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Jaw, face, and left shoulder pain - nerve or muscle related?
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Jaw, face, and left shoulder pain - nerve or muscle related?

Late last year I started to notice occasional shooting pains along the bottom line of my jaw and into my arms.  Not real intense but bothersome. Since that time they have progressed quite a bit. In May I noticed that what I assumed were the muscles in my neck under my jaw were "tight" from time to time and the jaw pain contined to increase in pain and duration.  The shooting pains still occured, but now more of a lasting ache at times. Can be at rest or exercise etc.  Now the pains and aches can be throughout my face and at times I get some tingling and numbness on the left side of my face that extend down through my "Trap" muscle and into my shoulder. The shoulder pinch seems to be there a lot and it feels like someone is literally pinching that muscle.

At times I can turn my head to the right and extend my left arm outward - this produces a tingling/ache from my left temple into my shoulder. I've tried ice over that shoulder and it seems to make that pathway worse.

I've been evaluated extensively for any potential cardiac problems and every test is clean as a whistle.

The jaw pain can be along the base of my jaw, or at the elbow of the jaw on either side, and at times all the way up to my temple etc.

Passed a brain MRI for MS. Bite guard for TMJ didn't help.

Does this sound neuro? Any suggestions on what it could be?  Could it be in a disc in my neck pinching something? Could the muscles be so tight they are impinging a nerve?

Are there tests a neurologist could do to pinpoint this? It is REALLY affecting my life.
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Avatar_n_tn
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.  The symptoms you describe are not classic for any single disorder, but you may have several things going on.
  The pain in the Jaw and numbness in the face are signals carried by the trigeminal nerve.  This nerve can be impinged by other structures such as blood vessels, muscles, tumors etc. and cause a condition called trigeminal neuralgia, which leads to shooting electric type pain in the face that can be very severe.  This pain is often triggered by eating, touching the face and often occurs without provocation as well.  This condition is diagnosed clinically by a neurologist, with the aid of tests such as an MRI with contrast and an MRA.  Nerves that are irritated will often light up with contrast and an MRA may show a vessel that is overlapping an irritated nerve.  Medications used to treat this condition include Tegretol and Neurontin, etc.  For medically refractive pain, surgery is sometimes helpful in isolating the nerve away from the irritating vessel/mass etc.
   Another possibility is cervicogenic disease (neck problems) such as disc herniation, osteophytes (from arthritis) pushing on spinal cord/nerves, syrinx, etc.  Neck problems may explain the shoulder pain and muscle stiffness, but it cannot explain the facial pain.  For the neck I would recommend an MRI of the cervical spine with contrast.  An EMG of the brachial plexus may also be useful if the MRI is negative.
   Finally, if the above test are negative, then I would recommend an LP (lumbar puncture-spinal tap) to test for encephalitis, lyme, west nile, HIV, demyelination etc. (Your neurologist will be able to tell you more about these test if they are needed)  Although these possibilities are less likely, you should pursue this aggressively so that you can get back to your life.
I hope this has been helpful.
9 Comments
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Avatar_n_tn
Fortunately I do not have headaches, thank goodness for that.  Neck, Jaw, and shoulder pain... and PVC's with my heart to boot. (so 15k later on heart tests that has been declared OK).

But otherwise, I don't get the bug like feeling, but the neck, jaw, face, and shoulder stuff is dead on.  It stinks.  Might request PT>
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Avatar_f_tn
Maybe have a doctor order an MRI of your neck to see if you have any bulging discs.   Also, you might want to have your arm pulses checked by a specialist, while you're moving your neck and stretching out your arms around -- some people can develop a condition where their blood stops going to the arms in certain position, and it might produce pain.  But I would start there.  A visit to a neurologist may be good too, in this case.
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Avatar_n_tn
Jenny - thankyou so much for that website adress! It is the most helpful site I've found so far - so easy to understand - unlike most I've seen. This has given me some hope. Get my latest MRI results on thursday and I bet they'll be fine. Neuro said my neck couldn't have caused the latest eye problems, but this info indicates otherwise and I know my neck has been painful when these attacks occured. Thanks again and I hope its helping you.
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Avatar_n_tn
What do muscle spasms feel like?  Are they always painful, or have different sensations?  Can they feel like a numb tight feeling.  I dont understand trigger points.  What do those feel like?  Feel like lumps in muscles?
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Avatar_n_tn
Josh - did you take a really good look at the site? It explains it all there - how the pain is seldom felt where the actual problem is - refered pain. Also explains how neuro symptoms (numbness, tingling etc) can be caused by trigger point inflamation (inflammation). I already had some understanding of this as I feel a burning sensation over my upper back and stomach most days and I have discovered that if I massage my arms against a wall with a tennis ball, the pain is relieved - really weird - its not usually my arms that hurt - until I massage them and discover the tendons are tight and swollen - massaging them is agony, but it usually makes a huge difference - weird, but it works. Bookmark that site and study it well.
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Avatar_n_tn
I came across this site by accident, but My sister-in-law had some of the same symptoms and was diagnosed with termporal arteritis.  It is inflammation of the veins and arteries that lead to the head.  She had severe migraines and did have jaw pain for months before the migraines. It can also cause vision problems.  I guess it is difficult to diagnose and she started treatment with high dose steroids.
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Avatar_n_tn
I had alot of tinkling and numbness in my face, I would also have electrical shock in my face.  I have some bad disk in my neck and in my lower  back. I have numbness and tinkling in and down my left arm. Someone recommended me to a atlas chiropractor. It was amazing what he has done for me, my spine was out of line and he lined me up, I have now no more electrical shock or numbness in my face as of today, I still get numbness and tinkling in my arm but that would correct in due time.  All I can say is find a atlas chiropractor close by and give them a try .. it sure want hurt to give them a try..
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Avatar_n_tn
For a decade, my father has suffered from pain in his neck, right side of his face, shoulders, and upper back.  The symptoms and pain are always there.  On good days, his pain level is a 4-5 out of 10.  On bad days, the level rises to a 8-9.  It is so dibilatating that he has missed close to 40% of work in the last 2 years.   He has tried exercises, steroids, pain-killers, and even minor surgical procedures without much success.  The pain resides temporarily, but eventually comes back.  My family and I would like to once and for all get to the root of this problem.  He just saw a pain specialist in Milwaukee so would like to extract a disc that was placed in his jaw nearly 8 years ago to help relieve the pain.  I feel that his may help only for a short while again.  Any suggestions?   Thanks, Tim
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