Conditions
Ear pain in adults: causes, what to do and when to see a doctor
Ear pain in adults often doesn’t start in the ear: it can come from the jaw, a tooth, the throat or the sinuses, as well as infections, earwax or pressure changes. The doctor assesses you by video, looks for the cause and, if appropriate, prescribes. If your eardrum needs to be checked in person, we refer you.
Is it an emergency? Call 911.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Sudden hearing loss: in-person care the same day
- Swelling, redness or pain behind the ear
- Weakness on one side of the face
- High fever with a stiff neck or confusion
- Severe dizziness or a bad headache along with the ear pain
Help lines
At a glance
Ear pain in adults
Common symptoms
- Ear pain, constant or coming and going
- A full or blocked feeling in the ear
- Drainage or fluid coming from the ear
- Fever
- Hearing less on that side
- Pain when chewing or in the jaw
- Other names
- Earache · Otalgia · Ear infection in adults
- Usual test
- Ear exam with an otoscope, in person when needed
- Treatment
- Pain relief and treatment of the cause; an antibiotic only when the medical evaluation calls for it
- Possible complication
- Ruptured eardrum or mastoiditis (infection of the bone behind the ear)
On this page(9)
What causes ear pain in adults?
In adults, according to MedlinePlus, ear pain is often "referred pain": you feel it in the ear, but it starts somewhere else. The most common causes are:
- Jaw joint (TMJ) problems or arthritis of the jaw
- An infected tooth (see toothache)
- A sore throat or sinusitis
- Pressure changes, for example as a plane descends
- Earwax buildup (see earwax blockage) or a perforated eardrum
- A middle-ear infection, less common in adults than in children, or an outer-ear infection
How we treat ear pain by video
You see Dr. Diana Nieves Castro, a Puerto Rico–licensed general practice physician with several years of emergency-department experience, in English or Spanish. She asks how the pain started, whether there is fever, drainage, hearing loss or dizziness, whether your jaw or a tooth hurts, and whether you’ve been swimming or flying. On camera she looks at the outside of your ear, behind the ear, your face and your throat.
She then tells you the most likely cause and how to treat it. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. Seeing the eardrum takes an otoscope; if your case needs it, we refer you for an in-person exam and tell you how soon to go. If the pain started after swimming, see swimmer’s ear; for a child, see ear pain in children.
This is virtual urgent care for non-emergencies. You need to be physically in Puerto Rico during the visit; visitors are welcome.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
Your visit in 3 steps
Request a visit online 24/7 — we confirm your time by email or text.
Request your visit.
Book a visit and choose "Doctor visit". You pay by card when you request it.
See the doctor by video.
We send you a secure video link. It works on your phone, tablet or computer. Good light and someone to hold the phone help.
Get your plan.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. If needed, we refer you for an in-person exam.
What an ear pain visit costs
Ear pain is handled in a US$79 doctor visit, the same price for every age, with no membership. You pay by card when you request the visit, and you get a full refund if the visit can’t take place. A doctor’s note after your visit is included. We do not bill insurance. See all prices. The service is run by The Health Initiative, a nonprofit.
Symptoms that come with ear pain
Tell the doctor if you have any of these:
- Ear pain, constant or coming and going
- A full or blocked feeling in the ear
- Drainage or fluid coming from the ear
- Fever
- Hearing less on that side
- Pain when chewing or in the jaw
What to do for ear pain, and when medicine is used
While you wait to be seen, MedlinePlus suggests:
- A cold pack or cold wet cloth on the outer ear for 20 minutes.
- Chewing gum, which can ease pressure.
- Resting upright instead of lying flat.
- Acetaminophen or ibuprofen for pain, as the label directs.
- Over-the-counter ear drops only if the eardrum is not ruptured. If fluid is draining from the ear, don’t use drops until you’re evaluated.
Not every ear infection needs an antibiotic. The doctor decides based on your symptoms and what she finds, and she doesn’t promise a medicine before evaluating you. If the cause is a tooth, the jaw or the throat, treatment targets that cause.
Middle ear infection or swimmer's ear?
A middle ear infection (otitis media) sits behind the eardrum and often starts shortly after a cold: pain, fever, a plugged feeling and reduced hearing. Swimmer's ear (otitis externa) is in the ear canal: the pain gets worse when you pull on the outer ear, and it usually follows swimming at the beach or pool or using cotton swabs. More in swimmer's ear.
When to go in the same day or to the ER
Get in-person care the same day if you suddenly lose hearing: the National Institutes of Health (NIDCD) treats it as a medical emergency, because treatment works best when started early. Also go if there is swelling or pain behind the ear, weakness on one side of your face, or if severe pain suddenly stops, which can mean the eardrum has ruptured.
According to MedlinePlus, see a doctor if pain, fever or other symptoms get worse or don’t improve within 24 to 48 hours, or if you develop dizziness, headache or swelling around the ear. For your safety, call 911 if you have a high fever with a stiff neck, confusion, or sudden weakness in the face, an arm or a leg.
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
Why does my ear hurt if I don’t have an infection?
Can an ear infection be treated by telehealth?
What should I do if my ear hurts after a flight?
When is ear pain urgent?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-09-30 · Updated: 2026-10-02
Sources (4)
- Earache (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)
- Ear infection - acute (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)
- Sudden Deafness (NIDCD, NIH) (opens in a new tab) (accessed 2026-10-02)
- Swimmer's ear (MedlinePlus) (opens in a new tab) (accessed 2026-10-02)