@dr-go
Thank you Richard and Dr Go
The neurologist I am seeing is the 4th. 2 of the other 3 were professors. This last one has tried the gabapentin and he is suggesting that the next least invasive thing is some very small botox injections. Having looked at MRIs etc he suggests that exploratory surgery runs great risk in further irritating nerves that are sending the pain signals.

Believe me I have searched the web, including emailing with a neuro prof in germany , one at Mt Sinai NY etc etc and knocked on pretty much every door available to me, even trumpet professors in US but everyone shakes their head in unbelief saying can't help, never heard of it, too hard.

Thanks again
Doug

@richard-iii
Richard
symmetrical when purse lips/form embouchure.
thanks again
Doug

@richard-iii
Thanks Richard
Nothing sagging.
Not painful to pressure except when it is already sore. Can contract muscles whilst pressure applied.
When not sore or painful there is no numbness.
After a lot of talking etc when it gets sore then there is a slight feeling of numbness, tingling etc in top lip (moustache area), dimple area when gets worse can spread to lower lip and vaguely into chin area.
Sorry Its a bit hard to be very specific at minute as I talked a fair bit yesterday (out with brother fishing) and still paying for it this morning (being about maybe 12- 16 hrs in front of you in US)
thanks for your interest
best wishes
Doug

@sessionaire
Thank you all for your time and contributions. My location approx 2 hours from Sydney.
And yes I know it is impossible to diagnose/recommend in absentia 10,000 miles away.
I am just looking for someone who may have had to walk the same journey...
A bit more history...to explain why I am at my wits end..

a) I have spent an incredible amount of $$$ and time in travelling probably 20 or more times to Sydney for consults basically a 6 hour round trip incl a consult.
b) Previously I have seen 3 other Neurologists at the professor level, and facial pain Clinic professor,
these have tried baclofen, Lyrica gabapentin and perhaps others that I cannot recall,
c) TENS machine and xylocaine
d) also a PhD physio professor who specialises in rehabbing brass musos in symphony orchestras using ongoing speciality exercises etc specifically, no change.

e) When visiting Chicago in 2011, I spent 2 hrs with one of the best known trumpet players/teacher there who said my technique was fine.
f) 2 x 10 week long sessions of acupuncture with 2 different practitioners,

The most recent MRIs and Ultrasounds have been in the last 10 months.

g) A cosmetic/plastic surgeon (one of the best in the nation) has recently offered to do exploratory surgery... but why would I want to create additional scar tissue??

h) learning more about anatomy I believe the junctions/connections between the Orbicularis Oris and Buccinators on both sides were damaged?? producing scar tissue? trapped nerves?

i) the latest Neurologist that I am currently consulting with tried me on Gabapentin for 2 months with dose as high as 300mg 3 times per day with minimal impact and unacceptable side effects.
He has suggested botox as he uses a lot with good results for migraine sufferers.

sorry to waffle.. but this is the bullet point summary..

I struggle to talk any more than a few short conversations per day and if above that then need to resort to paracetemol and xylocaine.
hence my frustration and interest in trying botox.. no one can offer me anything , buzzing a mouth piece etc and doing "restorative" exercises are not practical/possible.
Thanks for your comments Dr Go, I am torn....

thanks all
Doug

Greetings all, I am a damaged (ex ? ) trumpeter...I had been playing, trumpet and Fluegel regularly, mostly in "church rock bands" for over 30 years...
long story short, lip strain?/overuse? (orbicularis Oris) injury whilst playing (felt it happen) 12 years ago. End of lips both sides. I have had ongoing pain since then. It only pains if I talk, sing, whistle smile etc. Need to limit talking to only several short conversations per day. I am sick of taking analgesics and applying Xylocaine anaesthetic cream when it gets severe. If I remain in a "vow of silence" the pain subsides. I have not played since injured, very sad indeed ....I have sought solutions/remedies all over the world for last 10 plus years, MRIs and ultrasounds show no abnormality and there has been no surgery or obvious physical damage. I have had countless consults and discussions in person and via phone and web with Drs, professors, Neuros etc etc ... latest attempt to reduce pain was taking gabapentin, the small amount of relief was not worth the side effects of taking it.. The next (last?) throw of the dice is my Neurologist wants to try small botox injections at end of lip area... any one any thoughts? ideas? advice? experience??..
I do thank Steven very much for his thoughts on matter, over last couple of months. I just thought I would cast the net out again as I imagine the botox effects (side effects) will last at least 3 months.
Whilst I have taken up guitar and bass, which I do enjoy, it just doesn't "cut the mustard" with what you can express with a horn
To be pain free and normal again is the goal.. to play again would be an amazing bonus..
Thanks for taking the time to read my plaintive plea
Take care
stay well, God Bless Doug

Dear all
thanks so much for taking the time to reply... to answer a couple questions/clarify
... started playing late teens mostly twice a sunday in church plus other occasional gigs, rehearsed usually several times per week (ie whenever i could make the time , as trumpeters we just love to play)
I was 58 when "incident occurred" . had played a lot in the sunday morning service and in afternoon was rehearsing some high fanfares for christmas carols event.. eg Cs above the staff...lips were feeling a bit tired and then just had the feeling both sides, end of lip/dimples area.. pain etc

last few months the pain has nose dived.. I am popping analgesics like lollies ( yes I know that is not a good thing medically) and also need to use xylocaine topically to get relief...
talking now is a painful proposition.. ego gone, social life non existent
had to cross over to the dark side.. ie start to learn to play guitar...

thanks again for any thoughts
best wishes from down under

(2 trumpets, 2 Flugels and trombone in storage)

Greetings
I have a question re an injury....
I experienced an overuse injury? happened suddenly... when playing high Cs etc
sharp sensation, then pain, both sides of my face at the "end of the moustache ' area ie in dimples area...stopped playing ... 10 years later still not playing still have the pain which is frustrating, debilitating etc.. Have searched 'the world" via google etc etc for answers, spent heaps and heaps on analgesics, medical consults, ultrasounds, MRI scans etc. nothing shows up. Spoken with a number of trumpet professors etc..I have not found anyone in the medical world who has a clue. has anyone else heard of this, any clues , ideas. It seems lots of folks damage lips, get bruising , even split lips, seems they all rehabilitate... not me... any thoughts.... the pain is ongoing...
thanks for your time..
enjoy your playing
best wishes
stay away from the virus