Dr. Roach says sore ears could be caused by inflamed cartilage

Dear Dr. Roach: Please, please help me. I’ve visited my allergist, the ear-nose-throat specialist and my own internist. None of them has ever heard of my problem and don't know how to help me.

Starting in 1990, every couple of months I would get an awful pain on one of my ears if I had been lying on it during the night. It would happen to either ear, whichever one I lay on.

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I went to an ear-nose-throat specialist then, who did not know what to make of it.

The pain is so intense that it wakes me. It is not inside the ear but around the edges of the entrance to it. It is so painful that I can’t touch it. It will be throbbing. The only thing that will make it go away is when I stand up. Within 30 minutes, it is gone. I even tested it by massaging behind the ear (once I could bear to touch it), and it seemed to make the pain go away faster. The ENT said my ears are healthy.

I am very much afraid that the day will come when I will no longer be able to lie down in my bed to go to sleep.

I just had an MRI done, and the reading shows no “growths,” according to my doctor’s office.

This ear pain, however, is starting to affect my daily living, since I don’t seem to be able to get the restful sleep I need.

L.T.

Without doing an exam, obviously I can’t be sure, but I wonder if you have relapsing polychondritis. “Relapsing” means that it comes and goes, and “polychondritis” means there's inflammation of different cartilage in the body. The firm, flexible tissue in the ears is cartilage, as is the firm tissue in your nose and your windpipe. Relapsing polychondritis is a rare disease, often with a long delay in diagnosis due to its rarity and intermittent nature. It can affect just one or two areas, as might be the case with you, but it also can affect joints and critical organs, like lungs, heart, kidneys and blood vessels.

It appears to be an autoimmune disease, one in which the body’s defence system attacks its own cartilage. Usually, there is some redness or swelling of the cartilage.

Treatment varies with severity of the disease. Sometimes anti-inflammatories work wonders; other times, people need very powerful immune-suppression drugs. A rheumatologist is most likely to be familiar with this condition. I found a nice support group at health.groups.yahoo.com/group/Rpolychondritis/.

Dear Dr. Roach: I have major back pain. I’ve been to the emergency room and seen many doctors. One gave me hydrocodone then stopped and accused me of being an addict.

I can’t do anything strenuous: just cleaning house leaves me in tears. Is an operation my only choice?

S.G.

In general, there are three kinds of treatment for low-back pain: medication, therapy and surgery. Medications include anti-inflammatories, Tylenol and narcotics, but narcotics like hydrocodone are the least preferred due to both side effects and recent data showing that they don’t help over the long term.

I am sure it must be very frustrating to try to find a medication to help you and be wrongly labelled an “addict.” It can take patience to find a medication that helps.

By therapy, I mean physical therapy, but also acupuncture and chiropractic treatments, which are helpful in many cases.

Surgery is an option, but only for particular types of back pain (confirmed by MRI or other imaging) that aren’t getting better with other treatments.

 

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu

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