Pain in the chin
Pain in the chin occurs with traumatic injuries, local purulent processes, trigeminal neuralgia, atypical prosopalgia. In patients with dental pathologies and myositis of the cervical muscles, it has an irradiating character. It can be acute, dull, permanent, short-term, increasing, weak, intense, aching, jerking, bursting, shooting. The cause of the symptom is established according to the survey, general and dental examination, additional studies. Treatment is carried out using analgesics, antibiotics, anticonvulsants and other drugs. According to the indications, operations are performed.
Why does my chin hurt
Traumatic injuries
Purulent processes
Trigeminal neuralgia
Dental pathologies
Atypical facial pain
Other reasons
Diagnostics
Treatment
Conservative therapy
Surgical treatment
Prices for treatment
Why does my chin hurt
Traumatic injuries
The most common traumatic cause of the symptom is a bruise. Occurs as a result of a fight or a fall. It is manifested by moderate, gradually subsiding local pain, edema. The formation of hemorrhages or hematomas is possible. Opening the mouth is not difficult or slightly limited, all manifestations disappear after 1-2 weeks. Hematomas, as a rule, resolve on their own, an autopsy is required very rarely.
Median, mental and lateral fractures of the lower jaw body are the result of intense traumatic effects: frontal impact, road accident, falling of heavy objects on the face. The pain is very sharp, intense, decreases slightly over time. Bruises and bruises form on the skin. Hemorrhages appear on the mucous membrane, bleeding develops with an open fracture. Swelling is rapidly increasing. There is a stepped dentition, mobility and, often, dislocations of teeth.
Purulent processes
Due to the peculiarities of the skin, the increased fat content of this area of the face, possible contamination and contact with mechanical irritants, the chin is a favorite localization of superficial and deep pyoderma:
Ostiofolliculitis. It occurs most often. Initially, there is a zone of redness, slight soreness, which increases with pressure. The pain increases, a cone-shaped pustule with a yellow tip up to 0.5 cm in size is formed. Then an independently falling brownish crust is formed.
Folliculitis. When the inflammation spreads to the entire depth of the hair follicle, folliculitis develops. The symptoms are the same, but more pronounced than in the previous case. Pain at rest is insignificant, bursting, when touched – moderate. The pustule is opened, leaving behind a small ulcer that heals with the formation of a scar or a hyperpigmentation site.
A boil. The purulent infiltrate increases, turns into a cone-shaped purple knot. The pain is initially dull, bursting, quickly intensifying, becoming twitching, pulsating. There is extensive swelling. A fluctuation zone is formed. After the discharge of pus and rejection of the rod, the soreness decreases rapidly.
Adenophlegmon of the chin is not pyoderma, it develops due to suppuration of the subcutaneous lymph nodes after dental operations (for example, tooth extraction), with regional lymphadenitis of various genesis. The pathology is manifested by a progressive pain syndrome of a bursting, twitching nature. A dense swelling forms on the chin, quickly spreading to nearby areas. Palpation is sharply painful. Severe intoxication is noted.
Osteomyelitis in this anatomical zone has a post-traumatic character, affects the body of the lower jaw with open fractures, deep wounds with subsequent suppuration, the spread of local purulent processes on solid structures. With good drainage, the pain is moderate. They increase with bone involvement, accompanied by an increase in edema and hyperemia of the wound edges. In the absence of a pathway for the outflow of pus, the pain quickly becomes unbearable, supplemented by a pronounced intoxication syndrome.
Trigeminal neuralgia
Pain in the chin appears when the third branch of the trigeminal nerve is involved, spreads to the lower lip, lower jaw, gum, and oral mucosa. Pain paroxysms are short-term, but extremely intense, resemble electrical discharges, occur one after another, forcing patients to freeze without movement. Shaving, talking, laughing, chewing, and the effect of cold act as provoking factors of neuralgia.
Dental pathologies
Reflected odontogenic pains in the chin are detected when 1 premolar, canine and incisors are affected. They are caused by the propagation of impulses along autonomic nerve fibers to the corresponding zone of Zakharyin-Ged. They can be aching, drilling, pulling, shooting. Sometimes they develop in the absence of painful sensations in the affected area. They are provoked by tooth extraction, surgical operations, pulpitis.
