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Occipital Neuralgia – Causes, Symptoms, Diagnosis and Treatment

Occipital Neuralgia | American Association of Neurological Surgeons

Occipital Neuralgia is a condition in which the occipital nerves, the nerves that run through the scalp, are injured or inflamed. This causes headaches that feel like severe piercing, throbbing or shock-like pain in the upper neck, back of the head or behind the ears.


Occipital neuralgia can be the result of pinched nerves or muscle tightness in the neck. It can also be caused by a head or neck injury. Occipital neuralgia can either be primary or secondary. A secondary condition is associated with an underlying disease.

Although any of the following may be causes of occipital neuralgia, many cases can be attributed to chronic neck tension or unknown origins.


Symptoms of occipital neuralgia include continuous aching, burning and throbbing, with intermittent shocking or shooting pain that generally starts at the base of the head and goes to the scalp on one or both sides of the head. Patients often have pain behind the eye of the affected side of the head. Additionally, a movement as light as brushing hair may trigger pain. The pain is often described as migraine-like and some patients may also experience symptoms common to migraines and cluster headaches.

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When & How to Seek Medical Care

Occipital neuralgia can be very difficult to diagnose because of its similarities with migraines and other headache disorders. Therefore, it is important to seek medical care when you begin feeling unusual, sharp pain in the neck or scalp and the pain is not accompanied by nausea or light sensitivity. Begin by addressing the problem with your primary care physician. They may refer you to a specialist.

Testing & Diagnosis

Diagnosis of occipital neuralgia is tricky, because there is not one concrete test that will reveal a positive or negative diagnosis. Typically, a physical examination and neurological exam will be done to look for abnormalities. If the physical and neurological exams are inconclusive, a doctor may order further imaging to rule out any other possible causes of the pain. A magnetic resonance imaging (MRI) test may be ordered, which can show three-dimensional images of certain body structures and can reveal any impingement. A computed tomography scan (CT or CAT scan) will show the shape and size of body structures. Some doctors may use occipital nerve blocks to confirm their diagnosis.


Treatment of occipital neuralgia aims to alleviate the pain; however, it is not a cure. Interventions can be surgical or non-surgical.

Non-surgical Treatments

  • Heat: patients often feel relief when heating pads or devices are placed in the location of the pain. Such heating pads can be bought over-the-counter or online.
  • Physical therapy or massage therapy.
  • Oral Medication:
  • Percutaneous nerve blocks: these injections can be used both to diagnose and treat occipital neuralgia.
  • Botulinum Toxin (Botox) Injections: Botox injections can be used to decrease inflammation of the nerve


  • Occipital Nerve Stimulation: This surgical treatment involves the placement of electrodes under the skin near the occipital nerves. The procedure works the same way as spinal cord stimulation and uses the same device. The procedure is minimally invasive and surrounding nerves and structures are not damaged by the stimulation. It is an off-label indication for an FDA-approved device.
  • Spinal Cord Stimulation: this surgical treatment involves the placement of stimulating electrodes between the spinal cord and the vertebrae. The device produces electrical impulses to block pain messages from the spinal cord to the brain.
  • C2,3 Ganglionectomy- This treatment involves the disruption of the second and third cervical sensory dorsal root ganglion. Acar et al (2008) studied the short-term and long-term effects of this procedure. The study found that 95% of patients had immediate relief with 60% maintaining relief past one year.



Patients are encouraged to regularly follow up with their primary care providers and specialists to maintain their treatment. Surgeons like patients to return to the clinic every few months in the year following the surgery. In these visits, they may adjust the stimulation settings and assess the patient’s recovery from surgery. Following up with a doctor ensures that the patient is getting correct and effective care. Patients who undergo occipital nerve stimulation will follow up with a device representative who will adjust their device settings and parameters as needed, alongside their doctors.

Outlook/Latest Research

Currently Recruiting:

Recently Published:

  • Sweet, J. A., Mitchell, L. S., Narouze, S., Sharan, A. D., Falowski, S. M., Schwalb, J. M., … Pilitsis, J. G. (2015). Occipital Nerve Stimulation for the Treatment of Patients With Medically Refractory Occipital Neuralgia. Neurosurgery77(3), 332–341. doi: 10.1227/neu.0000000000000872J This systematic review compiles treatment recommendations for the use of occipital nerve stimulation to treat occipital neuralgia. The review found various articles supporting these recommendaitons.
  • Janjua, M. B., Reddy, S., Ahmadieh, T. Y. E., Ban, V. S., Ozturk, A. K., Hwang, S. W., … Arlet, V. (2020). Occipital neuralgia: A neurosurgical perspective. Journal of Clinical Neuroscience71, 263–270. doi: 10.1016/j.jocn.2019.08.102 This paper investigates the different causes of occipital neuralgia and surgical interventions that have aided in relieving pain. The paper also provides case examples for each cause and corresponding treatment. The paper found that the C2 nerve is the most common site for compression causing the pain. Treatments such as C2 neurectomy and/or ganglionectomy offer the most pain relief for patients.
  • Texakalidis, P., Tora, M. S., Nagarajan, P., Jr, O. P. K., & Boulis, N. (2019). High cervical spinal cord stimulation for occipital neuralgia: a case series and literature review. Journal of Pain ResearchVolume 12, 2547–2553. doi: 10.2147/jpr.s214314P This study uses a literature review to support the author’s personal experiences treating occipital neuralgia with spinal cord sitmulation to show the efficacy of the treatment for this condition. The study found that high cervical spinal cord stimulation results in 40-50% success in patients with occipital neuralgia and thus, spinal cord stimulation may be considered as a treatment option.

Resources for More Information

Author Information

Patient Pages are authored by neurosurgical professionals, with the goal of providing useful information to the public.

Julie G Pilitsis, MD, PhD, FAANS

Chair, Neuroscience & Experimental Therapeutics

Professor, Neurosurgery and Neuroscience & Experimental Therapeutics

Albany Medical College

Dr. Pilitsis specializes in neuromodulation with research interests in treatments for movement disorders and chronic pain.


