Sunday, January 8, 2012

A Cold Weather Syndrome.... Very Curious!

Dear Canadian Runner,

I am an ENT and have a few thoughts.  The fact that this is exclusively cold weather induced is the most significant piece of information.  This is actually very common, except that most people's pain goes away once they cover their ears.  With you, however, this does not help.  I agree that most likely this is nerve related caused by cold exposure to the face, or cold air within the nose, mouth or throat.  I'd be very interested to hear if wearing a face warming mask while running helps.

The jaw joint (TMJ) is an extremely common cause for ear pain, and the fact that your jaw locks in association with the ear pain is very suspicious.  But, why does your jaw do this in cold and not otherwise?  Do you clench in the cold?  If so, you may have an answer to the cause.  Even if you don't, the TMJ and ear share some of the same nerves and both issues may be cold/nerve induced.

Eustachian tube problems remain a possible cause, and you have some history and symptoms to suggest this as a cause, but usually that shouldn't be temperature related.

I agree seeing an ENT would be valuable as they can do exams and testing that should narrow the possible causes, and hopefully give you a diagnosis and resolution of the problem.

Keep me posted on how things go.  I'm interested in hearing what happens.

Good luck!  I hope we have helped.



Anonymous said...

Hi DOC123,

Thanks very much - I really appreciate your weighing in on this. I am going to try to get in to see an ENT, however in the interim I can answer a few of your questions.
I think that wearing a face warming mask might help, as I feel sensitive to the cold both inside and out (I actually never thought about that, but as soon as you mentioned it - lightbulb). Do you know where I could get this? I've looked a lot for colder weather running gear and I don't think I've seen one.
With respect to my jaw, I'm not sure about the cause. I don't clench in the cold and actually tend to run with my mouth slightly open.
Offhand (and I do promise to investigate this myself), do you think that I need to be concerned about preserving my hearing? Is this something that's simply annoying or something that you think requires medical attention?
Thanks for everything!

MD.STAT_DOC123 said...

First, I think it is very unlikely that your problem represents some serious, or something that might threaten your hearing. Of course, you can only know so much based this type of medical opinion. Therefore, I will always suggest you see a medical expert to evaluate this further. That being said, I think this is probably only an annoying issue. All in all, not many people run in the conditions you do.

As a test, I would just get a cheap full-face ski mask (the ones with eye and mouth holes). You may look like a running bank robber, but it might be worth a try.

I appreciate your gratitude. Best of luck. Stay in touch.

Anonymous said...

Hi Doctors - Canadian runner here
I wanted to let you know that I am waiting for my family physician to set up an appointment with an ENT, although she said it may be a bit of a wait due to the non-urgency of my situation.
Also, I understand that this is completely not the purpose of the site, but I have been granted a few interviews at medical schools in Southern Ontario, and, well - any advice? :)

MDSTAT_ER_DOC_1 said...

Dear Canadian Runner,
I'm sure we all would offer some advice looking back. The most important of which is this.... if you are sure you want to be a doctor then go to it. If you are going to try and be a doctor AND a mom AND a runner AND a wife, well, it's just very hard. Medicine is all consuming in that way. If you have that part worked out what kind of advice are you seeking regarding your interviews?