Severe Pain in the Middle of the Left Neck: Carotidynia

I had an interesting affliction the other day that a bit of research didn't answer completely.  I was sitting quietly at the beach when I felt a pinching pain in the middle of my left neck.  I began feeling disoriented, so I packed up my belongings and quickly went home.  I might add it was not an overwhelming hot day and I had only been there an hour.

On my bike ride home I noticed the pain worsening.  By the time I was home, and out of the shower, it was excruciating.  Not throbbing, not hot, just like some body builder punched me dead in the neck.  

I came across a few things on the Internet.  There's not much in that area, in terms of offering such severe pain, but I did come up with something - carotidynia.  I'd like to share it with you in case someone else has been in the same predicament.  Most importantly, I had to DIG DEEP for this one by scaling the health boards so that tells me it may not be common knowledge for most of our primary care physicians.  

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.

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.

​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
• Angiography
• MRI
• Intra-arterial angiography

​
HOME REMEDIES

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.

Of course, this is nothing to play around with.  Like I said previously, I have a call into my doctor to ensure this is not serious.  Should you experience the same, I advise you to seek medical treatment.  

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