Head Injuries: Pain in the Temple and Behind the Ear

I hit the back of my head, and now I have pain in my left temple and behind my ear?

Doctor: Hello, I hit the back of my head on the corner of a table last night.
It was extremely painful at the moment, but I did not experience any loss of consciousness or dizziness.
I sat down, closed my eyes to rest, and applied ice for a while.
After getting up, I did not feel dizzy or nauseous, but the pain persisted.
After some time, I started to feel a throbbing pain internally, but there was no swelling on the outside, just redness.
About an hour later, while taking a shower, I began to feel significant pain in the left temple area, which spread to behind my ear, and biting down on my left teeth caused pain.
I then went to sleep, and when I woke up the next day, there was no pain on either side, but later I felt a slight headache, and suddenly I had a sharp pain in the back of my head, which passed quickly.
Just now, I started to feel pain in the bone behind my left ear.
I would like to know what my condition might be, whether I should continue applying ice, or if I should go directly to the hospital.
Should I see a surgeon or a neurologist? I am concerned because I did not hit my temple, yet I am experiencing pain.
Thank you, Doctor! Ms.
Tseng.

Ms. Zeng, 20~29 year old female. Ask Date: 2017/01/06

Dr. Jiang Junyi reply Neurology

Hello, based on your described symptoms, they are very similar to those of cervical myofascial injury.
Clinically, it often presents as pain at the affected site, discomfort, muscle stiffness, or a sensation of heaviness.
Sometimes, palpable myofascial trigger points can be felt subcutaneously, as the muscle fascia connects to the forehead and temples.
During the acute phase, symptoms may include localized muscle tension, spasms, and limited range of motion.
Generally, ice therapy should be applied within the first 48 hours, primarily to reduce hematoma formation and alleviate pain.
I recommend consulting with a rehabilitation specialist or a neurologist/neurosurgeon for further evaluation and treatment.
Wishing you good health and peace.

Reply Date: 2017/01/06

More Info

Hello Ms. Tseng,
Thank you for sharing your experience regarding your head injury. Based on your description, it seems that you have sustained a head trauma, specifically to the occipital region (the back of your head), which has led to pain radiating to the temple and behind the ear. This type of pain can be concerning, especially when it involves areas that are innervated by the trigeminal nerve, which is responsible for sensation in the face, including the temple and jaw areas.

When you experienced the initial impact, it is a good sign that you did not lose consciousness or experience dizziness, as these can be indicators of more severe injuries such as concussions or intracranial bleeding. However, the pain you described, particularly the "internal throbbing" and the subsequent pain in the temple and behind the ear, suggests that there may be some irritation or inflammation in the surrounding tissues or even a potential mild concussion.

The fact that you experienced pain radiating to your teeth when biting down could indicate that the trigeminal nerve is involved, as this nerve has branches that innervate the teeth and jaw. This type of referred pain can occur due to nerve irritation or inflammation following trauma.

In terms of management, continuing to ice the area can help reduce any swelling and alleviate pain. Ice should be applied for 15-20 minutes every hour as needed, but be sure to protect your skin by placing a cloth between the ice and your skin. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can also be beneficial in managing your pain.

However, it is essential to monitor your symptoms closely. If you experience any of the following, you should seek medical attention immediately:
1. Worsening headache: If your headache becomes severe or does not improve with over-the-counter medications.

2. Nausea or vomiting: If you start feeling nauseous or vomit, this could indicate increased intracranial pressure.

3. Changes in vision: Blurred or double vision, or any other visual disturbances.

4. Confusion or difficulty concentrating: If you find it hard to think clearly or if your behavior changes.

5. Weakness or numbness: If you experience weakness or numbness in any part of your body, particularly on one side.

6. Seizures: Any seizure activity should be evaluated immediately.

Given your symptoms, it may be prudent to consult a healthcare professional. If you decide to seek medical attention, a visit to a neurologist would be appropriate, as they specialize in conditions related to the nervous system, including head injuries. They may recommend imaging studies, such as a CT scan, to rule out any intracranial bleeding or other serious injuries.

In summary, while your symptoms may be manageable at home with rest, ice, and over-the-counter medications, it is crucial to remain vigilant for any worsening symptoms. If you have any doubts or if your symptoms change, do not hesitate to seek medical care. Your health and safety are the top priority.

Wishing you a speedy recovery and good health!
Best regards.

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