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At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we are focused on treating patients after debilitating injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities.

If Dr. Alex Jimenez feels you need other treatment, then you will be referred to a clinic or Physician that is best suited for you. Dr. Jimenez has teamed with the top surgeons, clinical specialists, medical researchers, and premiere rehabilitation providers to bring El Paso the top clinical treatments to our community. Providing the top non-invasive protocols is our priority. Clinical insight is what our patients demand in order to give them the appropriate care required. For answers to any questions you may have please call Dr. Jimenez at 915-850-0900


Myofascial Trigger Pain On The Face

Myofascial Trigger Pain On The Face

Introduction

Everyone in the world has various expressions that reflect how they are feeling. From being excited, worried, sad, angry, and disgusted, facial expressions defy people who they are, what they eat, and how they look. Each of the different muscles that make up the face has other jobs to work at the various locations of the upper extremities. The muscles on the forehead and near the eyes help people see while opening, closing, and raising their eyebrows. The muscles around the nose help take in air to breathe. The muscles located in the jaw help people chew food and speak. The neck muscles help support the head and provide mobility. All these muscles have specific jobs, and when issues affect the upper body extremities, they can potentially lead to different problems. When environmental factors like stressanxiety, or depression begin to affect the body, it can also affect its facial features, causing unwanted symptoms to develop. Today’s article focuses on myofascial trigger pain on the face, the signs and symptoms associated with myofascial facial pain, and how to manage myofascial facial pain. We refer patients to certified providers who specialize in musculoskeletal and oral treatments to aid individuals suffering from myofascial trigger pain affecting their facial muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

How Does Myofascial Trigger Pain Affect The Face?

Have you been experiencing pain-like symptoms in your jaw? What about feeling constant pressure around your nose or cheeks? Do you feel tenderness in certain body areas around your face? Many of these symptoms you are experiencing could potentially involve myofascial trigger pain affecting the facial muscles. Having myofascial trigger pain in the upper extremities of the body can be challenging, as studies reveal that myofascial pain syndrome is a muscular pain disorder that is often misunderstood as it involves referred pain from small, tender trigger pain within the muscle fibers causing pain in different locations of the body than the actual source. Myofascial trigger pain often mimics other chronic conditions that cause doctors to be confused when patients mention that they have been experiencing symptoms and it’s affecting their daily lives. For myofascial trigger pain affecting the face, studies reveal that facial pain associated with myofascial trigger pain can be classified in various ways that affect the nasal, orbital, and oral cavities, the temporomandibular joint, and the sinuses from underlying pathologies. Myofascial pain correlating with the face can have many trigger points that can make a person feel miserable and affect their daily lives.

 

Signs & Symptoms Associated Myofascial Facial Pain

Like the rest of the body, the face has numerous nerves that branched out from the brain in the central nervous system, providing sensory-motor functions to the muscles. The trigeminal nerves help give movement to the face, and when myofascial pain affects the facial regions, studies reveal that the causes can include:

  • Idiopathic factors
  • Trigeminal neuralgia
  • Dental problems
  • TMJ disorders 
  • Cranial abnormalities
  • Infection
  • Acute muscle injury
  • Stress and anxiety

These signs are associated with myofascial facial pain due to common overlapping symptoms affecting each muscle around the face. Some of the symptoms related to myofascial facial pain include:

  • Tingling sensations 
  • Throbbing pain
  • Headaches
  • Toothaches
  • Neck pain
  • Shoulder pain
  • Feeling stuffed up
  • Muscle tenderness

 


Chronic Facial Pain-Video

Have you been experiencing muscle tenderness in certain parts of your face? What about feeling stuffed up around the areas of your cheeks and nose? Or have you been feeling stiffness and pain along your jaw, neck, or shoulders? If you have been experiencing these pain symptoms, it could be facial pain associated with myofascial trigger pain. The video above overviews chronic facial pain and how it affects the head and neck. Research studies reveal that pain affecting the body for more than six months is considered chronic. Just like any other chronic pain symptoms in the body, chronic facial pain causes a neuropathic response to the central nervous system, making an injury hypersensitive and potentially involving associated symptoms from other chronic disorders. Myofascial dysfunction related to facial pain may become severe to activate trigger points along the facial muscle fibers, causing prickling sensations in the face. Luckily, there are available treatments for managing myofascial facial pain.


