What Causes A Dull Pain At The Base Of The Head Extending Into The Right Side Jaw?

Posted on Thu, 10 May 2018

Question: I woke this morning with pain (dull ache that will somewhat intensify then subside some) in the base of my head, down my neck and into my shoulder on the right side and it sort of goes into my right side jaw. I don't believe this is a concern for heart symptoms, but in the back of my mind still wondered.

Answered by Dr. Ishu Bishnoi (14 minutes later)

Brief Answer:
need more information and possible differential diagnosis

Detailed Answer:
Hi xxxxxxxxxxxxxx, thanks for asking from HCM.

I can understand your concern. Your headache is occurring in the occiput region which is going towards neck, right shoulder and right side of jaw. Such kind of pain an be due to various causes like

- Neck muscle spasm specially Trapezius and sternocleidomastoid muscles.

- Cervical spondylosis with disc compressing right side nerve roots (most probably C2-5)

- Cervical spine mass lesion compressing right side nerve roots

- Migraine - It is less likely, but one sided headache. It must be kept as one possibility. It usually occurs with pain in eyes, photophobia, vomiting and aura like symptoms.

Now to conclude some diagnosis, I need more information about your symptoms

- Is there any history of neck muscle injury/pull/vigorous exercise/using large pillow/sleeping in prone position?

- Is there any history of such pain in past?

- Is there any complaint of tingling sensations in right upper limb, current like pain sensations radiating from neck till shoulder?

- is there any history of focal weakness?

- is there any complaint of eye pain, vomiting, Migraine like pain in past?

If you can provide me some details, it will be very helpful for me. If you have any doubt, do let me know. I will be happy to help you.

Thanks. Take care.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ishu Bishnoi (33 minutes later)

No history of injury. I do have a history of migraine but this is unlike any in the past. the pain is at the base of my head/neck and goes down the right side of my neck and into my shoulder and arm on the right side and into my right side jaw. no eye pain or stomach upset. not really a tingling sensation, just like a dull ache that will somewhat get more intense then back off.

Answered by Dr. Ishu Bishnoi (10 hours later)

Brief Answer:
Probable cause and how to manage it

Detailed Answer:
Hi xxxxxxxxxxxxxxx, welcome back.

Thank you for providing me detailed history. As there is no stomach/eye pain/current like pain/tingling sensations, it is most probably
" Neck muscle spasm".

The probable muscle involved are trapezius and sternocleidomastoid. To get relief, you should follow few steps

- Try sleeping in supine position. Avoid pillow in supine position.

- Totally avoid prone position

- Apply diclofenac gel and hot fomentation over pain site. Apply it two times per day.

- You can also take table diclofenac with chlorzoxazone for pain relief after prescription.

- Consult physiotherapist for neck exercise and stretching.

- If still no relief, then consult doctor for examination. he/she might advise MRI cervical spine after examination. It will rule out possibility of any other causes.

Hope it will help. If still any doubt, do let me know.
Thanks. Take care.

Above answer was peer-reviewed by : Dr. Yogesh D