Olga Khazen, BS

Research Coordinator

Neuroscience & Experimental Therapeutics

Albany Medical College

The AANS does not endorse any treatments, procedures, products or physicians referenced in these patient fact sheets. This information provided is an educational service and is not intended to serve as medical advice. Anyone seeking specific neurosurgical advice or assistance should consult his or her neurosurgeon, or locate one in your area through the AANS’ Find a Board-certified Neurosurgeon online tool.


Stomach Pain – Upper | Advocare Aroesty Ear, Nose & Throat Associates

Is this your symptom?

  • Pain or discomfort in the upper abdomen (stomach). This is the area below the rib cage and above the belly button.

Some Basics…

  • There are many things that can cause pain in the upper part of the stomach (abdomen). Most causes are not serious.
  • Pain in this area can be caused by eating too much. It can be caused by a food or a drug that upsets the stomach. It can also be caused by more serious problems like stomach ulcers or a gallbladder attack.
  • Reflux disease (GERD) causes a burning pain that goes into the chest. Laying down makes pain worse. Some people with reflux get a sour or bitter taste in their mouths.
  • Stomach pain is more likely to be serious in an older person.

Pain Scale

  • None: no pain. Pain score is 0 on a scale of 0 to 10.
  • Mild: the pain does not keep you from work, school, or other normal activities. Pain score is 1-3 on a scale of 0 to 10.
  • Moderate: the pain keeps you from working or going to school. It wakes you up from sleep. Pain score is 4-7 on a scale of 0 to 10.
  • Severe: the pain is very bad. It may be worse than any pain you have had before. It keeps you from doing any normal activities. Pain score is 8-10 on a scale of 0 to 10.

Common Causes of Upper Stomach Pain in People Younger Than 50 Years of Age

  • Appendicitis
  • Gallbladder disease
  • Irritable bowel syndrome (IBS)
  • Peptic ulcer disease

Common Causes of Upper Stomach Pain in People Older Than 50 Years of Age

  • Appendicitis
  • Bowel obstruction
  • Diverticulitis
  • Gallbladder disease
  • Pancreatitis
  • Peptic ulcer disease

Other Causes

  • Angina and heart attack
  • Abdominal aortic aneurysm
  • Hepatitis
  • Herpes zoster
  • Pneumonia



A person can have a heart attack and think that it is just “heartburn.” If you are over 40 years old or have any of these risk factors, you could be having a heart attack:

  • Diabetes
  • Hypertension
  • High cholesterol
  • Obesity
  • Smoking
  • Someone in your family (like a parent, brother or sister) has had a heart attack

When to Call for Stomach Pain – Upper

Call 911 Now

  • Passed out (fainted)
  • Very weak (can’t stand)
  • Sweat on or dripping down face
  • More than 50 years old and pain lasts more than 5 minutes
  • History of a heart problem and pain lasts more than 5 minutes
  • More than 35 years old and have at least one heart risk factor, including:
    • Hypertension
    • Diabetes
    • High cholesterol
    • Obesity
    • Smoker
    • Family member has had a heart attack
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • Fever over 103° F (39.4° C)
  • Fever and have diabetes
  • Fever and have a weak immune system (such as HIV, cancer chemo, long-term steroids, splenectomy, transplant)
  • Fever and are bedridden (nursing home patient, stroke, chronic illness, or recovering from surgery)
  • Whites of the eyes have turned yellow
  • Pregnant
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Stomach pains come and go (cramps), and last more than 24 hours
  • More than 60 years old
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Stomach pains off and on for weeks or months (are frequent, come and go)
  • Burning pains in chest with a sour taste in mouth
  • Stomach pains often occur 1 hour after meals
  • You have other questions or concerns

Self Care at Home

Care Advice for Mild Upper Abdominal Pain

  1. What You Should Know:
    • Mild stomach pain can be caused by an upset stomach, gas pains, or eating too much. It can also be caused by reflux disease (GERD). Sometimes mild stomach pain is the first sign of a vomiting illness like stomach flu.
    • You can treat mild stomach pain at home.
    • Here is some care advice that should help.
  2. Fluids: Sip only clear fluids until the pain is gone for more than 2 hours. Clear fluids include water, broth, and water mixed with fruit juice. Then slowly return to a normal diet.

  3. Diet:
    • Start with clear liquids. When you feel better, you can begin eating a bland diet.
    • Avoid alcohol or drinks with caffeine in them.
    • Avoid greasy or fatty foods.
  4. Stop Smoking: Smoking can make heartburn and stomach problems worse.

  5. Avoid Aspirin: Avoid aspirin and drugs such as Motrin, Advil, and Aleve. These drugs can bother your stomach. Try taking Tylenol.

  6. Antacid:
    • If you are having pain now, try taking a liquid antacid.
    • Read and follow all the instructions and warnings on the package insert of all medicines you take.
  7. Reflux Disease (GERD):
    • Eat smaller meals and avoid snacks for 2 hours before sleeping.
    • Avoid foods that tend to cause heartburn and stomach problems. These include fatty/greasy foods, spicy foods, mints, chocolate, drinks with caffeine, and alcohol.
  8. What to Expect: With harmless causes, the pain most often goes away within 2 hours. With stomach flu, the pain may come and go for 2 to 3 days. You may have belly cramps before you vomit or have diarrhea. If your pain does not stop and gets worse, it may be more serious.

  9. Call Your Doctor If:
    • Severe stomach pain occurs
    • Stomach pain is constant and lasts more than 2 hours
    • You think you need to be seen
    • You get worse

And remember, contact your doctor if you develop any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 12/5/2021 1:00:52 AM
Last Updated: 10/21/2021 1:00:51 AM

Copyright 2021 Amazon.com, Inc., or its affiliates.

Ear Fullness – Symptoms, Causes, Treatments

Ear fullness can be caused by infection, especially when accompanied by cold and flu-like symptoms. The feeling of fullness is the result a blocked Eustachian tube, which connects your ear to your throat and permits the drainage of fluid from your middle ear. If fluid builds up, the middle ear may become infected with bacteria or viruses, leading to pain and swelling. Hay fever and other allergies are also common causes of ear fullness.

Sudden, dramatic shifts in air pressure, such as those experienced when flying in an airplane or scuba diving, may cause fullness in the ear and even lead to rupture of your eardrum. This is known as barotrauma and occurs from extreme pressure differences between the inside of your ear and the outside.

