Norma

I had a cold last week that is gone now but, I have a sharp shooting pain from the left side of my neck to the left top side of my head.  Could this be a sinus infection or a ear infection and what are the symptoms of a anursym?  I took motrin and it help a little but the pain comes back. I also took Tylenol severe allergy tablets that helped a little.

[jcverive]

Is this the first time you have had this particular pain? Have you ever experienced severe trauma to the head or neck, such as whiplash or a serious fall? What you describe is typical for occipital neuralgia or occipital neuritis. The occipital nerve branch (one on each side of the head) exits from the spinal column, and travels through a portion of the trapezious muscles (shoulder/neck) and progresses to the top of the head. It is a sensory nerve, and serves much of the back of the head, usually stopping where the trigeminal nerve takes over, along an imaginary line drawn from the temple, with the lesser occipital nerve brach servicing the lower half of the head, where the line continues curving around the back of the ear and jaw.

There have been anecdotal reports of occipital neuralgia "popping up" after sinus or oral infections, though in most cases patients report previous head or neck trauma.

If the pain worsens or does not disappear within two weeks of the resolution of your head cold, please ask your doctor to consider occipital neuralgia or occipital neuritis.  Most people with severe occipital pain respond to selective serotonin reuptake inhibitors and/or selective norepinepherine reuptake inhibitors (found in many antidepressants), anti-seizure meds, and other nerve function meds. Tegretol, Trileptal, Cymbalta, Lyrica, Keppra, Neurontin, Elavil, Pamelor, and Lexapro are just a few common neuralgia meds, though there are many other drugs worth trying as well.  For breakthrough pain, narcotics are commonly prescribed, though long term use can actually make the pain harder to treat. Addiction is not considered to be a significant concern among patients without prior substance abuse tendencies, but some doctors and patients remain skeptical.

Best of luck -

Jeff