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Dr. Das, MD
Dr. Das, MD, Doctor
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Pain in the back left side of the head - no trauma - comes ...

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Pain in the back left side of the head - no trauma - comes and goes along with headaches (also left side of head) with onset of sinus pressure. MRI/CAT Scan of sinus's showed all passages clear and minor amount of thickness in lower left, front sinus. Blood work 100% normal. Additional info: Root canal on left back molar on year ago and one month later had high frequency hearing loss in left ear. Tinnitus in left ear appears louder correlating to sinus/head pain. Any ideas?


Since when have you had these pain? Since the root canal 1 year ago? Or even before that? Or much later?

Does the pain increase when you press on the region? Or do you feel relief?

Does it increase when you move the head from side to side? Is there any stiffness of the neck when the pain occurs?



Customer: replied 8 years ago.
First noticed the pain just prior to the root canal (April 07). About one month after the root canal, it seemed to re-occur. When I press on the point (and it is a specific spot), there is a small lump (that's been there my entire life) it hurts but massaging it makes it feel better. No stiffness in the neck, but again, sometimes localized pain that goes away when massaged. Very active and this doesn't bother me when I'm engaged in sports. When I noticed the high freq hearing loss, I went to an ENT and had MRIs/CAT scans of sinus, ear and neck. There were no abnormalities found. While high freq hearing has been gone in left ear since one month after root canal, head pain wasn't noticed again until recent (two weeks ago) head congestion/cold and sinus discharge. Currently only minor sinus discharge but pain continues.


I believe that you are suffering from occipital neuralgia, brought on either by infection from your sinuses or from pressure by the lump on the back of the head. It is likely that this lump is a sebaceous cyst - a harmless cyst from a sebaceous gland but possibly lying just over a nerve called the occipital nerve.


The occipital nerve supplies the muscles of the back of the head and neck and also sends fibres to the side of the head reaching the skin and muscle above the ear, to the sinuses and near the eyes.

A headache with tension of the muscles of the back of the head and neck can also cause pain over the point from which the nerve emerges from the skull.

Here is a very good image of the occipital nerve emerging from the skull:

- scroll down to the image midway on the page.

The pain goes away when you massage the area because the muscles relax, releasing pressure over the nerve.

Any pressure on the nerve, either by tense muscles or by a compression at the level where the nerve emerges from the spine or or by changes in the blood supply can cause pain and headache.

The standard treatment is injection of a steroid and local anesthetic at the base of the nerve. Possibly in your case, removing the sebaceous cyst will be necessary.

I hope this helps.

Let me know if you need more input. If not, please click on the green"Accept" button on this page. A positive rating and adding a bonus will be warmly appreciated.


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