[25F] With severe ear pain and decreased hearing

Patient Description

A 25-year-old female reports experiencing deep ear pain for the past three days, which has progressively worsened. The pain is described as throbbing and intensifies when opening or closing the jaw wide. The patient also notes a decrease in hearing in the affected ear, a sensation of pressure, and ringing (tinnitus). Additionally, there is jaw pain, clicking sounds when opening or closing the mouth, and swelling or tenderness around the ear and jaw. The patient has had difficulty swallowing but denies fever, dizziness, or recent upper respiratory infections. Various treatments such as gargling salt water, warm compresses, Advil, ibuprofen, congestion medicine, and sleeping upright have been attempted without significant relief. The patient had a dental cleaning last month, but the ear pain did not start shortly after. There is no history of smoking, pre-existing conditions, or regular medications, except for ibuprofen for ear pain. No medication allergies are reported.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Ear Infection (Otitis Media or Otitis Externa): Ear infections can cause deep ear pain, pressure, and hearing loss. Otitis media affects the middle ear, while otitis externa (swimmer's ear) affects the outer ear canal. Both can cause throbbing pain and may worsen with jaw movement.

    • Treatment: Ear infections often require antibiotics or antifungal medications prescribed by a doctor. Over-the-counter pain relievers like ibuprofen can help manage pain.
  • Temporomandibular Joint (TMJ) Disorder: TMJ disorders can cause pain in the jaw joint and muscles, which can radiate to the ear. Symptoms include jaw pain, clicking sounds, and difficulty swallowing.

    • Treatment: TMJ disorders can be managed with pain relievers, muscle relaxants, physical therapy, and sometimes dental appliances. Avoiding hard or chewy foods can also help.
  • Eustachian Tube Dysfunction: This condition occurs when the tube connecting the middle ear to the back of the nose becomes blocked, causing pressure and pain in the ear.

    • Treatment: Decongestants, antihistamines, and nasal steroids can help relieve symptoms. In some cases, a doctor may need to perform a procedure to open the tube.
  • Dental Issues: Sometimes, dental problems such as impacted teeth or infections can cause referred pain to the ear.

    • Treatment: Addressing the underlying dental issue with the help of a dentist can alleviate the pain.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment, here are some steps you can take to manage your symptoms in the meantime:

  1. Pain Relief: Continue taking over-the-counter pain relievers like ibuprofen as directed to manage pain and inflammation.
  2. Warm Compress: Applying a warm compress to the affected ear can help alleviate pain and pressure.
  3. Jaw Exercises: Gentle jaw exercises and avoiding hard or chewy foods can help if TMJ disorder is suspected.
  4. Stay Hydrated: Drink plenty of fluids to stay hydrated, which can help with overall health and recovery.
  5. Symptom Tracking: Use the MDandMe app to journal your symptoms, track your progress, and share your notes with your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe Pain: If the pain becomes unbearable or does not improve with over-the-counter medications.
  • High Fever: If you develop a fever (temperature over 100.4°F) or chills.
  • Discharge: If you notice any discharge or fluid coming from your ear.
  • Hearing Loss: If your hearing continues to worsen or you experience sudden hearing loss.
  • Dizziness or Vertigo: If you develop dizziness or a spinning sensation.

Remember, while I can provide information and suggestions, it's important to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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4 mo ago


People Also Ask


What are the common symptoms of a TMJ disorder?

Common symptoms of a TMJ disorder include jaw pain, clicking or popping sounds when opening or closing the mouth, difficulty chewing, ear pain, and sometimes headaches or neck pain.


How can I differentiate between an ear infection and TMJ disorder?

An ear infection often presents with symptoms like ear pain, hearing loss, and sometimes fever or discharge from the ear. TMJ disorder, on the other hand, is characterized by jaw pain, clicking sounds, and pain that worsens with jaw movement. A healthcare professional can help differentiate between the two.


What home remedies can help alleviate ear pain?

Home remedies for ear pain include applying a warm compress to the affected ear, taking over-the-counter pain relievers like ibuprofen, and staying hydrated. Avoiding hard or chewy foods can also help if TMJ disorder is suspected.


When should I see a doctor for ear pain?

You should see a doctor for ear pain if it becomes severe, does not improve with over-the-counter medications, is accompanied by high fever, discharge from the ear, worsening hearing loss, or if you experience dizziness or vertigo.

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