[33F] With constant left ear pain and swelling

Patient Description

A 33-year-old female has been experiencing constant pain in her left ear for about two days. The pain feels like pressure at the entrance of the ear and is accompanied by a hot sensation throughout the day. There is some swelling and redness around the left ear, especially when it feels hot. The patient has not noticed any discharge or fluid coming from the ear and has not had any recent injuries to the ear or head. She has some hearing loss in the left ear due to Bell's palsy, which she has had for 8 years, but does not believe there has been any significant change in her hearing recently. She has experienced some off-balance sensations and occasional headaches. Over-the-counter pain relief and Advil have been used to manage the pain. The patient smokes about a pack a day and has not had any recent travel or exposure to new environments that might have affected her ear. Her past medical history includes bipolar depression, PTSD, rapid heart rate, and Bell's palsy. She is currently taking Metoprolol (25 mg twice a day), Zoloft (50 mg once a day), and Trazodone (50 mg twice a day). She does not have any known allergies to medications and is not taking any over-the-counter medications, supplements, or herbal remedies.

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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:

  • Otitis Externa (Swimmer's Ear): This is an infection of the outer ear canal, often caused by bacteria. It can cause ear pain, a feeling of fullness, and redness or swelling of the ear. Even though you haven't been swimming, other factors like earwax buildup or minor injuries from cleaning your ear can lead to this condition.

    • Treatment: Typically involves ear drops containing antibiotics and steroids to reduce inflammation. Keeping the ear dry and avoiding inserting objects into the ear can help prevent it.
  • Otitis Media: This is an infection of the middle ear, which can cause ear pain, pressure, and sometimes fluid discharge. It is more common in children but can occur in adults, especially if there is a history of upper respiratory infections.

    • Treatment: Often involves oral antibiotics if a bacterial infection is suspected. Pain relief can be managed with over-the-counter medications like ibuprofen or acetaminophen.
  • Eustachian Tube Dysfunction: This occurs when the tube that connects the middle ear to the back of the nose becomes blocked or doesn't function properly, leading to a feeling of fullness, pressure, and sometimes pain in the ear.

    • Treatment: Decongestants, antihistamines, or nasal steroids may be recommended to reduce inflammation and open the Eustachian tube.
  • Earwax Impaction: Excessive earwax can build up and cause pressure, pain, and sometimes hearing loss. This can also lead to a feeling of fullness and discomfort in the ear.

    • Treatment: Over-the-counter ear drops can help soften the wax, and a healthcare provider can remove it safely.

What you can do

While it's important to consult a healthcare provider for a formal diagnosis and treatment, here are some steps you can take to help alleviate your symptoms:

  1. Keep your ear dry: Avoid getting water in your ear while showering. You can use a cotton ball lightly coated with petroleum jelly to protect your ear.
  2. Avoid inserting objects into your ear: This includes cotton swabs, which can push earwax further into the ear canal and cause more problems.
  3. Use over-the-counter pain relief: Continue using ibuprofen or acetaminophen to manage pain and reduce inflammation.
  4. Warm compress: Applying a warm compress to the affected ear can help alleviate pain and discomfort.
  5. Monitor your symptoms: Keep track of any changes in your symptoms, such as increased pain, swelling, or the development of new symptoms like fever or discharge. You can use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

What you should look out for

Seek medical attention more urgently if you experience any of the following:

  • Severe pain: If the pain becomes unbearable or significantly worsens.
  • Fever: A temperature over 100.4°F, which could indicate an infection.
  • Discharge: Any fluid or pus coming from your ear.
  • Hearing loss: Any sudden or significant changes in your hearing.
  • Dizziness or vertigo: If you experience severe dizziness or a spinning sensation.

Remember, while these suggestions can help manage your symptoms, it's crucial to consult a healthcare provider for a proper diagnosis and treatment plan.

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4 mo ago

People Also Ask


What are the common symptoms of otitis externa and how is it treated?

Otitis externa, also known as swimmer's ear, typically presents with symptoms such as ear pain, a feeling of fullness, redness, and swelling of the ear. It is often treated with ear drops containing antibiotics and steroids to reduce inflammation. Keeping the ear dry and avoiding inserting objects into the ear can help prevent it.


How can Eustachian tube dysfunction affect ear health and what are the treatment options?

Eustachian tube dysfunction can cause symptoms like a feeling of fullness, pressure, and sometimes pain in the ear. Treatment options may include decongestants, antihistamines, or nasal steroids to reduce inflammation and open the Eustachian tube.


What are the signs that ear pain might be due to an earwax impaction?

Signs of earwax impaction include pressure, pain, and sometimes hearing loss. A feeling of fullness and discomfort in the ear can also occur. Treatment typically involves using over-the-counter ear drops to soften the wax, and a healthcare provider can safely remove it if necessary.


When should someone with ear pain seek urgent medical attention?

Urgent medical attention should be sought if there is severe pain, fever over 100.4°F, discharge from the ear, sudden or significant changes in hearing, or severe dizziness or vertigo.


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