What could be the reason for pain under the bridge of nose?

Question

Hello doctor,

I have pain under the bridge of my nose for about six weeks. I sleep well with no pain but about 2 hours after, I wake up and start to feel pain in the bridge of my nose and maybe a dull headache, which usually goes for the rest of day and usually increases but stops short of a migraine. I have been to my GP about four times where he has given me a full blood count, allergy blood test, and a CT scan of my head and sinuses, all came back negative.

One thing I have noticed is that I have stopped sneezing, I usually sneeze every couple of days and multiple sneezes but I have gone three weeks without sneezing. When I did I had a few good days, but I have not sneezed again now for five days and it feels like the pressure is building in my nasal passage again. I have very little nasal discharge and it is clear. I use saline water rinsing daily and I have stopped using steam inhalation as that can also bring on headaches and nose pain and my nose also feel more blocked. I tried Nasonex which gave me headaches after two days of use. I ran a course of antibiotics for 10 days (Doxycycline) which seems to have done little as well. Some contributing factors could be the cold weather seems to irritate it, maybe not sneezing. What is causing this pain and headaches in my nose and how can I treat it?

Answer 1

Hello,

Welcome to icliniq.com.

I have seen the CT scan report (attachment removed to protect patient identity) which seems to be normal, but it says that there is some deviation. So I want to see the scan films, can you send me?

The report also says that there is some mucosal thickening which could be due to sinusitis which cannot be the cause of nasal pain, but the deviation of septum can be a cause of nasal pain. The treatment you have taken will reduce the symptom of sneezing and runny nose but not nasal pain. Your pain can be neurological also, but to diagnose a neurological pain I need to rule out other diagnoses. After seeing the CT scan films, I will be able to guide you better after that.

Answer 2

Hello,

Welcome back to icliniq.com.

The scan appears to be normal (attachment removed to protect patient identity). The pain can be neurogenic pain. You can continue your regular medications and saline nasal wash. Along with that, start taking Pregabalin 75 mg (brand name is Lyrica) once daily for seven days in the night. Review after 7 days and let me know if there is any relief before stopping the medicine after a week.