Adult Ear Pain Treatment (Otalgia)
MD-only online ear pain evaluation for adults in Texas with guideline-based screening for swimmer’s ear (otitis externa), middle ear infection (otitis media), eustachian tube dysfunction, TMJ, and dental causes. $49 flat-fee video visit, no insurance required.
Ear pain has many causes. Some can be treated safely through telehealth, especially swimmer’s ear and congestion-related ear pressure. Severe pain with high fever, swelling behind the ear, facial weakness, or neurologic symptoms needs urgent in-person evaluation.
- Focused history to narrow likely cause and safest plan
- Topical ear drops when appropriate, oral antibiotics only when justified
- Clear red flags for urgent care or ER referral
- Adults only (18+), video visit only
What Is Ear Pain (Otalgia)?
Otalgia means ear pain. In adults, common causes include otitis externa (swimmer’s ear), eustachian tube dysfunction from allergies or viral illness, acute otitis media, and referred pain from the jaw (TMJ) or dental issues. Treatment depends on the likely source of pain and any safety concerns.
In Texas, swimming, humidity in coastal regions, and allergy seasons can contribute to ear symptoms. TeleDirectMD provides adult-only, MD-only online care focused on safe triage, evidence-based treatment when appropriate, and clear thresholds for urgent in-person evaluation.
Symptoms and Red Flags
| Symptom | What it suggests | Telehealth appropriate? | Red flag requiring urgent in-person care |
|---|---|---|---|
| Ear pain with itching, pain when pulling ear, recent swimming | Otitis externa (swimmer’s ear) | Often yes | Spreading facial redness, severe swelling, immunocompromise |
| Ear pressure with congestion or allergies | Eustachian tube dysfunction | Often yes | Severe dizziness, sudden hearing loss |
| Ear pain with fever, recent cold, decreased hearing | Possible otitis media | Sometimes | Swelling behind the ear, ear pushed forward |
| Jaw pain, worse with chewing, teeth grinding | TMJ-related pain | Often yes | Locking jaw, facial swelling, or severe infection concerns |
| Dental pain, gum swelling, bad taste | Referred pain from dental infection | Sometimes | Facial swelling, fever, trouble swallowing or breathing |
| Severe headache, neck stiffness, confusion | Potential serious infection or neurologic issue | No | Urgent ER evaluation |
What Else Can Cause Ear Pain?
Otitis externa
Often itchy, worsened by pulling the outer ear, commonly after swimming.
Eustachian tube dysfunction
Pressure or popping with allergies, congestion, or elevation changes.
Acute otitis media
More likely with fever and recent viral illness. Diagnosis typically requires ear exam.
TMJ dysfunction
Jaw soreness, clicking, or pain with chewing can refer pain to the ear.
Dental infection
Tooth or gum infection can refer pain to the ear. Urgent evaluation if facial swelling or systemic symptoms.
Shingles
Ear pain with a new painful rash can indicate shingles and needs prompt evaluation.
Telehealth Eligibility
TeleDirectMD is appropriate for many adults with ear pain when symptoms are stable. Your physician screens for red flags and chooses the safest evidence-based treatment plan.
When a Video Visit Is Appropriate
- Adult 18+ with ear pain without severe red flags.
- Ear itching or pain after swimming consistent with swimmer’s ear.
- Ear pressure associated with congestion or allergies.
- No facial weakness, severe dizziness, or swelling behind the ear.
- Physically located in Texas at the time of the visit.
Red Flags Requiring In-Person or ER Care
- Swelling or redness behind the ear, ear pushed forward.
- Facial weakness, severe headache, stiff neck, confusion.
- Sudden hearing loss, severe dizziness, persistent vomiting.
- High fever with worsening pain or immunocompromise with severe symptoms.
- Facial swelling or trouble swallowing suggesting deeper infection.
Treatment Options
Swimmer’s ear (otitis externa)
- Topical antibiotic ear drops are first-line when appropriate.
- Keep the ear dry and avoid inserting objects into the canal.
- Oral antibiotics are rarely needed unless infection extends beyond the ear canal.
Congestion or eustachian tube dysfunction
- Saline, hydration, and steam can help congestion.
- Short-term decongestants may be considered when safe.
- Allergy control may reduce recurring pressure.
Pain control
- Acetaminophen or ibuprofen when safe for you.
- Avoid duplicate acetaminophen products.
- TeleDirectMD does not prescribe controlled substances.
For suspected middle ear infection, an in-person ear exam is often needed to confirm the diagnosis and assess the eardrum. TeleDirectMD prioritizes safe triage and may refer for urgent care evaluation when exam findings are necessary.
Medication Table
Common adult regimens are listed below. Your TeleDirectMD physician individualizes treatment based on symptoms, allergy history, and safety screening.
| Medication | Dose | Duration | When used |
|---|---|---|---|
| Ofloxacin otic solution | 10 drops in affected ear once daily | 7 days | Otitis externa when appropriate, including when tympanic membrane status is uncertain. |
| Ciprofloxacin with hydrocortisone otic | 3 drops in affected ear 2 times daily | 7 days | Otitis externa when appropriate and tympanic membrane is intact. |
| Acetaminophen | 650 mg by mouth every 6 hours as needed | As needed | Pain or fever when safe for the patient. |
| Ibuprofen | 400 mg by mouth every 6 to 8 hours as needed with food | As needed | Pain or inflammation when safe for the patient. |
| Amoxicillin-clavulanate | 875 mg by mouth 2 times daily | 7 days | Selected adults with suspected acute otitis media when appropriate and after safety screening, recognizing that in-person exam is often preferred. |
Home Care and Return to Work
Home care checklist
- Keep ear dry and avoid cotton swabs or earbuds during active pain.
- Use pain relievers when safe and follow dosing guidance.
- If swimmer’s ear, avoid swimming until pain improves and treatment is completed.
- For congestion-related pressure, consider saline rinses and humidified air.
When to recheck
- Worsening pain or fever after 48 hours of treatment.
- Drainage with severe swelling, spreading redness, or facial swelling.
- Hearing loss, severe dizziness, or new neurologic symptoms.
- Any red flags listed on this page.
Return to work depends on symptom severity and job requirements. Many adults can work if symptoms are mild and manageable, but swimming-related infections often improve faster with keeping the ear dry.
TeleDirectMD ear pain visits
TeleDirectMD provides MD-only virtual urgent care for adults for $49 flat-fee video visits in 25+ states. Your physician reviews symptom pattern, timing, exposures, and risk factors. When appropriate, we prescribe evidence-based treatments such as topical drops for swimmer’s ear and provide clear guidance for when an in-person ear exam is needed. No controlled substances are prescribed.