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Pain ("knot) in throat;sharp pain in neck
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Pain ("knot) in throat;sharp pain in neck

Hello--About a little more than a month ago, I started feeling discomfort in my throat when I swallow my saliva or yawn--I barely feel pain when I eat or drink.  The pain when I swallow feels like a knot on the right hand side of my throat.  It's almost as if the muscles are tight/constricted for whatever reason and don't move properly and therefore I feel pain.  I feel around my throat area and can't find any lumps and there isn't any swelling.  However, at times, the right side of my throat does feel a little "tighter" by touch than my left side.  In addition, over the past few weeks, I've also developed a discomfort in the right hand side of the back of my neck (basically at the base of the skull).  The pain isn't constant, it is quite sporadic in nature and not overpowering; it's quick and sharp and as quickly as it comes it goes away.  It's almost like a regular neck cramp except its lasted longer than any neck cramp I've had.  Inititally, I didn't associate the two together, but after reading a few things online one immediately starts to panic.  The words "cancer"/"tumor" start popping up everywhere.  I'm only 25, and although I'd rather not think the worst, there has to be an explanation as to why my throat hurts when I swallow and now I have a pain in the back of my neck.  After all, if it was nothing, it wouldn't be hurting.

I recently left my job (so of course this happens now), so I'm waiting for my COBRA to take over just so I can have this looked at.

In the meantime, any suggestions/thoughts would be appreciated (for peace of mind while I wait to go to the doc).

Many thanks,
Bula.
Tags: Pain, Neck
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4 Comments Post a Comment
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Avatar_n_tn
i have the same thing.  Have you gone to the doctor yet?
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Avatar_f_tn
I have this as well it has been going on for 4 months now.   Can you tell me if you still have it?  I was diagnosed with carotidynia although the version i have must be mild  
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1070914_tn?1282080944
Hi, this sounds like Eagle's syndrome (or carotidynia (not that different I believe)) to me. Below some information that I found in medical literature. I've been studying this because I have recently been diagnosed with Eagle's syndrome and will be undergoing surgery soon. Getting it diagnosed is hard.. if you have any questions, because I know what hell it is please ask!

I hope this may help you.


EAGLE'S SYNDROME - SYMPTOMS

Patients with vague head and neck pain symptoms can lead to an extensive differential diagnosis. One easily overlooked but important cause of chronic pain is Eagle’s syndrome (ES). Beginning in 1937, Dr. Watt Eagle published a series of articles describing a constellation of symptoms associated with an elongated styloid process. This syndrome that bears his name is associated with two classic presentations. The first, which the otolaryngologist is more familiar with, is throat pain radiating to the ear in a post-tonsillectomy patient. The second, and lesser-known presentation, is constant throbbing pain throughout either the internal or external carotid artery distributions.

A patient exhibiting the symptoms associated with Eagle’s syndrome, may consult their family physician or an otolaryngologist, a neurologist, a surgeon (neurosurgeon, maxillofacial or oral surgeon), a dentist or even a psychiatrist in order to be diagnosed. Persistent pain and other symptoms could aggravate the psychological state of a patient. By the time the syndrome is actually diagnosed, many patients have already visited some of these doctors, who have unsuccessfully tried to treat their symptoms.

Symptoms depend on a variety of factors, including the length and width of the styloid process, the angle and direction of its deviation and the degree of ossification. The pathogenesis of the syndrome was described by Eagle, who discussed types.

The first type, ‘‘classic Eagle’s syndrome,’’ typically occurs in patients after tonsillectomy, although it can also occur after any other type of pharyngeal surgery. A palatable mass may be observed in the tonsillar fossa, its palpation sometimes exacerbating the patient’s symptoms. Symptoms include ear pain, neck pain extending to the oral cavity and the maxilla, dysphonia, dysphagia, odynophagia, persistent sore throat, the sensation of a foreign body in the pharynx, painful trismus <25 mm, vertigo and tinnitus. Pain is also observed when turning the head or extending the tongue. Apart from turning the head, yawning can also trigger symptoms, particularly those resembling migraine. Other symptoms may include tongue pain in general, a sensation of increased salivation, alterations in taste, vocal changes, pain in the upper limbs, chest, and temporomandibular joint, facial paresthesia, pharyngeal spasm, pain triggered by the movement of the mandible, cough, dizziness, or sinusitis. Eagle’s syndrome has also been reported as the most important cause of secondary glossopharyngeal neuralgia or atypical craniocervical pain. All of these symptoms are attributed to the irritation of cranial nerves V, VII, IX or X, all of which are situated very close to the styloid process. The observation of symptoms after tonsillectomy generates the hypothesis that these nerves are entrapped in the locally formed granular tissue. Trauma to the soft tissues during tonsillectomy may cause bone formation, leading to an elongated styloid process or ossified stylohyoid ligament. Ossification typically appears from 2 to 12 months after the trauma.