Atypical facial pain
The chin is one of the possible localizations of atypical prosopalgia. The pain is deep, aching, dull, debilitating. Sometimes it is painful, but more often of medium intensity. Undulating, worries often or constantly, increases under the influence of external stimuli, disappears at night in many patients. It is often combined with facial pain of other localizations, migraines, painful sensations in the back.
Other reasons
Radiating pains in the chin can bother with myositis of the cervical muscles. They appear after hypothermia, are localized along the front surface of the neck, from where they spread upward to the chin and down to the upper arms. They can be blunt or shooting, they increase with physical exertion. In patients with shilopodylingual syndrome, the pain is unilateral, dull, occurs under the jaw, gives to the chin, TMJ, ear, root of the tongue. When turning the head, coughing becomes stabbing, sharp. Gradually progressing. It is supplemented by dysphagia, a feeling of a foreign body in the throat.
Diagnostics
The cause of the pain syndrome is determined by the maxillofacial surgeon. According to the indications of patients, a neurologist, a dermatologist, and other specialists are examined. During the conversation, the doctor clarifies how long the pain has been bothering, after which it appeared, how the disease developed, and what other symptoms it was accompanied by. During the examination, local changes are detected (hematomas, bruises, redness, swelling, the presence of infiltration), the general condition is assessed for intoxication syndrome.
Dental examination is necessary if odontogenic pain is suspected. Helps to detect the causal tooth, alveolitis of the hole of the removed tooth, etc. In case of superficial pyoderma, dermatoscopy is recommended to determine the depth of the lesion. To clarify the diagnosis , the following are prescribed:
Radiography of the lower jaw. It is a basic study for fractures and osteomyelitis. In the first case, the fracture line is visible in the pictures, you can set the direction and degree of displacement of the fragments, choose the optimal fixation option. In the second, the X-ray images show the pitted ends of the fragments, areas of destruction, sequestration. When using the technique, it is taken into account that radiological signs of osteomyelitis appear only a month after the onset of the disease.
Other visualization techniques. Orthopantomography may be required for patients with shilopodilingual syndrome and dental diseases. With the shilopod lingual syndrome, MSCT of the temporal bone and radiography of the soft tissues of the neck are also performed to visualize the deformed styloid process and calcified ligament, ultrasound or contrast MR angiography to confirm compression of the neck arteries.
Microbiological examination. With superficial pyoderma, as a rule, it is not required. In other cases, seeding of the separated or punctate on nutrient media is performed to determine the nature of the pathogen and its sensitivity to antibiotics. In most cases, staphylococci are detected.
Other laboratory tests. With purulent lesions, an increase in ESR, leukocytosis with a shift to the left is determined in the general blood test. Patients with adenophlegmon, severe osteomyelitis need a comprehensive examination, including biochemical tests to assess the general condition of the body and blood culture for sterility to exclude sepsis.
Dental examination
Dental examination
Treatment
Conservative therapy
The list of therapeutic measures is determined by the nature of the pathology:
Fractures of the lower jaw. A linear fracture of the body without displacement is an indication for double-jaw wire splinting. The patient is recommended a sparing diet. In the first days, painkillers are prescribed, antibiotics are used for open injuries.
Purulent processes. The skin around the hearth is treated with disinfectants and alcohol solutions. Antibacterial drugs are selected taking into account the sensitivity of the pathogen. The therapy regimen includes anti-inflammatory drugs, immunomodulators, immunostimulants, vitamin complexes.
Neuralgia. The basis of treatment is anticonvulsant medications, which are combined with medications to improve microcirculation, antispasmodics, antihistamines and therapeutic blockades to increase efficiency.
Dental diseases. They hold local events. According to the indications, it is recommended to take antibiotics and analgesics.
Atypical prosopalgia. Tricyclic depressants and anticonvulsants provide a good result (both separately and as part of complex therapy). With intense pain, botulinum toxin is injected to temporarily reduce sensitivity.
Shilopodilingual syndrome. NSAIDs, sedatives, blockades with corticosteroids and local anesthetics, ultraphonophoresis with hydrocortisone are prescribed.
Surgical treatment
Patients with chin pain may be shown the following operations:
Jaw fracture: various types of open osteosynthesis.
Purulent lesions: autopsy, drainage of boils and adenophlegmon.
Neuralgia: destruction of the nerve root by local gamma rays, percutaneous radiofrequency destruction.
Shilopodylingual syndrome: partial thyroidectomy (resection of the tip of the styloid process).
