Dr. Hitesh Kumar
Neurology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I had sinus and flap surgery on the left top jaw before one year. Since then, I have been experiencing pain on the same side. The surgeon suspects nerve damage. Till I get this officially checked by neurologists, what can I do to help with the pain? Painkillers did not help. I am looking into supplements that can help with nerve damage. I recently had a gum infection where the surgery took place, which made things worse. What can I do? I feel pain radiating around my ear and neck. My neck also feels blocked. I had stabbing pain in the temple and the jaw as well. What should I be asking the doctors? What kind of investigations should be done? Please advise on trigeminal neuralgia pain flare.
Hello,
Welcome to icliniq.com.
I read your query and can understand your concern.
I would like to know some detailed history about your symptoms:
1. When did you have sinus and flap surgery? And on which side (left or right)?
2. When did you start to have pain?
3. What type of pain do you feel? Please elaborate if it was heavy, stretching, current-like, burning, throbbing, pinprick, or other types.
4. Was the pain persistent or intermittent?
5. If intermittent, could you observe in which situation pain gets worse, like chewing, drinking, local touch by hands while taking a shower, air blowing over face, or something else?
6. If intermittent, how long does one episode of pain last?
7. When did you have a gum infection and surgery? And on which side?
8. After this surgery, what changes in pain have you noticed?
9. What are the areas you experienced pain?
10. Have you taken any medicines for this pain? If yes, which one? What was the effect of medicine?
11. Have you undergone any specific investigation to look for the cause of pain? If yes, please share.
12. Have you had any other associated medical illness, or are you taking some regular medicines?
Revert back with the answers.
Thank you and take care.
Patient's Query
Hello doctor,
Thank you for the reply.
The surgery took place on the left side and I am experiencing pain in the same area. After the surgery, it took about two to three months to recover and be pain-free. However, I experienced more sensitive and moderate pain before and during my period. The ringing in the ear (tinnitus) has never stopped since the surgery. The pain I was experiencing was like heaviness; stretching was more difficult as well but was manageable with heating pads and tablet Ibuprofen. Before one month, I developed gum infection on the site where the flap surgery was, and the dentist had to make a small incision to drain the infection, followed by a course of antibiotics. Since then, the pain has been throbbing. I took tablet Ibuprofen, but nothing helped. I also had a scan to exclude dental issues and sinus. The sinus is clear, and according to the dentist, there are no dental issues. The pain is exactly where I hold my fingers and behind my ear. Kindly help, doctor.
Hello,
Welcome back to icliniq.com.
I read your query and can understand your concern.
1. Was the pain been persistent or intermittent?
2. If intermittent, could you observe in which situation pain gets worse - chewing, drinking, local touch by hands while taking a shower, air blow over face or something else?
3. If intermittent, how long does one episode of pain last?
Revert with the answers.
Thank you and take care.
Patient's Query
Hello doctor,
Thank you for the reply.
The pain was intermittent. The previous intermittent episode lasted for a few days.
Hello,
Welcome back to icliniq.com.
Did you notice any triggering factors like fine touch, air blowing on the face, local pressure by fingers, chewing, or something else?
Where was the drainage of gum infection performed?
Revert with the answers.
Thank you and take care.
Patient's Query
Hello doctor,
Thank you for the reply.
I experienced pain during pressure with my finger. The gum infection and drainage were performed in the upper jaw.
Hello,
Welcome back to icliniq.com.
As per your description, this pain is not a feature of trigeminal neuralgia. However, the pain, which is long-lasting and worsening on local pressure with a finger, may indicate the possibility of local soft tissue inflammation or neuroma formation in the superior alveolar nerve due to local surgery events.
Thank you and take care.
Patient's Query
Hello doctor,
Thank you for the reply.
What can I do to ease the pain?
Hello,
Welcome to icliniq.com.
I read your query and can understand your concern.
It is difficult to suggest a particular remedy without a final diagnosis. Therefore, I suggest you consult a neurologist, dentist, or ENT (ear, nose, throat) specialist, discuss with them and take the medications.
Thank you and take care.
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Neurology
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