Management Of Myofascial Facial Pain

When managing myofascial pain associated with the face, many patients will go to their primary doctor and explain that they are experiencing pain and other symptoms that make them miserable. Doctors then examine the patient to see what is ailing them through a physical examination. Some doctors often utilize manual manipulation and other tools to diagnose that myofascial pain might be the cause. As stated earlier, myofascial pain associated with the face can be a bit complex as it can mimic other chronic conditions. Once the doctor diagnoses myofascial pain related to the face, they can refer their patients to pain specialists like chiropractors, physical therapists, physiatrists, and massage therapists to alleviate myofascial pain related to the face by examining where the causes are coming from. Pain specialists incorporate various techniques to relieve myofascial pain associated with the face:

  • Stretch & spray (Stretching the muscle and spraying a coolant spray to loosen tight muscles along the neck)
  • Putting pressure on the trigger point (This helps smooth out the affected muscle and fascia)
  • Gentle stretching exercises (Help strengthen the affected muscles)
  • Hot or cold compress (Helps relax the muscles and break up the adhesion from scar tissue)

Incorporating these treatments can help manage the symptoms associated with myofascial pain and can help alleviate muscle pain, thus preventing further issues from developing over time.

 

Conclusion

The facial muscles have specific jobs with different functions that help the body function properly. These jobs help various sections of the face by expressing how we feel, what we eat and taste, breath, and other jobs that define people. When issues begin to affect the upper extremities of the body, they can cause lead to different problems that affect the facial features of the face and cause unwanted symptoms to develop. This is known as myofascial pain and is often misunderstood,s since it can mimic other chronic conditions that affect the body. Different factors and symptoms associated with myofascial pain can become difficult to diagnose. Still, various techniques can help manage the symptoms over time to prevent further injuries from occurring on the face and the body.

 

References

Fricton, J R, et al. “Myofascial Pain Syndrome of the Head and Neck: A Review of Clinical Characteristics of 164 Patients.” Oral Surgery, Oral Medicine, and Oral Pathology, U.S. National Library of Medicine, Dec. 1985, pubmed.ncbi.nlm.nih.gov/3865133/.

Williams, Christopher G, et al. “Management of Chronic Facial Pain.” Craniomaxillofacial Trauma & Reconstruction, Thieme Medical Publishers, May 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC3052669/.

Yoon, Seung Zhoo, et al. “A Case of Facial Myofascial Pain Syndrome Presenting as Trigeminal Neuralgia.” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, U.S. National Library of Medicine, 25 Dec. 2008, pubmed.ncbi.nlm.nih.gov/19111486/.

Zakrzewska, J M. “Differential Diagnosis of Facial Pain and Guidelines for Management.” Define_me, July 2013, www.bjanaesthesia.org/article/S0007-0912(17)32972-0/fulltext.

Zakrzewska, Joanna M, and Troels S Jensen. “History of Facial Pain Diagnosis.” Cephalalgia : an International Journal of Headache, SAGE Publications, June 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5458869/.

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What Is TMJ Dysfunction?

What Is TMJ Dysfunction?

Introduction

The lower jaw of the body has the mastication muscles surrounding the mandible and provides functionality to the jaw through chewing, moving the lower jaw up, down, left, and right, and speaking. The jaw also has joints known as the temporomandibular joints that slide back and forth to provide movement also. The jaw is also home to the teeth and tongue, which play a role in the mouth by consuming and grinding food into smaller bites to travel down to the gut system. Just like every joint and muscle in the body, common issues or injuries can affect the jaw and cause pain symptoms associated with the problem. Sometimes normal wear and tear can affect the joints in the jaw, or traumatic events can affect the surrounding muscles causing soreness in the jaw area. If the issue involving the jaw is not treated over time, it can lead to chronic disorders and overlap with other chronic disorders that can affect the whole body and the jaw. One of the jaw disorders is TMJ dysfunction, which can cause overlapping symptoms in the jaw and the body. Today’s article examines what TMJ dysfunction is, the signs and symptoms, and ways to manage TMJ dysfunction in the jaw. We refer patients to certified providers who specialize in musculoskeletal and oral treatments to aid individuals suffering from TMJ dysfunction affecting their jaws. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

What Is TMJ Dysfunction?

