What is Carotidynia?
Table Of Content:
Carotidynia refers to a syndrome which causes a one-sided/unilateral tenderness of the carotid artery near the bifurcation. Palpation of the carotid artery present in the neck results in a type of a headache that resonates on the face, ears and neck. In most cases, carotidynia occurs in people below the age of sixty and women are four times more prone to suffer from such a pain.Image Source: en.wikipedia.org
Sometimes, people describe carotidynia as a secondary headache because of its association with other underlying health problems that can be the probable cause of the pain. Misdiagnosis of carotidynia as chronic sinusitis or trigeminal neuralgia is an ordinary possibility in the early stages of the syndrome.
Characteristics of the pain
- Usually centered around the neck, it can radiate to the ears, molar region and the face as well
- Dull throbbing pain that may occur throughout the day or may come and go for some hours
- Intensity of the pain varies from mild to agonizing
- Pain may increase substantially while yawning, swallowing, sneezing, coughing or lifting the head towards a collateral side
Causes of Carotidynia
- Vascular changes: The carotids artery is a primary blood vessel that supplies oxygenated blood to the brain and is present around the neck. Any change or inflammation in the carotid artery can cause carotidynia.
- Genetic causes: It is seen that people whose parents suffer from carotidynia are more likely to experience a similar kind of pain. This indicates that genetic material could also carry elements that result in such type of pain. Hence, carotidynia can also be a hereditary problem.
- Environmental factors: Exposure to cold weather may trigger a headache in some people. People who are in the habit of smoking regularly are also susceptible to carotidynia due to plaque formation in the arteries. The pain may also occur in people who have undergone a recent dental surgery.
- Migraine: Migraine is a common cause of carotidynia. There is a high incidence of vascular headaches in family or individual medical backgrounds before the onset of carotidynia. People having ‘migraine personalities’ which has sensitivity, compulsiveness and conscientiousness as its characteristics are more likely to be subject to such pain. If migraine is the cause of carotidynia, patients suffer most while experiencing fatigue, stress or frustration. In such cases, the pain may continue to recur over months and years accompanied with pain that is deep-seated and dull.
- Infection or Post infection: Health conditions such as infection in aphthous ulcers, pharyngitis and viral upper respiratory tract infection occur before the onset of carotidynia. Such instances are more likely among those who have anxiety and the most common symptom is the experience of a sore throat. People suffering from carotidynia due to infection or post-infection do not have a history of a migraine in their family or their past. The symptoms may be present for an average of 11.6 days, and the condition is a result of a viral cause.
- Carotid Artery Aneurysm: Carotid artery aneurysm is a tender carotid artery that can be present anywhere along the internal or common carotid arteries. The mass may or may not be pulsatile if at all it is palpable. Neurological complications such as strokes, transient cerebral ischemia, coma, amaurosis fugax, syncope, etc. are common while rupture of the artery is unusual.
- Giant Cell Arteritis: Cranial arteritis mostly occurs among people aged over 55 years. However, younger people may be subject to carotid arteritis. Low-grade fever, tender carotid arteries and malaise are characteristics of this health problem.
Symptoms of Carotidynia
- Eyes appear watery
- Pain radiates behind the ears and jaw
- Tenderness of the carotids artery
- A branch of carotid artery running behind the ear causes pain deep in the ears
- Pain one side of the head and/or neck
- Ringing in the ears
- Visual disturbances leading to sudden blindness
- Pain in the tongue and jaw while chewing
- Inflammation of the carotid artery
Diagnosis of Carotidynia
- Physical examination
- Thorough examination of the individual’s personal and family medical history
- Laboratory or radiology test
- Examination of the head & neck
- Direct or indirect laryngoscopy
- Duplex scanning
- Intra-arterial angiography
Using an ice pack on the neck may be helpful in reducing the pain and swelling, apply the ice pack for about 10 – 20 minutes while placing a thin cloth between the skin and the ice pack. Prevent chances of frostbite by making sure of not leaving the ice on the skin for too long
Use a heating pad set on low or a bottle of warm water or a warm cloth is advisable, but avoid going to sleep with a heating pad on the skin
Treatment of Carotidynia
Usually, carotidynia is a condition that is self-correcting. The doctor prescribes medications to treat migraine and corticosteroids. The medication prescribed depends on the course of treatment that the doctor chooses for the patient. Certain medicines that prevent the occurrence of irreversible blindness are also given to the patient.
When to visit a Doctor?
Carotidynia manifests itself in the form of a headache which is one of the most mundane physical problems that people may be experiencing on a daily basis. It increases the chances of misdiagnosis. Moreover, the intensity and frequency of the pain may also vary from a person to another. In cases, where a person experiences mild pain that recur after a few days’ interval, the individual may not pay too much attention to the problem which could cause further complications in the health.
Following are certain conditions under which a doctor’s advice must be sought at the earliest:
- Pain worsens as time passes
- Pain creates a hindrance towards the performance of daily activities
- Experience of numbness or weakness
- Fever for a prolonged period
- Home treatments do not work
So basically it’s a pain in the neck… So why are we patients advised to seek ER treatment if all your going to do is advise mild heat and BOP and rest…..