urgent cause needs evaluation | No | Same-day urgent evaluation recommended |
| Dizziness, vertigo, severe headache | Inner ear or neurologic involvement | No | Urgent evaluation recommended |
| Swelling behind the ear, ear pushed forward | Mastoiditis or deeper infection | No | ER evaluation recommended |
| Ear pain after trauma, foreign body concern | Injury or obstruction | No | Urgent evaluation recommended |
| Diabetes with severe ear pain or nighttime pain | Higher-risk otitis externa complications | No | Urgent evaluation recommended |
What We Screen For With Adult Ear Pain
- Otitis externa: canal pain, itching, tenderness with ear movement, often after water exposure.
- Eustachian tube dysfunction: pressure, popping, muffled hearing with viral URI or allergies.
- Acute otitis media: deeper ear pain, fever, reduced hearing, usually needs otoscopy to confirm.
- Eardrum perforation: drainage, sudden relief of pressure, hearing change, often needs in-person exam.
- TMJ or dental pain: jaw pain, chewing pain, tooth sensitivity or swelling.
When a Video Visit Is Appropriate vs. When to Go In-Person
When a Video Visit Is Appropriate
- Adult 18+ with mild to moderate ear pain, stable symptoms
- Recent swimming with typical swimmer’s ear symptoms, no severe swelling
- Ear pressure or fullness after a cold or allergies without high fever
- No sudden hearing loss, severe dizziness, or severe headache
- No uncontrolled diabetes or significant immunosuppression
- Physically located in California at the time of the video visit
Red Flags Requiring In-Person or ER Care
- Sudden hearing loss or rapidly worsening hearing on one side
- Severe dizziness, fainting, severe headache, or neurologic symptoms
- High fever, severe pain, or toxic appearance
- Swelling behind the ear, ear pushed forward, severe tenderness over bone
- Diabetes with severe ear pain or nighttime pain
- Trauma, foreign body, or uncontrolled bleeding
Treatment Options for Adult Ear Pain
Treatment depends on the most likely cause. Many cases related to viral congestion improve with time and supportive care. Swimmer’s ear often responds well to prescription ear drops when appropriate. Suspected middle ear infection in adults often needs an in-person ear exam to confirm because antibiotics are not always needed and the diagnosis depends on otoscopy.
Supportive Care and Pain Control
- Acetaminophen 650 mg by mouth every 6 hours as needed, maximum 3000 mg per day.
- Ibuprofen 400 mg by mouth every 6 to 8 hours as needed with food if safe for you.
- Warm compress to the outer ear for 10 to 15 minutes, several times daily.
Congestion and Pressure Relief (Often Viral or Allergic)
- Saline nasal spray or rinse daily.
- Fluticasone nasal spray 2 sprays per nostril daily for 7 to 14 days if congestion or allergies.
- Chewing gum, yawning, and gentle pressure equalization for flying-related symptoms, avoid forceful blowing.
Prescription Treatment for Swimmer’s Ear When Appropriate
Otitis externa is commonly bacterial and is often treated with antibiotic ear drops. If the eardrum status is uncertain, ofloxacin is commonly used because it is appropriate when tympanic membrane status is unknown.
| Medication | Dose | Duration | When used |
|---|---|---|---|
| Ofloxacin 0.3% otic solution | 10 drops in affected ear 1 time daily | 7 days | Suspected otitis externa when appropriate by telehealth |
| Fluticasone nasal spray | 2 sprays per nostril 1 time daily | 7 to 14 days | Eustachian tube dysfunction from allergies or congestion |
| Acetaminophen | 650 mg by mouth every 6 hours as needed | As needed | Pain or fever control when safe for you |
| Ibuprofen | 400 mg by mouth every 6 to 8 hours as needed | As needed | Pain or inflammation control when safe for you |
Antibiotics are not automatically needed for ear pain. TeleDirectMD focuses on guideline-based evaluation and will recommend in-person otoscopy when the diagnosis is uncertain, symptoms are severe, or red flags are present. TeleDirectMD does not prescribe controlled substances.
Home Care, Recovery, and Return to Work
Many mild cases improve over 24 to 72 hours with supportive care. If you were prescribed ear drops, use them as directed and keep the ear dry during treatment.
- Keep the ear dry, avoid swimming, use a shower cap when bathing.
- Avoid inserting cotton swabs or objects into the ear canal.
- Seek urgent evaluation for fever, rapidly worsening pain, swelling behind the ear, facial weakness, or sudden hearing loss.
Many adults can work as tolerated if they feel well. TeleDirectMD can provide a brief work note when medically appropriate as part of your $49 visit.
What to Expect From Your TeleDirectMD Visit
TeleDirectMD provides adult-only, MD-only virtual urgent care by secure video. Visits typically last about 10 to 15 minutes and cost $49 as a flat cash fee with no insurance involvement. During your ear pain visit, the MD will review symptoms, timing, recent water exposure, congestion, fever, hearing changes, and red flags.
If your presentation is appropriate for telehealth, we can send an electronic prescription to your preferred local pharmacy in California when appropriate. If you need in-person evaluation for otoscopy, ear cleaning, testing, or concern for serious infection, we will explain why and guide you on the safest next step.
We do not prescribe controlled substances.
Ear Pain Treatment FAQ
Is ear pain usually viral or bacterial?
It depends on the cause. Eustachian tube dysfunction from a cold or allergies is often viral or inflammatory. Swimmer’s ear (otitis externa) is often bacterial. A middle ear infection can be bacterial but is less common in adults and often needs an in-person exam to confirm.
Can you diagnose an ear infection by video visit?
A video visit can evaluate symptoms and screen for red flags. Confirming some diagnoses, especially middle ear infection, often requires otoscopy in person. When symptoms fit swimmer’s ear and there are no red flags, treatment may be appropriate by telehealth.
When is ear pain an emergency?
Seek urgent care for sudden hearing loss, severe dizziness, facial weakness, high fever, swelling behind the ear, severe headache, confusion, severe worsening pain, or diabetes with severe ear pain.
What can I do at home for ear pressure and popping?
Saline rinses, fluticasone nasal spray, and time often help when symptoms follow a cold or allergies. Avoid forceful nose blowing. If you have severe pain, fever, or worsening symptoms, you may need an in-person exam.
Do I need antibiotics for ear pain?
Not always. Antibiotics are used when there is a clear bacterial diagnosis and the benefits outweigh risks. Many cases improve without antibiotics, especially when related to viral congestion or pressure changes.
What is swimmer’s ear and how is it treated?
Swimmer’s ear is inflammation and infection of the ear canal, often after water exposure. It is commonly treated with antibiotic ear drops when appropriate, plus keeping the ear dry.
Can I use hydrogen peroxide or alcohol in my ear?
It is not recommended as a default because it can irritate the canal and can be unsafe if there is a perforated eardrum. A clinician should guide ear care, especially if there is drainage, severe pain, or hearing loss.
Why does my jaw or tooth pain feel like ear pain?
Nerves can refer pain from the jaw joint, teeth, and throat to the ear. If chewing hurts, you have tooth sensitivity, or gum swelling, dental evaluation may be needed.
Can TeleDirectMD prescribe ear drops?
Yes, when the presentation is appropriate for telehealth and there are no red flags. If the diagnosis is uncertain or symptoms suggest a deeper problem, we will recommend in-person evaluation.
Which states do you serve for online ear pain care?
TeleDirectMD serves adults in California and in more than 25 additional states. During booking, you will confirm that you are physically located in a licensed state at the time of your visit.
Can you provide a work note for an ear pain visit?
TeleDirectMD can provide a brief work note when medically appropriate as part of the $49 visit.