Have you been experiencing muscle pain in your neck, shoulders, and jaw? What about tenderness in your cheek when you lightly touched it? Or do you have difficulty chewing or moving your jaw when speaking? Many of these symptoms are signs that you could be experiencing TMJ dysfunction in your jaw. TMJ dysfunction, or temporomandibular dysfunction, is part of a group of orofacial pain conditions that affects the jaw joint and muscle, thus causing overlapping issues in the lower jaw. TMJ dysfunction also affects the mastication muscles that help move the jaw by making the muscles hyperactive and causing referred pain to the rest of the body. Studies reveal that about 25% of the population does get affected by TMJ dysfunction since it is a degenerative musculoskeletal condition associated with morphological and functional jaw deformities.

 

The Signs & Symptoms Of TMJ Dysfunction On The Jaw

TMJ dysfunction may potentially not only cause jaw pain but can also affect the neck and shoulders connected to the cervical spine. Studies reveal that TMJ dysfunction is correlated with neck disability, jaw dysfunction, and muscle tenderness in many individuals that suffer pain with or without TMJ dysfunction. TMJ dysfunction is associated with these issues because the jaw structures are affected by trigger points along the neck and jaw. To that point, TMJ dysfunction is often accompanied by back, joint, and abdominal pain. But how would TMJ dysfunction correlate with these pain issues? Studies reveal that disturbances in the upper body extremities may cause an increase in muscle tension associated with the whole-body imbalance that is potentially causing TMJ dysfunction. Some of the related symptoms of TMJ dysfunction in the jaw include:

  • Pain in neck and shoulders
  • The jaw becomes “locked” in an open or closed position
  • Headaches
  • Earaches
  • Muscle tenderness in the jaw
  • Having difficulty chewing
  • Swelling on the side of the face
  • Body imbalance

 


Exercises For TMJ Dysfunction- Video

Have you been experiencing muscle tenderness in your jaw? What about having some difficulty chewing or speaking? Do you hear popping sounds when your open or close your mouth? Some of these symptoms are associated with a musculoskeletal jaw disorder known as TMJ (temporomandibular joint) dysfunction. The video above shows the top 3 exercises for TMJ dysfunction that can help alleviate pain from the jaw, face, or ear. TMJ dysfunction is a musculoskeletal disorder that affects the mastication muscles and causes referred pain to the neck, head, and ear. TMJ dysfunction is tricky to diagnose since trigger points associated with TMJ may also affect the teeth, causing tooth pain in the oral-facial region. This is known as somato-visceral, where the affected muscle correlates with the corresponding organ. Thankfully, there are ways to manage TMJ dysfunction and its associated symptoms.


Ways To Manage TMJ Dysfunction In The Jaw

 

Many people can use various ways to manage TMJ dysfunction in the jaw to alleviate the pain. Some non-surgical treatments that individuals can incorporate include:

  • Heat or cold pack applied to the side of the face 
  • Gentle stretching exercises for the jaw
  • Eating soft foods
  • Wearing a night guard while sleeping

If the pain from TMJ dysfunction still affects the individual, therapies like chiropractic care can help manage the symptoms. Chiropractic care can effectively treat TMJ dysfunction, especially spinal subluxation or misalignment in the cervical region. Chiropractors will fully evaluate the patient’s temporomandibular joint and surrounding muscles, joints, and ligaments to identify the TMJ problem and the underlying causes. To that point, a chiropractor may suggest a range of treatments, which includes stretches and exercises to not only alleviate pain and stiffness in the jaw point but also to bring back balance to the body. This allows minimal rubbing and friction in the jaw joint.

