What is causing shooting pains in my neck and jaw?

I have been suffering for months with a shooting pain that runs from the left side of my neck up to my jaw and on to the back of my ear.

- DR ROSEMARY LEONARD

Q It is quite painful, and I dare not move until it has gone. It lasts from around 20 to 40 seconds. It first started happening once or twice a day but now, three months on, it's up to six times a day. Should I be worried? I take statins and am 75.

A Shooting pains are often a symptom of neuralgia, caused by an irritated or damaged nerve. The most well-known form of this is trigeminal neuralgia, which causes pain in the face, but it can occur anywhere, and I suspect you have occipital neuralgia.

The occipital nerve runs up from the base of the neck and has branches that go up to the top of the scalp, and also behind the ear on each side. Though sometimes no cause can be found for this, in older people, pressure on part of the nerve from arthritic changes in the neck can often be to blame. Any tension in the neck muscles can make this worse.

Standard painkillers, such as paracetamol or ibuprofen, don't usually help neuralgia, which is better tackled with other types of pain-relieving agents, such as amitriptyline or gabapentin. These have to be taken regularly, every day, and they work gradually, not straight away, so you do need to be patient when you start treatment. They are only available on prescription.

But it is also important to investigate and treat any possible underlying cause. A neck X-ray can usually show if there is arthritis in the neck, and in addition, a CT or MRI scan may be helpful in showing if there is pressure on any of the nerves. If you do have arthritis, then physiotherapy and regular neck exercises can help relieve associated tension in the muscles.