Pain In The Chin : Causes, Symptoms, Diagnosis & Treatment

• Why Does My Chin Hurt
• Traumatic Injuries
• Purulent Processes
• Trigeminal Neuralgia
• Dental Pathologies
• Atypical Facial Pain
• Other Reasons
• Diagnostics
• Treatment
• Conservative Therapy
• Surgery

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, constant, short-term, growing, weak, intense, aching, twitching, arching, shooting. The cause of the symptom is established according to the survey, general and dental examination, additional studies. Treatment is carried out with the use of analgesics, antibiotics, anticonvulsants and other drugs. Operations are carried out according to indications.

Why does my chin hurt

Traumatic injuries

The most common traumatic cause of a symptom is a bruise. Occurs as a result of a fight or fall. It is manifested by moderate, gradually subsiding local pain, swelling. Hemorrhage or hematoma formation 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 body of the lower jaw are the result of intense traumatic impact: frontal impact, road accident, heavy objects falling on the face. The pain is very sharp, intense, slightly reduced over time. Hematomas and bruises form on the skin. On the mucosa, hemorrhages appear, with an open fracture, bleeding develops. Swelling builds up quickly. There are staggering of the dentition, mobility and, often, dislocations of the 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 pyodermas:

• Ostiofolliculitis. Occurs most often. Initially, there is a zone of redness, slight soreness, aggravated by pressure. The pain intensifies, a cone-shaped pustule with a yellow apex up to 0.5 cm in size is formed. Then a brownish crust that falls off on its own is formed.
• Folliculitis. When 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 slight, bursting, when touched - moderate. The pustule opens, leaving behind a small sore that heals with the formation of a scar or area of ​​hyperpigmentation.
• Furuncle. Purulent infiltrate increases, turns into a cone-shaped crimson node. Pain at first dull, bursting, quickly intensify, become twitching, pulsating. There is extensive swelling. A fluctuation zone is formed. After the discharge of pus and rejection of the rod, the pain quickly decreases.

Adenophlegmon of the chin is not pyoderma, it develops as a result of suppuration of the submental lymph nodes after dental operations (for example, tooth extraction), with regional lymphadenitis of various origins. Pathology is manifested by a progressive pain syndrome of arching, twitching character. A dense swelling forms on the chin, which quickly spreads to nearby areas. Palpation is sharply painful. There is severe intoxication.

Osteomyelitis in this anatomical zone is post-traumatic in nature, affects the body of the lower jaw with open fractures, deep wounds with subsequent suppuration, the spread of local purulent processes to solid structures. With good drainage, the pain is moderate. They increase with the involvement of the bone, accompanied by an increase in edema and hyperemia of the wound edges. In the absence of a path for the outflow of pus, the pain quickly becomes unbearable, complemented by a pronounced intoxication syndrome.

Pain in the chin

trigeminal neuralgia

Pain in the chin appears when the third branch of the trigeminal nerve is involved, spreads to the lower lip, lower jaw, gums, and oral mucosa. Pain paroxysms are short-term, but extremely intense, reminiscent of electrical discharges, occur one after another, forcing patients to freeze without movement. The provoking factors of neuralgia are shaving, talking, laughing, chewing, the effect of cold.

Dental pathologies

Reflected odontogenic pain in the chin is detected when the 1st premolar, canine and incisors are affected. They are caused by the propagation of impulses along the autonomic nerve fibers to the corresponding zone of Zakharyin-Ged. They can be aching, boring, pulling, shooting. Sometimes they develop in the absence of pain in the affected area. They are provoked by the extraction of teeth, 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 - painful, but more often of medium intensity. Undulating, disturbing often or constantly, aggravated by external stimuli, in many patients it disappears at night. Often combined with facial pain of other localizations, migraines, pain in the back.

Other reasons

Irradiating pain in the chin can be disturbing 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 downward to the shoulder girdle. They may be blunt or shooting, aggravated by exertion. In patients with stylohyoid syndrome, the pain is unilateral, dull, occurs under the jaw, radiates to the chin, TMJ, ear, root of the tongue. When turning the head, the cough becomes stabbing, sharp. Gradually progresses. Complemented by dysphagia, sensation of a foreign body in the throat.

Diagnostics

The cause of the pain syndrome is established by the maxillofacial surgeon. According to the indications, patients are examined by a neurologist, dermatologist, and other specialists. During the conversation, the doctor specifies how long the pain has been bothering, after which it appeared, how the disease developed, what other symptoms were accompanied. During the examination, local changes are detected (hematomas, bruises, redness, swelling, the presence of infiltrate), the general condition is assessed for intoxication syndrome.

Dental examination is necessary if odontogenic pain is suspected. Helps to detect the causative tooth, alveolitis of the socket of the extracted tooth, etc. With superficial pyoderma, dermatoscopy is recommended to determine the depth of the lesion. To clarify the diagnosis are assigned:

• X-ray of the lower jaw. It is a basic study for fractures and osteomyelitis. In the first case, the fracture line is visible on the images, it is possible to set the direction and degree of displacement of the fragments, and choose the optimal fixation option. In the second, the eroded ends of the fragments, areas of destruction, sequesters are visible on the radiographs. When using the technique, it is taken into account that radiographic signs of osteomyelitis appear only a month after the onset of the disease.
• Other Imaging Techniques . Orthopantomography may be required for patients with stylohyoid syndrome and dental disease. In stylohyoid 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 arteries of the neck.
• Microbiological Research . With superficial pyoderma, as a rule, it is not required. In other cases, the discharge or punctate is sown on nutrient media to determine the nature of the pathogen and its sensitivity to antibiotics. In most cases, staphylococci are found.
• Other laboratory tests . With purulent lesions in the general blood test, an increase in ESR, leukocytosis with a shift to the left is determined. Patients with adenophlegmon, severe osteomyelitis need a comprehensive examination, including biochemical tests to assess the general condition of the body and blood cultures for sterility to exclude sepsis.

Dental checkup

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 early days, painkillers are prescribed, and 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 are anticonvulsant drugs, which are combined with drugs to improve microcirculation, antispasmodics, antihistamines and therapeutic blockades to increase efficiency.
• Dental diseases . Organize local events. According to indications, it is recommended to take antibiotics and analgesics.
• Atypical prosopalgia . A good result is provided by tricyclic depressants and anticonvulsants (both separately and as part of complex therapy). With intense pain, botulinum toxin is injected to temporarily reduce sensitivity.
• Stylohyoid syndrome . NSAIDs, sedatives, blockades with corticosteroids and local anesthetics, ultraphonophoresis with hydrocortisone are prescribed.

Surgery

For patients with chin pain, the following surgeries may be indicated:

• Jaw fracture : different types of open osteosynthesis.
• Purulent lesions : opening, drainage of boils and adenophlegmon.
• Neuralgia : destruction of the nerve root by local gamma rays, percutaneous radiofrequency destruction.
• Stylohyoid syndrome : partial styloidectomy (resection of the apex of the styloid process).