Infectious causes of ear fullness

Ear fullness may be caused by infections including:

Incidental causes of ear fullness

Ear fullness can have other causes including:

  • Acoustic neuroma (benign tumor of the nerve connecting the inner ear to the brain)
  • Barotrauma (effects caused by sudden or extreme changes in air pressure)
  • Ear wax buildup
  • Eustachian tube dysfunction
  • Exposure to loud noises, such as drilling, hammering, fireworks or music
  • Foreign body in the outer ear canal
  • Hay fever or allergic reaction from animal dander, dust, cosmetics or pollen

Serious or life-threatening causes of ear fullness

Ear fullness is usually the result of a cold or flu that blocks the Eustachian tube and may lead to ear infection. In some cases, ear fullness may be a symptom of severe infection of the bone behind the ear, which is a serious or life-threatening condition that should be evaluated immediately in an emergency setting.

Questions for diagnosing the cause of ear fullness

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your ear fullness including:

  • How long have you had a feeling of ear fullness?
  • Are you taking any medications?
  • Are you experiencing oozing, pus, or any other discharge from the ear?
  • Do you feel otherwise healthy?
  • Have you spent a lot of time outdoors lately?
  • Have you been swimming or scuba diving?
  • Have you recently been in an airplane or done anything else that would have exposed you to sudden changes in altitude or air pressure?
  • Have you been in an environment where you were exposed to extremely loud noise, such as at a construction site or rock concert?

What are the potential complications of ear fullness?

Ear fullness usually resolves after a few days, but it is important to determine its underlying cause and rule out a serious infection. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications.

  • Cholesteatoma (tumor or cyst most commonly found in the middle ear)
  • Facial paralysis
  • Mastoiditis (inflammation of the bone behind the ear)
  • Meningitis (infection or inflammation of the sac around the brain and spinal cord)
  • Permanent hearing loss
  • Recurring ear infections
  • Speech or language impairment
  • Spread of infection


  1. Ear problems. FamilyDoctor.org. http://familydoctor.org/familydoctor/en/health-tools/search-by-symptom/ear-problems.html.
  2. Ear infections. FamilyDoctor.org. http://familydoctor.org/familydoctor/en/diseases-conditions/ear-infections.html.
  3. Tierney LM Jr., Saint S, Whooley MA (Eds.) Current Essentials of Medicine (4th ed.). New York: McGraw-Hill, 2011.

Is Your Pain a Sinus Infection or a Toothache?

Is it a toothache or a sinus infection?

You’ve woken up to a throbbing feeling in your upper jaw, and you are pretty sure it’s a toothache… or a sinus infection. Should you make an appointment with your doctor or your dentist? Because the roots of the upper teeth are often close to the sinus, the origin of the pain can be confusing you and making you unsure of what’s happening. Here are some considerations that might help you decide which healthcare professional you need to see.

Referred Pain

The reason you’re not sure where your pain is coming from is because the nerves in the face are situated so close to one another. Sometimes, an ear infection, a migraine headache, or even a problem in the lower jaw can cause pain in what feels like an upper tooth. Pain doesn’t usually cross the midline of the face, but anything going on on the left side of your face or head can cause pain in the teeth on the left (and, of course, it’s the same situation on the right side, too). It’s not uncommon for a patient to go to their primary care physician for what turns out to be a tooth problem or for someone to go to their dentist for what ends up being a sinus or ear infection. So if you are in pain, make your best guess and go to whichever provider you think is the right one; if you’re mistaken, you’ll simply be referred to the other.

Sinus Infection Symptoms

If you’ve had a cold that has been slow to clear up, or if you have a lot of congestion or seasonal allergy symptoms, it’s possible that a sinus infection is to blame. A sinus infection can also cause a sore throat and green or yellow nasal discharge. Tooth pain does not cause these symptoms. A fever could indicate either a sinus infection or a tooth infection. If you have recently been ill or you are blowing your nose a lot, then pain in your upper jaw is more likely a sinus issue or even an ear infection than a tooth problem.

Toothache Symptoms

On the other hand, if you’ve recently had a filling done and the next day you wake up with upper jaw pain, that’s a good indication that it’s a tooth problem. Sensitivity to heat and cold in one tooth is another red flag that can indicate tooth decay or leakage under a filling. Tapping your teeth together and feeling pain can be attributed to either a sinus infection or a tooth problem. If you’ve had recent dental work in the area or you know that you have a cavity that needs to be filled, it’s likely that your toothache is truly coming from the tooth.

A dental x-ray will clear up any doubt, because it can show either damage to the tooth or cloudiness in the sinus. If you’re having upper jaw pain and you suspect it’s coming from a tooth, give us a call and we’ll take an x-ray to see what the problem is. If it ends up that you’re having a sinus issue, we’ll refer you to your doctor for treatment.

Creative Commons image by Vincent Angler.

Red ear syndrome precipitated by a dietary trigger: a case report | Journal of Medical Case Reports

RES is a clinical diagnosis for which there is no specific diagnostic test. One hundred cases have been reported in the literature so far, with an estimated male-to-female ratio of 1:1.25 and a median age at onset of 44 years (with a wide range of ages: 4 to 92 years) [1]. Lance [2] was the first to describe RES in the literature in a 1996 report of 12 patients with recurrent RES. Pain in RES varies from mild to severe [3, 4]. Its duration may be seconds [5] or hours [2]. The frequency of episodes may be several times per day, or there may be year-long remission periods [6]. Raieli and colleagues [4] reported that unilateral or bilateral 30- to 60-minute episodes can occur in isolation and be associated with migraine (before, during or after). In 10% of the cases they reported, red ears preceded onset of a painful migraine attack. In their series of 96 children admitted with headache, who ranged from 6 to 18 years of age, 55 (57%) had migraine, and RES was found in 16 migraine cases. RES did not occur in the other headache groups. It was associated with severe pain in 62.5% and neurovegetative symptomatology (nausea, vomiting, phonophobia and/or photophobia) in 50% [4].

Episodes have been reported to occur spontaneously or to be triggered by heat [2]; by entering a hot room [7]; by touch [2, 5]; by neck movement [2, 5]; by sneezing, coughing, hair-brushing, physical exercise, chewing, and stress [2]; and by exposure to cold and lying on the affected side [8].

