Earaches to IBS


(Sumter, SC)

Chilly night air always causes a throbbing earache in my left ear as does air from an air conditioning vent. The pain spreads to my other ear and then to my neck and sinuses. Before long I have a throbbing headache, pain in my teeth and jaw area. The pain is so intense that my lower abdomen begins to cramp and I feel sick all over. These symptoms recently lasted for 5 full days and nights, and I became very weak from not being able to eat.

I have had sinus and ear infections off and on for about 10 years which were usually resolved with antibiotics. I also developed IBS symptoms and was treated with Reglan for 6 months which caused tardive dyskenesia (jaw clenching). My doctor stopped the medication and put me on Paxil for depression.

Two years later I was able to wean off the Paxil. I also have allergies (dust, mold, chocolate, eggs to name a few).

Recently, a CT scan showed up TMJ problems and a deviated septum. I still have to be very careful what I eat and how much I eat. I'm sure the daily stress of caring for my 97-year-old mother for the past 4 years and having to use a patient lift to move her from bed to wheelchair,etc. has not helped my situation. I love my mother dearly and she is such a sweet person. I am not sure where to start, but I don't know if I can get through another pain episode like this last one.

I love to work in my yard which helps relieve some stress, but I'm afraid to go outside unless the weather is "perfect". I forgot to mention that a sudden thunderstorm also starts my earaches, etc. even though I am inside.????? I am 71 years old and otherwise in excellent health.

Hello,

Because the Trigeminal nerve, the fifth cranial n, carries sensory information from a huge area in the head, all with the sensory nucleus in the upper neck, one often gets a confusing pattern of symptoms, as you describe. What is sometimes difficult is be certain where the primary source of pain is. It could be the sinuses, the teeth, the jaw joint, the skin of the face including the external ear and the meninges covering parts of the brain. Each of the parts has to be considered separately; a neurologist is often the best qualified to make the correct diagnosis.

However, you yourself can give vital information. Do you have painful tooth when you chew on it, or a blocked sinus? Does your jaw joint pop or click when you open your mouth. If you place your fingers just in front of the tragus of the ear is the jaw joint particular sensitive to pressure? If you touch your face, or squeeze the pinna of the ear, is it sensitive.

There is often associated pain in the neck because that's where the sensory nucleus is located.

That jaw clenching may be very significant. At the TMJ anatomy page you will see the temporalis muscle. Press on it. Is it particularly sensitive, and does the pain radiate with pressure? Jaw clenchers have a much higher contraction of the muscle, even when asleep.

Has anyone put their finger into your mouth, between the upper teeth and the cheek into the pocket high up behind your wisdom tooth, testing the external pterygoid muscle? You can do it yourself. Is it extremely tender with pressure? These may be signs that your pain is coming from the TMJ and not from your ear or sinuses. In which case start looking for someone who works with the jaw joint. Avoid surgery.

It's possible you have a condition called trigeminal neuralgia which is extremely painful and not dissimilar to the symptoms you describe.

I hope this all contributes. Certainly you are an amazing family.

Dr B

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