In the stylo-carotid artery syndrome, an elongated styloid process deviating slightly from its normal direction can impinge the internal or external carotid artery, stimulating the sympathetic nerve plexus accompanying the artery and causing pain during artery’s palpation. Stimulation of the internal carotid artery causes pain along the artery that is sometimes accompanied by pain in the eye and parietal cephalalgia. These symptoms can result in wrong diagnoses, such as cluster headache or migraine. Symptoms may also include aphasia, sight disturbances, weakness or even syncope episodes. Stimulation of the external carotid artery causes facial pain, mainly in the area under the eyes. Histological examination of the vessel wall in such cases may reveal arteriosclerosis. Stylo-carotid artery syndrome might also result in arterial variation.



DIAGNOSIS

The diagnosis of Eagle’s syndrome is based on four different parameters:

(1) clinical manifestations
(2) digital palpation of the process in the tonsillar fossa
(3) radiological findings and
(4) lidocaine infiltration test. During the lidocaine infiltration test, lidocaine anesthetic is administered to the area where the styloid process is palpable in the tonsillar fossa. If the patient’s symptoms and local sensitivity subside the test result is considered positive and Eagle’s syndrome is diagnosed.

A patient exhibiting the symptoms associated with Eagle’s syndrome, may consult their family physician or an otolaryngologist, a neurologist, a surgeon (neurosurgeon, maxillofacial or oral surgeon), a dentist or even a psychiatrist in order to be diagnosed. Persistent pain and other symptoms could aggravate the psychological state of a patient. By the time the syndrome is actually diagnosed, many patients have already visited some of these doctors, who have unsuccessfully tried to treat their symptoms. This is quite understandable considering that the clinical manifestations of Eagle’s syndrome resemble those of many other diseases. Consequently, it is quite difficult to make a correct diagnosis based solely on clinical manifestations. However, it is very important for physicians and dentists to include Eagle’s syndrome in their differential diagnosis when treating patients experiencing pain in the cervicofacial and cervicopharyngeal regions.

A 3D-CT scan is considered the gold standard in the radiological diagnosis of Eagle's Syndrome. It provides an accurate measurement of the length and angulation of the styloid process and is considered to be the best supplement to the plain x-ray.

It is important to note that an elongated styloid process does not necessarily signify Eagle’s syndrome, as the majority of individuals exhibiting this anatomical anomaly experience no symptoms. Additionally, although an elongated process is found bilaterally in most cases, patients typically display unilateral symptoms. Also it is noteworthy that the occurrence of the syndrome correlates with the length of the styloid process, its width and its angulation. In fact a number of mechanisms can result in the onset of the syndrome and are responsible for the variety of symptoms. Consequently, patients may experience any number of symptoms, which often mislead physicians and necessitate the use of other data such as radiological findings to confirm the diagnosis. Both physicians (head and neck, oral and maxillofacial surgeons) and dentists must have a high index of suspicion for this clinical entity. Eagle’s syndrome should be included in the differential diagnosis of cervicofacial and pharyngeal pain. The fact that it is often excluded in such cases results in underdiagnosis and, consequently, an underestimation of the incidence of this syndrome.

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Avatar_m_tn
I am just wondering....I too am in the same state you are...What else could it be?  Some of the symptoms sound way too far away from my symptoms.
Couldn't it be possible that we tore something when yawning?  how do we know?  What other direction can we go?  I have pinching pain when I swallow or talk too long or sing.  It feels like pins.  Those are my only symptoms I have had for three months.  CAT said no cancer.  So, WHAT IS IT?
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