An Overview of Carotidynia

Carotidynia is also called Fay syndrome. It is a rare idiopathic pain syndrome. It affects the neck and face. It is not usually serious and tends to go away on its own.

The condition is "idiopathic" because it happens suddenly for unknown reasons.

Carotidynia was first described in 1927. Even today, the medical community is divided as to whether it is a disorder of its own or a symptom of another condition.

People with carotidynia have pain and tenderness near the carotid artery. The pain is usually unilateral, which means it is only on one side of the neck.

Pain in the area can also be caused by more serious conditions. These conditions need to be ruled out before a diagnosis can be made.

This article looks at the pain syndrome carotidynia and its symptoms, causes, and diagnosis. It also discusses treatment.

Symptoms of Carotidynia

People with carotidynia have neck tenderness and pain. The pain is usually where the carotid artery divides into two branches.

The carotid arteries provide blood to the head. They run along both sides of the neck. The pain from carotidynia, however, is typically only on one side.

The pain may be sudden and severe. Patients often describe it as throbbing.

Patients with this syndrome usually do not have an injury to the head or neck. The pain is generally not associated with a recent infectious illness.

Patients may also have some swelling or fullness where the carotid artery divides. The carotid pulse may be more pronounced.

People with carotidynia don't usually have fever. They don't usually feel unwell, either. They often have stressful jobs. In some cases, the syndrome occurs in people who get migraine headaches.

Neck pain and tenderness in the region can also occur in people who have carotid artery disease. Severe pain can also be a sign of more serious conditions. Giant cell arteritis is one example.

Causes of Carotidynia

The exact cause of carotidynia is unknown. It may be a distinct but uncommon condition. It may also be a symptom of other conditions that affect the head, neck, and jaw.

Inflammation seems to play a role in the development of the syndrome. Researchers have found lymphocytes in tissue samples from patients with carotidynia. These white blood cells are associated with chronic inflammation.

The exact cause of the inflammation is not well understood. Research on the subject is limited.

Characteristics of carotidynia pain include:

• The pain is sudden and unexplained
• The pain is on one side of the neck
• The pain is over the carotid artery

People with these symptoms may undergo imaging studies. In patients diagnosed with carotidynia, these tests often show:

• Inflammation
• Swelling
• Thickening of the artery

Carotidynia is different from other causes of neck pain because there are no structural abnormalities in the neck, jaw, or artery.

Diagnosis of Carotidynia

The diagnosis is usually made after all other potential causes have been ruled out. Medical professionals sometimes call this a "diagnosis of exclusion."

Some conditions that cause neck pain can be serious and potentially life-threatening. When a person has neck pain, tests can rule out many of these conditions.

Tests that may be ordered include:

• A physical exam where the doctor palpates or feels the neck.
• Imaging tests like an MRI, MR angiogram, CT scan, CT angiogram, ultrasound of the head and neck, and most recently PET-CT.
• Blood tests that look for viruses, bacteria, or other abnormalities.

A physical exam of the neck may be very painful for someone with carotidynia. Imaging tests may be normal.

Some patients diagnosed with carotidynia have signs of inflammation near the carotid artery. The area may also look fuller or more swollen than the other side.

Blood tests, including those that look for markers of inflammation, are often normal.

How Carotidynia is Treated

People usually recover completely from carotidynia without any long-term problems. The pain usually begins to improve within a week.

There is no specific treatment for carotidynia. Over-the-counter anti-inflammatory pain medications such as Bayer (aspirin) and Advil (ibuprofen), can be helpful.

Drugs called calcium channel blockers have also helped some patients.

In some cases, steroids such as prednisone have helped reduce inflammation. These medications should not be taken for a long time.

A person who has been prescribed steroids will need to work closely with a doctor to reduce the dose and stop the drugs safely.

When carotidynia occurs in people who get migraines, standard migraine treatments can help.

Summary

Carotidynia is a rare pain syndrome. Its cause isn't known. Researchers don't know if it is a disorder or a symptom of other conditions.

People with carotidynia have sudden pain on one side of the neck. The pain occurs over the carotid artery. It isn't usually associated with injury or illness.

Diagnosis is often made after ruling out other conditions. A physical exam, imaging tests, and blood tests can help a healthcare provider diagnose carotidynia.

Carotidynia usually starts to improve within a week. There is no standard treatment for the syndrome, but it can be managed with medication.

A Word From Verywell

People with carotidynia have neck tenderness and pain. It is usually one-sided over the carotid artery. The pain can be sudden and severe.

Diagnosis involves the exclusion of other conditions including injury or illness.

Carotidynia usually resolves without any long-term issues. In most cases, it can managed with medication.

Carotidynia is generally not serious and does not tend to recur. Still, any sudden, severe neck pain should be evaluated by a doctor.