There are various views regarding the pathophysiology of this condition. Lance [2] suggested that the syndrome is induced in patients with cervical disorders, predominantly C3 root discharge causing antidromic release of vasodilator peptides (peripheral mechanism). He proposed that the primary mechanism is activation of the trigeminovascular system. He pointed out, and Hirsch [9] reiterated, that parasympathetic vasodilatation is greater in the nose and cheek than in the ear; therefore, red ears must be mediated primarily by inhibition of sympathetic vasoconstriction or activation of sympathetic vasodilatation. Thus, the presence of RES suggests an underlying dysregulation of sympathetic outflow. Purdy [10] noted that, in RES, there is pain in and around the ear associated with autonomic phenomena, including erythema of the ear ipsilateral to the pain. He suggested that the condition be labeled auriculoautonomic cephalalgia or be placed in the trigeminal autonomic cephalgia group. Several authors, including Kumar and colleagues [5], have used brainstem trigeminovascular activation to explain RES associated with migraine. Lambru and colleagues suggested that it is possible that trigeminoautonomic parasympathetic activation occurs with sympathetic deficit. The imbalance between parasympathetic and sympathetic systems thus may facilitate inhibition of sympathetic tone of the ear. Sympathetic dysregulation, not parasympathetic activation as formerly believed, may be the predominant mechanism of RES [1].

Another group [7] has suggested that RES is an auricular form of erythromelalgia with similar burning pain, erythema and increased skin temperature. Erythromelalgia is a condition affecting hands and feet that might be caused by sensory and sympathetic nerve dysfunction.

RES has been associated with various conditions, including upper cervical pathology (arachnoiditis, facet joint spondylosis and cervical root traction), glossopharyngeal and trigeminal neuralgia, temporomandibular joint (TMJ) dysfunction and thalamic syndrome [2]. Associations have been reported with primary headache disorders, including migraine, chronic paroxysmal hemicranias [3], hemicrania continua and the short-lasting unilateral neuralgiform headache with conjunctival injection [11]. Other cases are idiopathic. Donnet and Valade proposed two types of RES: (1) a primary form that occurs in young people and is associated with migraine and (2) a secondary form that occurs in older adults and is associated with cervical disorder or trigeminal autonomic cephalalgia phenomenon [6].

Various treatments for RES have been used with varying success. Among the 12 patients Lance described, one improved with methysergide therapy. One experienced partial symptomatic relief with indometacin, and others with propranolol, application of a cold pack, amitriptyline, or imipramine [2].

Inconsistent results have been reported following treatment with non-steroidal anti-inflammatory drugs [12], topical anesthetics, cooling the ear [7], verapamil and gabapentin [8] and greater auricular nerve blockade with a combination of local anesthetics and steroids. Some authors have reported relief over an eight-week period, and others have noted no benefit [2, 13]. Bender [14] suggested that in primary or idiopathic cases, treatment of the coexisting headache disorder with drugs such as propranolol, amitriptyline, imipramine and flunarizine helps to resolve these cases to varying degrees. Secondary forms may be more resistant to treatment [12]. In one review, secondary cases appeared to have a greater response to treatment than idiopathic cases [15]. In secondary cases, such as those associated with TMJ dysfunction, a dental plate was reported to be useful in relieving symptoms [2, 9]. In cases associated with chronic paroxysmal hemicrania, indometacin was found to be effective [3, 16].

Transient unilateral sensation of aural fullness with tinnitus was described in one of Lance’s original cases [2] and blockage without tinnitus in 2 further cases of chronic paroxysmal hemicrania [3]. Aural fullness was present in our case on the first presentation; additional subjective hearing loss in background noise without evidence of hearing loss on audiometry was possibly due to central auditory pathway changes.

Various triggers of RES have been identified; however, we found no reports of dietary triggers that provoke RES. Alcohol and spicy foods are known to cause bilateral facial flushing. Gustatory flushing is mediated by an autonomic neural reflex involving the trigeminal nerve. The presence of a dietary trigger that causes neurological symptoms suggests a migrainous etiology, as such triggers in migraine are well-known and avoidance is a therapeutic mainstay. The non-concentrate orange juice that our patient consumed is a well-known brand in the United Kingdom. There is a possibility that ethyl butyrate (also known as butyric acid ethyl ester), which is often used in flavoring extracts, could be the culprit rather than the orange juice itself. In our patient, dietary, stressor and lifestyle modifications were sufficient to relieve her physical symptoms and psychological distress. We advocate examining a patient’s lifestyle and encouraging the patient to keep a symptom diary to identify environmental factors that provoke RES. Clinicians should be made aware of the likelihood of migraine pathogenesis in primary RES and the range of management options available (non-pharmacological lifestyle changes as well as prophylaxis).

RES is a little known condition with much variation in individual patients’ symptoms and variable responses to proposed treatments. It may go unrecognized and can cause the patient undue anxiety. Often patients feel ignored without a firm diagnosis or management. Patients may present repeatedly to emergency departments, general practices or various specialist departments (ear, nose and throat; dermatology; neurology; audiovestibular medicine; and/or audiology) before being diagnosed. Raised awareness of this disorder with prompt diagnosis has cost benefits by reducing the number of primary and secondary care presentations, decreasing psychological distress and speeding return to usual daily activities.

A Tricky Case of Arm Pain and a Swollen Ear

Patient Profile

I recently saw a 52-year-old woman who had presented to her local doctor 3 months earlier with significant swelling, redness, and tenderness of the upper aspect of the right ear that lasted a few days and eventually resolved.

During the previous year, she experienced intermittent episodes of pain without redness, warmth, swelling, or significant functional limitation in the fingers, toes, and right sternoclavicular joint. She is also affected by mild fatigue and has to take a nap in the middle of the day.

The possibility of polychondritis was considered, but the patient has had no recurrence and has experienced no nasal, tracheal, internal ear, or eye inflammation.