Conclusion

Overall, TMJ dysfunction is a musculoskeletal jaw disorder that affects the mastication muscles and causes referred pain to different areas in the upper extremities of the body. Some of the symptoms of TMJ dysfunction can make it difficult for the jaw to open or close, causing pain, headaches, and muscle tenderness in the neck and shoulders. To that point, individuals suffering from TMJ dysfunction may potentially deal with pain-related symptoms. Various non-surgical treatments are available to manage TMJ dysfunction and reduce associated pain symptoms affecting the jaw.

 

References

Kim, Doori, et al. “The Relationship between Spinal Pain and Temporomandibular Joint Disorders in Korea: A Nationwide Propensity Score-Matched Study – BMC Musculoskeletal Disorders.” BioMed Central, BioMed Central, 29 Dec. 2019, bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-019-3003-4.

Murphy, Meghan K, et al. “Temporomandibular Disorders: A Review of Etiology, Clinical Management, and Tissue Engineering Strategies.” The International Journal of Oral & Maxillofacial Implants, U.S. National Library of Medicine, 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC4349514/.

Silveira, A, et al. “Jaw Dysfunction Is Associated with Neck Disability and Muscle Tenderness in Subjects with and without Chronic Temporomandibular Disorders.” BioMed Research International, Hindawi Publishing Corporation, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4391655/.

Walczyńska-Dragon, Karolina, et al. “Correlation between TMD and Cervical Spine Pain and Mobility: Is the Whole Body Balance TMJ Related?” BioMed Research International, Hindawi Publishing Corporation, 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4090505/.

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TMJ Dysfunction On The Lateral Pterygoid Muscle

TMJ Dysfunction On The Lateral Pterygoid Muscle

Introduction

The jaw allows the host to chew, speak, and move while being stabilized by the surrounding muscles that help the jaw structure. The other surrounding muscles that support the jaw are the neck muscles when food is consumed and swallowed. The lower jaw has joints on each side that connect to the upper part of the skull, while the surrounding muscles provide the motor function to the jaw. To that point, normal wear and tear or various factors can not only affect the joints and the surrounding muscles, but they can cause overlapping pain profiles to the tendons, organs, and jaw muscles that may potentially affect a person’s quality of life. Today’s article examines the lateral pterygoid muscle, how TMJ dysfunction and trigger points affect this muscle, and ways to manage TMJ dysfunction and trigger points in the jaw. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from trigger point pain associated with TMJ dysfunction affecting the lateral pterygoid muscle. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

What Is The Lateral Pterygoid Muscle

 

Have you heard popping sounds in your jaw when you open or close your mouth? Does your jaw feel stiff, and the pain travels down the neck? Does your jaw lock up, causing difficulty for you to open or close your mouth? Some of these symptom overlap with pain associated with the lateral pterygoid muscle. As part of the mastication muscles, the lateral pterygoid muscle is also a craniomandibular muscle that has a crucial role in the inferior temporal region. The lateral pterygoid muscle works together with the medial pterygoid muscle to provide functionality to the mandible or the lower jaw. The lateral pterygoid muscle also has nerves that branch off the trigeminal nerve and sends information to the brain. This information causes the muscles to move and function when food is consumed; however, when injuries or traumatic events affect the lateral pterygoid, it can disrupt the lower jaw structure and the surrounding muscles.

 

How TMJ Dysfunction & Trigger Points Affect The Lateral Pterygoid

When the lateral pterygoid is affected by TMJ (temporomandibular joint) dysfunction, studies reveal that many individuals often experience pain around the jaw causing limited jaw movement and pain in the lateral pterygoid muscles. When the lateral pterygoid muscles become overused due to excessive chewing or by traumatic forces that affect the jaw, it can cause the muscle fibers of the lateral pterygoid to develop tiny knots known as trigger points to affect the jawline. Trigger points cause pain symptoms associated with other chronic issues that cause jaw pain. When trigger points affect the lateral pterygoid, it can develop discomfort and pain in TMJ dysfunction.

