Hi @Gtx! Welcome to our forum! You’ve asked some great questions so I’ll answer to the best of my ability.
First, your symptoms do sound like those experienced from ES. I disagree with the ENTS you saw as sometimes calcified ligaments &/or elongated styloids can be felt under the jaw - I had bilateral ES & could feel my left styloid/calcified ligament under my jaw in the area you’re describing for yourself. When I poked the hard “lump” I’d get a shooting pain into the area where my thyroid is. I initially thought it was a problem related to my thyroid but saw an ENT who listened to my symptoms (there were others besides pain at the front of my neck), felt the lump & immediately told me he thought it was ES. He sent me for a CT scan which confirmed I had it bilaterally. On a positive note, it’s great that you have doctors familiar with ES near you!
Your oral surgeon friend’s opinion from your pano x-ray is a valuable one as it confirms what you’re feeling & what you suspected.
ES surgery is major surgery & not to be taken lightly. It can take 6-12 months for nerves irritated by the styloids/calcified ligaments to completely heal, however, many people are able to go back to work, at least part time, starting a couple of weeks after surgery. Physical energy level is reduced for a month or two after surgery thus the need to start back to work gradually as stress & fatigue slow the rate of recovery. We recommend having surgery when the symptoms are severe enough that you can’t function normally from day to day i.e. you don’t need to be bedridden, but if symptoms are keeping you from living your life fully/working competently, then it’s time to consider surgery.
•There are people who have successfully reduced their symptoms for awhile by taking a nerve pain medication such as Gabapentin, Amitriptyline or Carbamazepine. These do have side effects the most common being drowsiness & fatigue. They can also take several weeks to become effective once you start on them.
•Another option is an ultrasound guided injection of lidocaine + cortisone into the tonsilar area in the throat. Some people get several months of pain relief from an injection, whereas others get shorter duration relief or no relief & occasionally this injection makes pain worse. It can only be done about 3x.
•Icing or applying heat to your neck in the painful area(s) can also be helpful. We recommend gel ice packs because they conform to the neck shape - 15 min. on & 45 min. off w/ a thin cloth between ice & skin. If ice doesn’t help, try heat.
•Over time, symptoms do tend to get worse. It may be because the styloids/ligaments calcify further or because they wear on the nerves more over time, but eventually, surgery most likely be necessary for symptoms relief.
•Posture correction can be helpful. With your long hours in front of the computer you likely have forward head posture (AKA Upper Crossed Syndrome). This causes loss of the lordotic curve in your neck, which puts a lot of strain on your shoulders & neck as they have to support your head in a position it wasn’t meant to be i.e. sticking out in front vs upright over your shoulders. There are YouTube videos with exercises that can help restore your neck curve & upper body posture. The following two thread by @vdm have lots of great information on this topic - My Favourite List of Research/Educational Resources
List of my favourite resources on YouTube to learn anatomy
It’s more likely the terrible cough you had either fractured or shifted the calcified stylohyoid ligament on your more painful side than your weight loss being the culprit. However, it is possible that the change in the density of the soft tissue in your neck is also contributing as you suggested. It’s really impossible to know everything that comes into play with ES symptoms. What we do know is that once the calcification is removed, symptoms are often relieved or at least reduced to a more tolerable level.
I have upgraded your account so you can now post images. Please feel free to share your pano x-ray.
.