Hujafa hujaumbika

Redey said:

wanajamvi kwa mara nyingine naomba mchango wenu kimawazo. Kuanzia jtatu wiki hii nasikia maumivu makari sana upande mmoja wa shavu like shoti ya umeme au kama vile moto unaniunguza. Nimetembelea vituo vya afya na wamenipa dawa lakini sioni nafuu. Swali langu kwenu wenyeufahamu na tatizo hili-
nini kifanyike ili kuondokana na hili tatizo, au ni wapi naweza pata uhakika wa matibabu sahii. Natanguriza shukrani. Kweli natabika make kula hata kuongea kwangu sasa ni mateso makubwa. Weekend jema...

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The pain you describe is probably a neuralgia arising from one of the cranial nerves, either the X! (accessory nerve) or the V (trigeminal). The accessory nerve does pass through the area where you're having the pain, so that's probably the one causing the problem. This nerve also gives off some branches which serve local areas. Now the question becomes: Why?

Cranial nerve neuralgias are often due to a viral infection, most often herpes simplex, and sometimes some more obscure problem. Usually, however, what you're describing is, in fact, a sort of post-herpetic pain. Perhaps you had chickenpox as a child. Once you've had chickenpox the herpes simplex virus remains dormant in the body and can flare up occasionally as shingles (which may be what's happening with you as well, but without any lesions).

My only concern is that you've been having the pain intermittently but for a fairly long time now, so there may be something irritating it. You probably would do well to arrange a consult with a neurologist. If there's no serious underlying cause (and most often there's not), there are medications specifically aimed at blocking this sort of pain until it resolves.

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What this sounds like to me most of all is an inflamed nerve (neuritis or neuralgia) along a nerve pathway, probably a cranial nerve, and may well be a sequel to or herald of a bout with shingles. If it is going to be shingles you'll know soon enough, as you'll have lesions (blisters most likely) start to show up along the nerve pathway where the pain is now. (Anyone who's ever had chickenpox is at fairly high risk of eventually having a bout of shingles, as the varicella virus never really goes away, just lies dormant). On the other hand if you've had shingles before, even if you weren't aware of it, then what this may be is post-herpetic pain, which usually doesn't last more than a day, though it can become quite chronic in certain people. It really does sound like nerve pain, isn't the jugular, could however be a nerve that paralllels the path of the jugular, possibly a branch of the XIII, IX or X cranial nerve. Each serves a different purpose and only the IX, which normally would also cause pain in the mouth or throat, is potentially serious if troubled. Since the pain starts in the ear it's probably a branch of the auditory nerve, the VIII one, which can cause some pretty exquisite pain. This often responds to over-the-counter (OTC) non-steroidal anti-inflammatory (NSAID) pain meds such as Advil or Aleve (ibuprofin or naproxyn). Sometimes the pain is persistent and other measures are required to control it, but if it's the VIII cranial (auditory) nerve or a branch of it, usually this will subside shortly on its own. It may also recur. Again, if you begin to notice small bumps turning to blisters (similar to chickenpox lesions) along the path of the pain, that would be shingles.

At any rate it's not your jugular vein gone screwy on you. Shooting, stabbing, startling pain is almost always nerve pain, and if it originates in any part of the head (including the ear) it's usuall a crainial nerve or at least a subsidiary of one. This is almost always a nuisance, but hopefully isn't announcing a new case of shingles (more often that pain comes after the blisters, sometimes before, though), and usually responds well to non-Rx pain meds. If it continues or becomes worse, or if anything new happens, please follow up here with us. Good luck to you.

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