According to Dr. Janet G. Travell, M.D., many people with severe pain in their jaws may have myofascial pain syndrome from musculoskeletal disorders caused by active trigger points in the lateral pterygoid muscle. Since the lateral pterygoid is potentially involved with trigger points associated with TMJ dysfunction, studies reveal that the lateral pterygoid muscle may suffer from muscle atrophy while correlating with disc displacement associated with TMJ dysfunction. TMJ dysfunction is when the surrounding muscles and ligaments around the lower jaw are irritated from active trigger points. When a person suffers from TMJ dysfunction, the pterygoid muscles become stiff and cause pain-related symptoms affecting the jaw and the surrounding oral-facial region.


Jaw Pain & TMJ Dysfunction-Video

Have you been experiencing pain along your jawline? Do your jaw muscles feel stiff when your open or close your mouth? Have you heard popping sounds when you open your jaw, and it hurts? Many of these symptoms are associated with TMJ dysfunction affecting the lateral pterygoid muscle. The video above explains how TMJ disorder and jaw pain affect the body. Studies reveal that the activities of the lateral pterygoid muscle allow movement to the jaw for the host; however, when factors begin to affect the jaw and the lateral pterygoid muscle, it may lead to derangement and disc displacement in the TMJ. TMJ dysfunction associated with trigger points in the jaw may be combined with other factors that cause pain to the jaw and the rest of the body. This is known as somato-visceral pain, where the muscle affects the corresponding organ. TMJ dysfunction associated with trigger points is complex and challenging to diagnose since trigger points often mimic other chronic symptoms that may be potentially involved. Since the lateral pterygoid muscle has sensory-motor functions in the jaw, when the muscle becomes sensitive, those neuron signals become hypersensitive and cause disorganized muscular activation to the jaw; thus, determining factors in TMD (temporomandibular disorders) make an appearance. Luckily there are ways to manage TMJ dysfunction associated with trigger pain in the jaw from affecting anyone.


Managing TMJ Dysfunction & Trigger Pain In The Jaw

 

When a person is experiencing pain symptoms in the jaw from TMJ dysfunction associated with trigger point pain, many try to find various treatments to minimize the pain. Since trigger point pain in the jaw can cause referred pain associated with toothaches and tension-type headaches, the pain that a person is feeling can be confusing when there is no physical alteration. To that point, many people would take over-the-counter medicine to dull the pain. However, those who want to manage pain without medication can go to a musculoskeletal specialist that their primary doctor refers to, who can come up with a treatment plan catered to that person. Many musculoskeletal specialists, like chiropractors, can obtain the patient’s information on where they feel pain during the examination. Afterward, chiropractors can devise a solution through clinical thinking before applying the treatment to the patient’s pain. Some of the various techniques that a chiropractor utilizes for an individual dealing with jaw pain associated with trigger points include:

  • Stretch and spray: Where the lateral muscle is stretched and sprayed with a coolant to alleviate the trigger points.
  • Cervical spinal manipulation: Spinal adjustment to the cervical spine to loosen up stiff muscles surrounding the neck and lower jaw. 
  • Heat compression: A hot pack is placed on the jaw to relax the muscles.

When chiropractors utilize these techniques on the trigger points affecting the lateral pterygoid, it may potentially alleviate TMJ dysfunction symptoms associated with trigger points. 

 

Conclusion

The lateral pterygoid is part of the mastication muscles that work with the medial pterygoid muscle to stabilize the jaw and provide motor function when the host is chewing or speaking. When the lateral pterygoid muscle becomes overused through excessive chewing or being affected by traumatic factors can cause the development of pain symptoms associated with trigger points. Trigger points are tiny knots in the muscle that can cause referred pain to different locations in the body. When this happens, many individuals suffer from other chronic conditions associated with trigger points. One of them is TMJ dysfunction, where the surrounding muscles in the lower jaw become irritated and can make the jaw lock up. Fortunately, various treatments exist for many individuals to relieve trigger point pain associated with TMJ dysfunction affecting their jaws and help prevent the associated symptoms from progressing further.

 

References

Litko, Monika, et al. “Correlation between the Lateral Pterygoid Muscle Attachment Type and Temporomandibular Joint Disc Position in Magnetic Resonance Imaging.” Dento Maxillo Facial Radiology, The British Institute of Radiology., Oct. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5595028/.

