What is myofascial pain?
Myofascial pain is a condition affecting the skeletal muscles of the body and can affect the jaw, face, and neck muscles. Myofascial pain leads to trigger points (colloquially described as muscle knots) in the muscle tissue that can lead to severe pain and inability to move the affected body part, or with a lot of discomfort. Anatomically, skeletal muscles are separated by layers of deep fascia which consist of collagen and other connective tissue. The elastic property of deep fascia is essential for normal and healthy muscle function, such as neck movement or chewing. Essentially, myofascial pain pertains to the damage of deep fascia and associated muscle malfunction.
What are trigger points? What are other symptoms of myofascial pain?
Trigger points can arise from acute trauma, repetitive overuse of muscles or without any particular reason. Trigger points are characterized as nodules that stimulate pain receptors when touched. The trigger point can refer pain to other muscles and body parts. Some examples to illustrate how trigger points refer pain include:
· pain felt behind the eyes caused by a trigger point in the neck muscles
· a phantom toothache caused by a trigger point in the jaw muscles
· temple headache caused by trigger points in the neck and jaw
Mechanistically, trigger points are taut muscle fibers that release pain-producing neurotransmitters, which stimulate pain receptors (Robbins, 2014). Due to the referral pattern of these trigger points, the diagnosis of myofascial pain can be tricky and a thorough manual palpation of the head, neck and jaw is highly recommended.
Could muscle knots be the cause of facial pain, headaches and TMJ?
Absolutely! Trigger points, or ‘knots’, in the trapezius (upper neck and shoulder blades), sternocleidomastoid (neck), and the temporalis (along the sides of the skull) of the cervical musculature commonly cause facial pain (Robbins, 2014). Headaches and temporomandibular joint pain (TMJ) are characteristics of facial pain. Chronic headaches, such as migraines and tension-type headaches, may derive or be intensified by trigger points in the trapezius and sternocleidomastoid. Trigger points in the sternocleidomastoid and temporalis can refer pain to the temporomandibular joint area (Robbins, 2014).
References: Robbins, Matthew S. and et al. “Trigger Point Injections for Headache Disorders: Expert Consensus Methodology and Narrative Review.” Wiley Periodicals 54.9 (2014): Pages 1441-1459.