[47F] Experiencing intermittent left ear pain

Patient Description

A 47-year-old female presents with a history of intermittent left ear pain lasting for over six months, described as a continuous, dull ache deep inside the ear. The pain is exacerbated by cold or stress. There is no associated fever, chills, hearing changes, ringing, discharge, or sensation of fullness in the ear. The patient has a history of TMJ and fungal ear infections, but does not believe these are related to the current ear pain. The ear specialist noted an absence of earwax production and constant flaking and itching of the ear canals. The patient's extensive medical history includes anxiety, depression, idiopathic juvenile arthritis, endometriosis, ovarian cysts, bicornate uterus, c-sections, hysterectomy, lap chole, multiple kidney stones, hemorrhoidectomy, frequent UTIs, hip bursitis, attention deficit disorder, fatigue, and body aches. The patient has an adverse reaction to pindolol causing oral lesions and is currently taking levothyroxine, diclofenac, ativan, and diovan for edema. The patient also suffers from occasional insomnia related to severe situational anxiety, treated with over-the-counter unisom, and has a history of migraines that have decreased significantly following weight loss, with occasional mild to moderate headaches treated with over-the-counter analgesics.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your ear pain include:

  • Eustachian Tube Dysfunction: This is a condition where the tube connecting your middle ear to the back of your throat becomes blocked or doesn't open properly. This can cause a feeling of fullness, pain, or pressure in the ear, and sometimes even hearing loss. However, you've mentioned that you don't have any sensation of fullness or pressure in your ear, which makes this less likely.

    • Treatment typically involves decongestants, antihistamines, or steroid nasal sprays to reduce inflammation and promote drainage. In some cases, a procedure to insert tubes in the ear to improve drainage may be recommended.
  • Chronic Otitis Media: This is a long-term infection or inflammation of the middle ear. This condition can cause persistent or intermittent ear pain.

    • Treatment typically involves antibiotics to clear the infection, and in some cases, a procedure to drain fluid from the middle ear may be necessary.
  • Temporomandibular Joint Disorder (TMJ): You've mentioned a history of TMJ, which can sometimes cause ear pain, even if it feels like the pain is coming from deep inside the ear. However, you've indicated that you don't believe your current ear pain is related to your TMJ.

    • Treatment for TMJ typically involves pain relievers, anti-inflammatories, or a range of non-drug therapies like oral splints or physical therapy.

Please note that this is not an exhaustive list of all possible conditions that could be causing your symptoms. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Consult a healthcare provider: Given the duration and persistence of your symptoms, it would be a good idea to consult with a healthcare provider. They can perform a physical examination, ask further questions, and possibly order tests to determine the cause of your ear pain.

  2. Pain management: Over-the-counter pain relievers like acetaminophen or ibuprofen may help to manage your ear pain in the short term. However, these should not be used as a long-term solution without consulting a healthcare provider.

  3. Stress management: Since you've noted that stress seems to trigger your ear pain, techniques to manage stress may be beneficial. This could include relaxation techniques, mindfulness, or cognitive-behavioral therapy.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe ear pain
  • Discharge or bleeding from your ear
  • Sudden hearing loss
  • Dizziness or problems with balance
  • Fever or severe headache

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, diagnosis, and treatment.

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1 yr ago

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People Also Ask


What are common causes of intermittent ear pain without hearing changes or discharge?

Common causes of intermittent ear pain without hearing changes or discharge can include Eustachian Tube Dysfunction, Temporomandibular Joint Disorder (TMJ), and chronic otitis media. Each of these conditions can cause pain without necessarily affecting hearing or causing discharge.


How can stress exacerbate ear pain, and what are some effective stress management techniques?

Stress can exacerbate ear pain by increasing muscle tension around the jaw and ear area, potentially worsening conditions like TMJ. Effective stress management techniques include mindfulness, relaxation exercises, cognitive-behavioral therapy, and regular physical activity.


What is the relationship between TMJ and ear pain, and how can it be managed?

TMJ can cause ear pain because the temporomandibular joint is located near the ear canal, and dysfunction in this joint can refer pain to the ear. Management includes pain relievers, anti-inflammatories, oral splints, and physical therapy.


What are the potential side effects of long-term use of over-the-counter pain relievers for ear pain?

Long-term use of over-the-counter pain relievers like acetaminophen or ibuprofen can lead to side effects such as gastrointestinal issues, liver damage, or kidney problems. It's important to use these medications as directed and consult a healthcare provider for long-term pain management strategies.


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