Liu, Meng-Qi, et al. “Functional Changes of the Lateral Pterygoid Muscle in Patients with Temporomandibular Disorders: A Pilot Magnetic Resonance Images Texture Study.” Chinese Medical Journal, Wolters Kluwer Health, 5 Mar. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7065862/.

Lopes, Sérgio Lúcio Pereira de Castro, et al. “Lateral Pterygoid Muscle Volume and Migraine in Patients with Temporomandibular Disorders.” Imaging Science in Dentistry, Korean Academy of Oral and Maxillofacial Radiology, Mar. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4362986/.

Rathee, Manu, and Prachi Jain. “Anatomy, Head and Neck, Lateral Pterygoid Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 29 Oct. 2021, www.ncbi.nlm.nih.gov/books/NBK549799/.

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Trigger Point Pain Affecting The Medial Pterygoid Muscles

Trigger Point Pain Affecting The Medial Pterygoid Muscles

Introduction

The jaw has a primary function in the head as it allows the muscles to move up and down, helps chew food, and allows the host to speak. Each of the muscles and organs inside the jaw has its functions that will enable the head to function correctly. The mouth, part of the gut system, allows air to travel into the lungs so the body can breathe and consume food to be swallowed and digested to be turned into energy for the rest of the body to move around. The mouth, the tongue, and the teeth have a casual relationship as the teeth can grind the food into small pieces to be digested, while the tongue can taste the food. When issues begin to cause an effect on the jaw, it can lead to symptoms that can, over time, be painful to the surrounding muscles, organs, and even nerve endings along the jaw’s skeletal structure. Today’s article looks at the medial pterygoid muscle, how trigger point pain affects this muscle, and ways to manage trigger point pain on the medial pterygoid muscle. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from trigger point pain associated with the medial pterygoid muscle along the inside of the jaw. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

What Is The Medial Pterygoid Muscle?

 

Do you have any problems or issues chewing your food? What about throat soreness from swallowing something hard? Or have you noticed stiffness along your jawline? Individuals experiencing these symptoms might be dealing with pain along the medial pterygoid muscle in their jaw. The medial pterygoid muscle is part of the mastication muscles, which includes the temporalis, lateral pterygoid, and masseter muscles of the jaw. The medial pterygoid is a rectangular-shaped muscle that lies inside the lateral pterygoid muscle. The medial pterygoid muscle works together with the masseter muscle as a sling to help stabilize the mandible or the lower jaw. In contrast, the medial pterygoid nerves provide sensory-motor functions to make the lower jaw move and promote chewing action, thus sending nerve signals to travel through the trigeminal nerve and send the information to the brain. Just like any of the different muscles in the body, the medial pterygoid muscle may succumb to injuries that can affect the sensory-motor function of the jaw while triggering various issues to cause more pain to the jaw and the body.

 

How Does Trigger Point Pain Affect The Medial Pterygoid Muscle?

 

When various issues begin to affect the muscles of the body, it can be something simple like repetitive motions that causes the muscles to be overused or injuries that can cause the muscles to become inflamed and, if not treated, can become sensitive to the touch. To that point, tiny knots known as trigger points are formed along the taut muscle fibers that can make the muscle become sensitive and overlap various issues that can cause pain in different body locations. Since the medial pterygoid and the masseter muscle work together, studies reveal that muscle hypertrophy may associate with the masseter, medial pterygoid, or both and can potentially be involved with the risk of dental problems or other issues that are affecting the oral-facial region. Trigger points along the medial pterygoid muscle may be challenging to diagnose due to the referred pain that affects different body areas while mimicking various pain symptoms that become the causes. An example would be a person experiencing ear pain associated with jaw pain. Now how would these two correlate when the person is dealing with ear pain? Since trigger points can mimic other symptoms, the jaw muscles (which include the medial pterygoid) become aggravated and overused, causing referred pain to the teeth overlapping with ear pain.


