The Doc Replies

Our expert answers your medical questions

What is trigeminal neuralgia?

A sudden and severe facial pain that usually feels sharp, like an electric shock. It can affect the side of the face, jaw, teeth and gums. Usually they’re quite brief attacks, which suddenly start and stop, usually on one side. Attacks can occur regularly over hours, days or even months, sometimes hundreds of times a day. It can be aggravated by touching the face, brushing your teeth or hair, or washing your face, or can happen spontaneously.

Usually it’s because the trigeminal nerve, a cranial nerve that transmits pain and touch sensations from the face, teeth and mouth, is being compressed by a blood vessel. It can also happen from the nerve being affected by conditions such as multiple sclerosis. It usually starts in middle age and is more common in women.

Initial treatment is carbamazepine, a drug used in epilepsy treatment, that suppresses the nerve impulses and reduces pain messages. The dose is gradually increased until you get response. Sometimes surgery can be an option but only if medication doesn’t work.

When and how should I get a build-up of ear wax treated?

Your ears make earwax to keep them clean but build-up and blockage is common. It can be due to narrow ear canals, people sticking their fingers or cotton buds in their ears, which you should never do as it just pushes the wax in further, and sometimes hearing aids or earplugs. Eardrops from a pharmacy, olive oil, almond oil or sodium bicarbonate can be used ideally several times a day. After three to five days, the earwax will come out by itself.

Is it normal to have chest pain after pulling a side muscle?

If you pull a chest wall muscle, there will usually be pain when taking deep breaths. It can also cause sharp pain or spasms on particular movements. Recovery from muscle pain is down to resting and avoiding movements which pull on the muscle, plus anti-inflammatory drugs or paracetamol. Avoid constant shallow breathing by supporting the chest with your hand to take a deep breath every hour or so.

The Doc Replies

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