When I first saw the patient, her physical examination was normal and the following laboratory tests were negative or normal: chemistry screen, complete blood count, thyroid-stimulating hormone, C-reactive protein, erythrocyte sedimentation rate, antinuclear antibody, rheumatoid factor, and anti-cyclic citrullinated peptide antibodies to extractable nuclear antigens. The test for anti-Sjögren syndrome A was weakly positive.

The patient returned 1 month later with intermittent joint pain, particularly in the shoulders, without redness, warmth, or swelling of the wrists, hands, ankles, or feet. She had some mild redness on the outside of her ears, more prominently on the left ear, but it was nowhere near the acute inflammation she had experienced in the past. She took ibuprofen on an as-needed basis for her ear and joint symptoms.

The next month, the patient returned and reported increased intensity and frequency of short-lived episodes of redness, tenderness, and warmth of both ears, not involving the lobules. She had developed a parvovirus B19 infection after her son became infected, which she characterized as the presence of a “slapped cheek” rash on her face and a lacy red rash on her arms and legs. Four days after the onset of the rash and increased symmetrical joint pain and swelling of the hands, wrists, ankles, and feet, she developed severe burning, searing, and incapacitating pain in her left shoulder, upper arm, and neck. She tried ibuprofen, acetaminophen, Percocet®, Vicodin®, and gabapentin because of the intensity of pain in her left shoulder and arm. She reported a slow improvement in pain by about 50% and in the development of left upper extremity weakness. MRI of the brachial plexus and shoulder showed intramuscular denervation changes involving one or more muscle groups of the shoulder girdle. Most involved were the supraspinatus and infraspinatus muscles.

Ear Related To Back Pain | Physio Gold coast

Your brain enables balance via sensory information

Our brains are wired so that we can maintain an upright vertical position without really giving it too much thought.  From the time we were toddlers learning to stand and walk our brains had worked out what it takes to defy gravity.

We take for granted what our brains are doing “behind the scenes” on a day to day basis to keep our spines straight.

Balance is a function of the sensory information our brains receive.  This information comes from three parts of our body

  • the feeling in our muscles and joints,
  • our eyes
  • our ears

The brain processes all 3 sources of information and then, with lightning speed, tells our muscles in our spine and limbs two things

  • when to contract
  • how much to contract

If all this has been done correctly, our balance is steady and our spine is straight.


When things go wrong

HOWEVER, and this is the thing, IF the information coming into the brain is not accurate, then the spinal stability will be affected.

If, for example, for some reason, the inner ear is sending incorrect information to the brain and telling it that straight is actually 5 degrees to the left, the brain will need to tell the muscles of the spine to on the RIGHT side to switch on to avoid falling to the left.  In this sense, the spinal muscles will get tight as they hold the person from falling left, where the ears are telling the brain to go.

This constant tug of war between inner ear imbalance and reflexive spine muscles will be a cause for lower back pain.

From the outside, the person will look straight but on the inside the spinal muscles are pulling constantly to achieve the balance.

If you have back pain, close your eyes and stand with your feet together to see how much you sway.  How much you sway is an indication of how well you can balance without your eyes to help.


So what does this mean?

Fixing the back pain , in the case of the inner ear imbalance, requires fixing the inner ear or vestibular portion of the balance equation.  Many people don’t realise this, and will continuously get physical treatment for their back without any permanent resolve.

You can solve the balance-back pain problem by working on the inner ear or eyes so that you calibrate them to be accurate again.  This alleviates the need for spinal muscle “workload” and so settles the back pain.

To do this you must find a therapist with neurological training and go through the necessary steps.  MWE therapists are trained to look at the central structures of the brain.

Life’s better when you’re moving with ease

Paul Michael

90,000 Why does the right ear hurt and radiates to the right side of the head and how to treat it? | Clinical Institute of the Brain

Ear pain that spreads to the right side of the head is a sign of dangerous diseases that can progress over time. Doctors at the Clinical Institute of the Brain warn: do not ignore the first symptoms, it is important to get tested on time and determine their source. If headaches can occur due to simple overwork, then the ear hurts only if there is an inflammatory process. Treatment at home is ineffective , since the methods differ for different diseases.

Causes of pain

Painful sensations in the ear and right side of the head can occur during inflammatory processes, as well as in violation of blood circulation in this area. The process can spread from the organ of hearing to part of the head and vice versa. When the first complaints appear, it is necessary to undergo an examination and establish their cause.

Otitis media

Ear inflammation (otitis media) can occur in adults and children.It occurs as a complication of viral diseases (ARVI, influenza), trauma, hypothermia, or inflammation of the sinuses. At the first stage, the patient is worried about constant ear pain, which spreads to the entire surface of the head. However, otitis media can progress and develop in several stages:

  • aseptic inflammation that causes aching pain;
  • accession of a bacterial infection;
  • development of purulent inflammation – accompanied by acute pain and hearing impairment;
  • Possible complications in the form of purulent fusion of the tympanic membrane, as well as the spread of infection to the inner ear and the lining of the brain.

Otitis media is often chronic and occurs annually. The otolaryngologist will help you choose the most effective treatment regimen after the examination. It is important to pay attention to the first symptoms in time, since the chronic course of the inflammatory process can provoke partial or complete hearing loss.

Diseases of the outer ear

The outer ear is the peripheral part of the organ of hearing, which is separated from the middle section by the eardrum.Pathological processes in this area are often manifested by acute pain in the right ear and head. With timely treatment, they pass without complications, but in the absence of intervention, they can spread to the middle and inner ear.

  • Furunculosis, eczema, fungal infection of the skin – these processes are accompanied by inflammation and soreness. The skin of the auricle turns red and flakes, and ulcers (boils) can form on it. Treatment consists of topical anti-inflammatory and antifungal medications.
  • Diseases that lead to the formation of a sulfur plug – it forms deep in the ear canal, so it is impossible to remove it yourself. The reason may be the anatomical features of the structure of the organ of hearing or excessive formation of sulfur.
  • Injuries, falls and bruises are another cause of external ear inflammation. In young children, the process can be triggered by the ingress of foreign objects into the ear canal.

When diagnosing, it is important to assess the condition of the tympanic membrane.Inflammatory processes can spread to it and even cause its perforation. Also dangerous are injuries that cause damage.

