Myofascial pain syndrome is among the most common conditions the patients present to the dental department. It is characterised by pain in the muscle and fascia of the face. The pain can often result in limited mobility of the TMJ and supporting structures.
While myofascial pain can occur in any part of the body, especially the neck, shoulders and back - the most severe effects of myofascial pain can be observed on the face. Women in their twenties and those around menopause are commonly affected.
What Causes Myofascial Pain?
Myofascial pain starts from a knot of muscles which can be a trigger point. The knot results in the blockage of blood flow which can lead to reduced oxygen supply to that area. Therefore, the lack of oxygen and accumulation of waste can irritate the trigger point. The point then sends out pain signals which are often translated as a lack of activity by the brain. The lack of mobility in the muscle can lead to muscle weakness which results in a poor range of motion.
Physical causes include poor posture, stress, muscle injury, muscle strain and a cold environment.
How to Diagnose the Condition?
Myofascial pain syndrome requires an extensive workup to diagnose the condition. In most instances, the condition gets overlooked and undiagnosed. The symptoms are not physically, making it impossible for the dentist to diagnose them with the help of imaging and blood work. Clinical examination is always the best bet, along with evaluating the patient's symptoms. Meanwhile, a Polysomnography test should be done if sleep-disordered breathing is suspected.
Physical Examination
Since the physical examination is the best option to diagnose the condition, it requires thorough evaluation. It allows the dentist to evaluate the taught spots and identify the trigger points. Palpating the trigger point results in pain immediately at the site or a short distance - referred pain.
Symptoms of Myofascial Pain
With myofascial pain syndrome, the symptoms can vary from patient to patient. The pain can range from minor flare-ups to constant and lingering dull pain. Pain and tenderness of the masticatory muscles can also be observed. It can lead to limitations in jaw opening and excursion, along with muscle fatigue. Patients often complain of pain at a single spot which can be a trigger point.
In patients with parafunctional habits, the symptoms often tend to aggravate.
Treatment Options for Myofascial Pain
Mild analgesics are the most appropriate treatment resource for patients with myofascial pain. Over-the-counter heat patches and mouth guards can be used for pain relief. However, such devices are only applicable for short-term usage since mouth guards can create unwanted tooth movements leading to increased muscle activity.
Low doses of anxiolytics along with NSAIDS or acetaminophen are indicated for long-term use. In chronic cases, antidepressants can be advised under the guidance of a medical practitioner.
Counselling, physical therapy, and relaxation techniques are also some of the modalities often used to treat myofascial pain syndrome.
In most cases, the condition usually subsides within 6-12 months. However, it is best advised to consult your dentist to prevent the acceleration of pain and symptoms.
