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Pain, soreness below right ear, stiffness in neck. Received shots of decadron, rocephin. Still paining. When will it go ?

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I presented with pain and soreness below right ear and stiffness in neck. Began to have pain in back of head in neck on right side that seemed to radiate to above right eye; diagnosed two days ago with ear infection and prescribed augmentin 875, ear drops, and received shots of decadron and rocephin; pain in back of head and neck is still a problem when I sit up and stir around; seems to be positional as I can actually find positions that make it subside; can lie down on right side, and pain is relieved quickly in minutes; is the neck and head pain the result of the ear infection, and when should it go away?
Posted Sat, 30 Jun 2012 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Sumit Bhatti 55 minutes later
Hi,

Thank you for your query.

1. Ear ache is often as severe as dental pain.

2. You should ask your physician to add a strong pain killer such as a combination of paracetamol with ibuprofen or tramadol.

3. Get a neurophysician's opinion on the stiff neck to rule out meningism and an ENT specialist's opinion on the exact findings in the ear (to rule out unsafe ear disease and fungal infections). Impending intra-cranial complications of ear infections must be ruled out if headache and a stiff neck are present. Is there any ear discharge which can be sent for culture and sensitivity? Which ear drops have been prescribed?

4. Imaging such as cervical spine and mastoid x-rays should be done. If the pain or neck stiffness worsens, a CT/MRI of the temporal bones and cervical spine may be done.

5. Painkillers tend to mask signs of complications and hence it is better to rule out any link with the ear disease before using a strong painkiller, local heat and local ointments.

6. If your imaging is normal and the present medication is working, your pain should reduce soon.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Pain, soreness below right ear, stiffness in neck. Received shots of decadron, rocephin. Still paining. When will it go ? 1 hour later
There has been no discharge. auralgan drops were prescribed.

The pain in the back of my head on the right side with the infected ear comes on when I sit up and move around. However, certain positions allow it to go away, and it always goes away without any pain meds by just lying down. Massage along the base of the skull from just behind the ear to the spine helps. It almost seems to be associated with muscle tension; it is very painful. Laying on a heat pad also brings relief.

Is this pain likely to be the result of the ear infection and not something more serious?
 
 
Answered by Dr. Sumit Bhatti 9 hours later
Hi,

Thank you for writing back.

1. If the head ache and pain in the neck arose after your ear infection then it is probably related to it.

2. Follow the instructions and investigations suggested above.

3. If the pains subside with treatment, further investigations may be deferred by your doctors.

4. I must emphasize that the chance of a serious problem is rare.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Pain, soreness below right ear, stiffness in neck. Received shots of decadron, rocephin. Still paining. When will it go ? 32 hours later
Urgent care physician yesterday discovered a rash on my scalp in the area of the head and neck pain. Rash is a clusterings of red spots but with no blistering. He thinks the Decadron steroid shot may have prevented the characteristic blistering. He treated me yesterday for muscle spasms with cyclobenzaprine 10mg. I am to call back if this does not work, and he will prescribe treatment for shingles. Do you think shingles could be the problem given all the symptoms I have prescribed? I have taken already three doses of the muscle relaxer. While it helps some, the pain still comes back.
 
 
Answered by Dr. Sumit Bhatti 16 hours later
Hi,

Thank you for writing back.

1. Herpes zoster (shingles) is due to reactivated chicken pox virus dormant since childhood.

2. It is possible that this is shingles if your ear infection is herpes and was diagnosed otherwise.

3. There is no harm in starting anti virals such as acyclovir, famciclovir or valciclovir immediately.

4. I must emphasize that herpes is treatable.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
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