Diseases of the inner ear

Inflammation of the inner ear is the cause of acute pain in the right side of the head and in the ear. The organ has a complex structure and is responsible not only for hearing, but also for balance. It is presented in the form of channels and labyrinths filled with liquids. This is where bacteria multiply, which cause inflammation.

Diseases of the inner ear require immediate treatment, for this in most cases antibiotic therapy is used. The tympanic cavity is a comfortable breeding ground for bacteria, and they can cause suppurative inflammation. This leads to hearing loss, persistent headaches, and the development of complications, including acute meningitis – an inflammation of the lining of the brain.

Changes in blood pressure

An increase or decrease in blood pressure is a common cause of pain in the right ear and the right side of the head.Hypertension (high blood pressure) occurs due to insufficient elasticity of blood vessels, nervous tension and other factors. It manifests itself with characteristic symptoms:

  • pressing headache that spreads to the back of the head, temple, can affect the ear;
  • Hearing and vision impairment, tinnitus;
  • redness of the skin and mucous membranes, the appearance of small capillary hemorrhages.

With a decrease in pressure (hypotension), there is an increase in heart rate, weakness, impaired coordination of movements.The skin and mucous membranes may become pale. An insufficient supply of oxygen to the brain is dangerous, since it can provoke a stroke or transistor ischemic attacks.


Acute cerebrovascular accident is a stroke. It occurs when an abrupt cessation of the flow of oxygen-enriched blood to certain parts of the brain. Distinguish between ischemic (manifested by blockage, squeezing of the vessel, low blood pressure) and hemorrhagic (the result of damage to the artery and hemorrhage in the brain) stroke. The first type is more common and manifests itself with the following symptoms:

  • sudden headache, often one-sided, which can affect the ear;
  • impaired coordination of movements;
  • Weakening of the facial muscles on the injured side;
  • discomfort and soreness in the chest;
  • violation of diction, the appearance of memory lapses;
  • loss of consciousness.

The main reason why strokes occur is the lack of early diagnosis.Doctors at the Clinical Institute of the Brain recommend that you undergo regular scheduled examinations to determine the diseases of the cardiovascular system in the early stages. Monitoring blood pressure indicators, proper nutrition and dosage loads, as well as systematic intake of drugs as needed are the basis for the prevention of stroke at any age.

The ear and the right side of the head hurts with neuralgia

If the head hurts and radiates to the right ear, this may be a sign of neuralgia.It is not a separate disease, but a type of pain that occurs when a nerve is inflamed or damaged. The trigeminal nerve, which gives off branches to the muscles of the face, the organ of hearing, the upper and lower jaws, is more often affected.

Neuritis is an inflammatory process that develops in nerve fibers. It is accompanied by acute throbbing pain, which can be one-sided, affecting part of the head, ear and half of the face. It increases with harsh sounds, bright lighting and other stimuli, as well as when chewing and turning the head.Treatment consists of taking pain relievers and anti-inflammatory drugs. If they are ineffective, a nerve block is indicated – injections along its course with anesthetics and hormonal anti-inflammatory drugs.

Diseases of the cervical spine

In the cervical spine are arteries that carry blood from the heart to the brain, organs-analyzers, muscles and skin of the face. Their mechanical entrapment leads to a violation of the sensitivity of certain areas and chronic headache.Normally, the vessels are located in the channels formed by the processes of the vertebrae, and the blood moves freely along them. However, a number of diseases are distinguished that lead to impaired blood circulation, pain in the head and ear:

  • osteochondrosis – a pathology of intervertebral discs, in which they become fragile and cannot absorb in motion, and the distance between adjacent vertebrae decreases;
  • spondylosis – fusion of two or more adjacent vertebrae as a result of trauma, inflammatory or degenerative changes, destruction of cartilage;
  • curvature of the spine, more often cervical scoliosis;
  • chondrocalcinosis – the deposition of salts in the periarticular tissues, which leads to a decrease in joint mobility;
  • intervertebral protrusions and hernias – protrusion of intervertebral discs, their gradual erasure up to rupture of the outer fibrous membrane;
  • displacement of the vertebrae.

Diseases of the spine often manifest as headaches. It can be one-sided, since the load on the spinal column becomes uneven, and mechanical compression of blood vessels and nerves occurs.

Inflammation of the lymph nodes

Lymphadenitis – inflammation of the lymph nodes. Pain in the right ear and right side of the head can be caused by involvement of the parotid lymph nodes. It is acute, throbbing, and may be accompanied by fever. The disease occurs as a complication of a viral infection of the upper respiratory tract, a bacterial or fungal pathogen can also be diagnosed.

With lymphadenitis, there may be redness of the skin behind the ears, the appearance of a hard induration. The local temperature is elevated and pulsation is felt. Treatment consists of taking antibiotics, anti-inflammatory drugs, and pain relievers.

Diagnostic Methods

At the Clinical Institute of the Brain, a complete diagnosis is carried out, which considers all possible causes of pain in the right ear and right side of the head. The primary appointment is carried out by a therapist. Based on the data of the anamnesis (medical history), examination and questioning, the patient receives a referral to a narrow specialist.To exclude diseases of the organ of hearing or paranasal sinuses, it is necessary to consult an otolaryngologist, in the presence of a neurological picture, a neurologist. With high blood pressure, it is recommended to regularly conduct routine examinations with a therapist.

To obtain a complete picture of the disease, an individual diagnostic scheme is assigned. It can include the following steps:

  • general and biochemical blood tests – will show the concentration of leukocytes (an indicator of the inflammatory process), deficiency of important microelements, as well as glucose levels;
  • additional analyzes – studies to determine the gas composition of arterial blood (to detect hypoxia) and hormones;
  • MRI and CT – the most accurate and informative methods for assessing the state of the brain, are prescribed for suspected neoplasms, various defects of nervous tissue, pathological changes in blood vessels;
  • electroencephalography – a method for assessing the bioelectrical activity of brain tissues;
  • Ultrasound of the vessels of the neck and head (dopplerography) – indicates areas of narrowing of the arteries, impaired blood flow and other pathologies;
  • examination by an otolaryngologist to identify diseases of the organ of hearing.

Based on the diagnostic results, an individual treatment regimen can be prescribed. It is important to go through all the stages and carry out the necessary tests. At the Clinical Institute of the Brain, examinations are carried out on modern equipment, which allows you to get the most accurate results.

