Q: I have a lot of trouble with earache. The pain starts in the ear and
then goes down the side of my face and into my jaw and sometimes down
as far as my neck. It can suddenly switch from the right ear after
weeks or months to the left. It can be painful for a week and then
suddenly no pain for a month or more. It does not seem to make any
difference if I lie on the sore side or not. What might this be? Every
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time I decide to go and get it checked, it goes away. I am a
41-year-old female.
A: You do not mention any discharge from the ears, deafness or other
ear-related symptoms. Because it switches sides, I think this problem
may not arise from the ears at all. You should really get the ears
checked to be on the safe side.
One of the interesting things about pain is that it does not always
come from the place where the trouble lies. For example, when you have
problems in the hip joint, the pain is often felt in the knee. This
phenomenon is known as referred pain. In your case, the pain could be
coming from the jaw joints, the vertebrae in the upper part of the
spine in the neck, or even from the back teeth. The pain can also come
from the sinuses.
I suggest a visit to the dentist to determine if you have cavities in
the rear molars or impacted wisdom teeth. The dentist can also check
out your jaw joints to determine if there is uneven wear on the teeth
due to bite problems.
Do you have pain or dizziness when you move your neck suddenly? An
X-ray of the cervical spine in the neck area could show signs of wear
from an old injury or arthritis.
Trigeminal neuralgia is an inflammation in the nerve just in front of
the ear. This can be painful and can come and go suddenly, but it is
not common in people under 60. Some medications can be helpful, but
have side effects. Trigeminal neuralgia tends to gradually improve and
eventually go away on its own but it can take several months.
Another possible cause is temporal arteritis, not to be confused with
arthritis. This is an auto-immune disease of the artery in the face and
temple, which is painful and can also be associated with eye problems.
But it generally occurs in people over the age of 70.
Shingles or herpes zoster, caused by the chicken pox virus, can also
cause facial pain and earache. It is accompanied by a red, painful rash
in the affected area.
Clare Rowson is a medical doctor living near Belleville, Ont. Her
columns are intended for general information only. Individuals are
encouraged to also seek the advice of their own doctor regarding
medical questions and treatments.
