Medical Questions? Ask a Doctor Online!
How long has this been bothering you?
Is there tenderness when you press in a particular location?
What dose of ibuprofen are you taking?
How often are you taking the ibuprofen?
Thank you for the additional information.
Both TMJ and SCM can cause pain around the ear, headache, and symptoms of imbalance. Although the perception of pain can be diffuse, the area of tenderness will tend to better suggest the underlying problem. The TMJ is situated just in front of the ear canal, so would have tenderness in front of the ear or while pressing forward on the ear canal, and the tenderness would be exacerbated during range of motion of the jaw. The tenderness associated with SCM is along the muscle, which lies beneath and behind the ear. Another possibility is inflammation or infection within a sinus that exists in the bony prominence to which the muscle attaches, which would have tenderness along the bone. The tenderness above the cheek bone may also be due to inflammation of infection in a different sinus. Stress is non-specific, and can make any of these conditions worse. Indeed, stress has been demonstrated to make virtually every disease worse, so does not help narrow down the possibilities. Ultimately, it would require an appropriate medical evaluation to determine the exact cause, but the use of ibuprofen is reasonable to try to relieve inflammation to see of the problem improves, although it may need to be taken at a higher dose. Like all anti-inflammatory medicines, lower doses may help ease pain, but higher doses are frequently necessary to relieve inflammation. For ibuprofen, it generally requires 1600-2400 mg per day to relieve inflammation. An over the counter antihistamine to try to relieve inflammation in the sinuses also would be reasonable to try. If these interventions are not successful, then it would be appropriate to seek further evaluation.
Neck pain would be more consistent with a musculoskeletal cause. Sinus infection would not directly cause pain down the neck, but there can be reactive enlargement of lymph nodes that can cause neck pain. Massage therapy is a double-edged sword. During an acute exacerbation, it may make symptoms worse, but in the long run, it does tend to help.