What to do if the ear and the right side of the head hurts

Treatment is selected individually, depending on the nature and intensity of the pain syndrome, the exact diagnosis, the patient’s age and other factors.The scheme can include several stages that can be combined with each other.

  • Drug treatment: at the first stages, non-steroidal anti-inflammatory drugs (Ibuprofen, Meloxicam and others) are prescribed. They affect inflammatory processes of any origin, not complicated by a bacterial infection. To relieve episodic pain, analgesics are used – pain relievers (Analgin).
  • Antibiotic therapy: antibiotics are indicated for purulent inflammation, as well as to prevent its development.These drugs are often prescribed for otitis media.
  • Muscle relaxants – used in addition to the main treatment regimen (Mydocalm). These drugs help to relax the muscles and relieve vascular spasms.
  • Nootropics – a group of drugs to improve the blood supply to the brain (Glycine, Phenibut). The decision on their effectiveness for various disorders is made by the attending physician.
  • Surgical treatment – an operation is prescribed only if conservative methods do not bring results.It may be necessary for purulent otitis media, some pathologies of the cervical spine, the consequences of trauma.

The Clinical Institute of the Brain specializes in the diagnosis and treatment of headaches. The center is equipped with the necessary technical base for a full examination of patients. Treatment is carried out both on an outpatient basis and in a hospital, with the constant supervision of competent specialists. Doctors recommend not to endure pain in the ear and head, especially if it is intense or manifests itself often – timely diagnosis and initiation of treatment will prevent dangerous consequences.

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Possible causes and methods of therapy

The onset of painful sensations in the ear is often accompanied by a weakening of the auditory function, which significantly impairs the quality of life person. When contacting an otolaryngologist, in most cases, a popular inflammatory process is found that covers the middle ear, nasopharynx or oropharynx.If a sore throat radiates to the ears, a complicated course of the disease should be suspected.

What causes ear pain?

Shooting pain in the right ear (or left) can be caused by chronic otitis media, otosclerosis, mastoiditis, furunculosis. It often indicates an inflammatory process, so a person should not self-medicate. If, with a slight pressure on the cartilage of the ear, severe pain is felt, then most likely it is otitis externa. If the pain in the ear is intense and purulent discharge appears, this is an inflammation of the follicle.

If, in addition to the listed symptoms, a person’s hearing is severely impaired, then most often it is otitis media. With this disease, the body temperature rises, a headache and general weakness appear.

If a person has a pressing pain in the ear, this indicates that they have a wax plug or there is a foreign object in the ear. The color of the secreted fluid in case of pain in the ear also gives information about the disease.

If the discharge is gray with white dots, this indicates the appearance of otitis externa.If the discharge in the ear in a person has a red or bloody tint, this indicates that the auricle is damaged.

Common ARVI can cause ear pain. Cervical pain can cause ear pain. Acute sensorineural hearing loss results in hearing loss, malaise, and severe pain.

Shooting in the ear

Shooting pains over the ear are quite common symptoms and can represent the following conditions:

  • otitis media;
  • sinusitis;
  • sinusitis;
  • polyneuropathy caused by alcohol abuse or poisoning with other toxic substances;
  • Sluder’s syndrome;
  • Hunt syndrome;
  • advanced caries;
  • Inflammation of the trigeminal nerve due to the development of infection, trauma, hypothermia or tumor.


Only a doctor can determine the exact cause of the shooting pains over the ear. If they occur, you should immediately contact the ENT and undergo an examination, since neglected inflammation, regardless of its cause, can be complicated by suppuration and neuritis of the trigeminal nerve with the loss of its main functions and functions, for which its processes are responsible:

  • hearing;
  • salivation;
  • motor activity of half of the face;
  • swallowing;
  • partially visual;
  • of the sensitivity of the half of the head for which he is responsible.

Due to the fact that the left and right trigeminal nerves are one of the 12 main pairs of cranial nerves directly leading to the brain, its inflammation, and even more the development of purulent processes can lead to inflammation of the brain with all the ensuing consequences, to avoid which will be helped only by the timely identification of the true causes of the disease and its treatment.


With shooting pains in the ear or over it, you should not get carried away with traditional medicine, and even more so to warm the sore spot.While this may provide temporary relief, it can also speed up the formation of pus and cause complications. If you cannot see a doctor right away, you can take anti-inflammatory drugs or antibiotics and pain relievers, but you should not delay visiting a doctor.

Lumbago without pain

Walking in cold or windy weather often leads to lumbago in the ears, which can be symptoms of various diseases.Therefore, establishing the cause of their occurrence will avoid the risk of complications. Possible reasons for shooting in the ears without pain are as follows:

  1. Inflammatory diseases of the mouth and throat, such as tooth decay and tonsillitis, can cause shooting in the ear.
  2. Neuritis of the facial nerve may be accompanied by lumbago in the ears.
  3. Lumbago also occurs as a result of ear diseases – types of otitis media, labyrinthitis, mastoiditis.
  4. The consequence of an untreated rhinitis (eustachitis) often manifests itself as discomfort and lumbago in the ears.
  5. The occurrence of lumbago is possible with sharp temperature changes, as well as after air flights, accompanied by a sharp drop in pressure, which leads to blockage of the Eustachian tube. This is based on physiological causes that do not require intervention and go away on their own.

Lumbago in the ears can be troubling with manifestation only on one side of the head. So, lumbago on the left can be caused by arthritic changes in the joints. If the pain in the ear shoots to the head on the right side, this indicates a purulent inflammation in the parotid region.

If you get lumbago without pain, don’t worry. However, with their duration, accompanied by unpleasant sensations, you should seek help in establishing the cause from the following specialists: otolaryngologist, neurologist and therapist.

Sore throat

If the ear begins to ache, you should start therapy without waiting for complications. Before using ear drops, you need to make sure the integrity of the membrane. In this, no doubt, only a doctor can help.

Regardless of whether the disease is traced on the left side or on the right, the use of ear drops is prescribed for two ears. This can help not only get rid of clinical signs, but also prevent the spread of infection from the nasopharynx / oropharynx into the second ear. For a sore ear, it is necessary to prescribe a therapeutic dosage, for a healthy ear, there is plenty of a prophylactic dose.

Throat and Ear Treatment

If a sore throat is shot in the ear, a systematic therapeutic approach is necessary.In the treatment of pain in the ear, substances for systemic administration are also used:

  1. Antihistamines, for example “Tavegil”, “Suprastin”. They can help reduce the swelling of the mucous membrane of the auditory tube, increase its gap, thereby improving ventilation function. Rehabilitation of the middle ear compartment guarantees the suppression of the activity of pathogenic bacteria.
  2. When nausea occurs, antiemetic drugs are prescribed, for example, “Cerucal”. Vomiting indicates destruction of the inner ear compartment.
  3. In the absence of purulent masses, but with massive secretion of serous discharge, hormonal preparations are recommended.
  4. Antipyretics are indicated for the fight against fever. The use of non-steroidal anti-inflammatory drugs will not only reduce hyperthermia, but also the severity of inflammation.

Shooting Ear Pain: What to Do

Some of the best drugs to help with ear pain can be purchased at any pharmacy. All the drugs that have been listed will 100% help with ear pain, but you should consult with your doctor before buying, and some of them are prescribed by the doctor himself.


It is a strong antibiotic, but it is used only if the patient has purulent otitis media. It is prescribed as a complex therapy drug and only by a doctor. It is forbidden to give medicine to children under 12 years old, as well as to people with intolerance to the components of the drug.


The drug is quite widespread, and the effect of its use is almost instantaneous. Otipax is a good antiseptic, a good pain reliever, and also has an anti-inflammatory effect.This drug is suitable for both children and adults. The drug should not be used if the patient has an intolerance to the components of the drug, is allergic to lidocaine, and if the eardrum is damaged.

Boric alcohol

Like Otipax, it is a good antiseptic used to drip into the ears. For the best effect, this solution is heated, so it will also have a warming effect that will help fight pain.


Antibiotic with a wide spectrum of action.The drug is dispensed only as directed by a doctor. “Otofa” fights against many pathogens, such as gonococcus and staphylococcus. Warm up and use three times a day before use.


The drug is used for the treatment of external and barotraumatic otitis media. It is used two or three times a day, and for the best effect, the drug must be warmed up in the palms. The tool must be used with caution, as the patient may have allergies and irritation of the ear canal.Otirelax is suitable for children and newborns. The drug should not be used by those who are sensitive to its components, and if the tympanic membrane is damaged.

Traditional methods

Traditional medicine should not be used as the main one, it is ideal as an addition to drug treatment. Folk remedies will help patients recover faster. How to treat a shooting ear pain? The following recipes will have a beneficial effect on the ears:

  1. Beetroot.It is necessary to peel, chop and boil small beets with honey. After preparing the mixture, it must be applied to the ear, which hurts and causes inconvenience.
  2. Vegetable oil. Vegetable oil is a good pain reliever that will relieve not only shooting but also aching pain.
  3. Nut and almond oils are the most popular. They are used as follows: drip two to three drops of oil into each ear and bandage with something warm.
  4. Beet juice.It is necessary to peel and boil the beets, then extract the juice from it and drip two or three drops into each ear.
  5. Bow. Wrap a few pieces of onion in cheesecloth and tuck it into your ears. Onions will not only relieve pain, but will also have a beneficial effect on a stuffy nose.
  6. Chamomile infusion. Pour boiling water over a few tablespoons of chamomile, wait until the infusion has cooled, strain it. Each ear should be rinsed with this solution in turn. Chamomile is a good antiseptic.
  7. Walnut Leaves – Another way to relieve a shooting ear pain.Squeeze the juice from the leaves of the walnut and drip four drops into each ear. The pain will go away pretty quickly.
  8. Propolis and honey. Mix honey and propolis tincture in a one-to-one ratio, for example, one spoonful of tincture and one spoonful of honey. The resulting solution must be dripped two to three times every day.
  9. Lemon balm infusion. Pour one spoonful of lemon balm with a glass of boiling water. The broth must be allowed time to cool, and then strain thoroughly. The infusion can be taken as tea or dripped into each ear.

Ear pain most often occurs at night, it is difficult to relieve it, and children suffer most from it. Do not delay a visit to the doctor, because every minute everything can get worse.

Pain after tooth extraction: what to do

The hellish pain that precedes the removal goes away thanks to the actions of the dentists, however, another one appears – aching sensations that haunt the patient for days. Need to worry? Depends on a number of factors: the nature of the painful sensations (throbbing, acute, aching), duration, sector (right, left), hurt ear, presence of puffiness, other nuances.Consider the characteristic features of the procedure, the likely consequences.

Should there be pain after tooth extraction?

The procedure in question inevitably injures the gum, jaw, causing bleeding, a reaction of the nervous system. A two-day toothache is the norm for an absolutely perfect removal. Difficulties in performing the operation can increase the period, including a four-day period. Increased duration, increased suffering, additional symptoms, are cause for concern when re-visiting the dental clinic.

Severe pain after tooth extraction – risk factors

  • Well infection . The ingress of pathogenic bacteria into an open wound that remains after removal provokes the development of inflammation that harms the surrounding tissues and nerves. Urgent treatment with antibiotics prescribed by a qualified doctor normalizes the situation.
  • Remaining shard of enamel . Complex cases of elimination of sick indigenous people are often accompanied by destruction, introducing pieces of dental tissue into the gum.Pain after tooth extraction for more than a week, given to the ear – is regular with similar initial data. Additional surgical intervention is required to remove the remaining fragments.
  • Injury of the trigeminal nerve , characteristic of the treatment of the lower jaw. An acute ear pain is noticeable, extending to the neck, temples.
  • Formation of painful hematoma at the point of injection.

The reason for the pain of the surrounding tissues excludes self-medication, requiring a visit to the dentistry.Does the pain after tooth extraction give to the ear? Urgent medical care is needed to remove the dangerous consequences of the development of inflammation. Ignoring, patience, overcoming are ways to get an ear infection, blood poisoning, damage to the jawbone. The help of specialists will allow you to avoid dangerous consequences, guaranteeing healthy conditions for further prosthetics.