The Anatomy Of The Medial Pterygoid Muscle-Video

Have you been experiencing unexplainable ear pain? What about your jaws feeling stiff when chewing on something? Or have you been dealing with tooth pain in the back of your jaw? Many of these issues are correlated to referred pain symptoms associated with the medial pterygoid. The video above gives an overview look of the anatomy of the medial pterygoid muscle, its functions, and how it helps the body. When the medial pterygoid is affected by trigger point pain, it may potentially cause various conditions to affect the oral facial region or the surrounding areas of the head. Studies reveal that myofascial pain is often characterized by a trigger point in the taut skeletal muscle band or the fascia. When trigger point pain affects the mastication muscles, it may lead to other comorbidities like muscle tension, poor posture, headaches, and jaw disorders like TMJ(temporomandibular joint) pain. Fortunately, there are ways to manage trigger point pain on the medial pterygoid muscle.


Ways To Manage Trigger Point Pain On The Medial Pterygoid Muscle

 

Trigger point pain often affects the muscles in certain body areas, causing pain that affects the region of the body, thus making the muscle sensitive. Many individuals who suffer from trigger point pain associated with the medial pterygoid muscle would often complain of toothaches or headaches affecting their daily activities to their primary doctors. After an examination, many doctors would refer their patients to musculoskeletal specialists to see what issue is causing the patient pain in their bodies. Since trigger point pain is a bit complex, musculoskeletal specialists like chiropractors or physical therapists will examine trigger points associated with pain. Many musculoskeletal specialists utilize various techniques to release trigger points along the affected muscle to manage the pain and its related symptoms. At the same time, many musculoskeletal specialists incorporate other multiple treatments to help manage trigger point pain on the medial pterygoid muscle. These various treatments allow the muscles to relax and avoid a relapse in future injuries affecting the muscle.

 

Conclusion

The primary function of the jaw in the head is to allow the muscles to move up and down, enabling the host to speak and help the mouth chew food. The medial pterygoid is one of the four main mastication muscles that help support the jaw, which is rectangular shaped and helps stabilize the lower jaw. This muscle allows the sensory-motor function of the lower jaw and promotes chewing action. When traumatic or ordinary factors cause the medial pterygoid muscles to become overused can developed trigger points along the muscle fibers and initiate pain associated with toothaches and headaches. Trigger points along the medial pterygoid muscle can make the affected area sensitive and challenging to pinpoint. Fortunately, musculoskeletal specialists like chiropractors or physical specialists can help alleviate the pain while managing trigger points on the affected muscle through various techniques. When people begin to incorporate treatments to manage pain in their bodies, it can allow them to be mindful and avoid future injuries.

 

References

Guruprasad, R, et al. “Masseter and Medial Pterygoid Muscle Hypertrophy.” BMJ Case Reports, BMJ Publishing Group, 26 Sept. 2011, www.ncbi.nlm.nih.gov/pmc/articles/PMC3185404/.

Jain, Prachi, and Manu Rathee. “Anatomy, Head and Neck, Medial (Internal) Pterygoid Nerve.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 June 2022, www.ncbi.nlm.nih.gov/books/NBK547712/.

Jain, Prachi, and Manu Rathee. “Anatomy, Head and Neck, Medial Pterygoid Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 June 2022, www.ncbi.nlm.nih.gov/books/NBK546588/.

Sabeh, Abrar Majed, et al. “Myofascial Pain Syndrome and Its Relation to Trigger Points, Facial Form, Muscular Hypertrophy, Deflection, Joint Loading, Body Mass Index, Age and Educational Status.” Journal of International Society of Preventive & Community Dentistry, Wolters Kluwer – Medknow, 24 Nov. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7791579/.

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Temporal Headaches & Toothaches

Temporal Headaches & Toothaches

Introduction

Headaches are one of the common issues that affect anyone worldwide. Different issues can cause headaches and affect other individuals depending on the issue. The pain can range from being dull to sharp and affect a person’s mood, sense of belonging, and body. Different headaches can have different effects on people since headaches can be acute or chronic and overlap with other issues affecting the body. To that point, the surrounding muscles and organs around the face may be involved with other conditions where headaches are a symptom rather than a cause. Today’s article examines the temporalis muscle, how trigger pain affects the temporalis muscle, and how to manage the pain associated with trigger points. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from trigger point pain associated with the temporal muscle pain along the side of the head. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

What Is The Temporalis Muscle?

temporal-muscle.jpg

 

Have you been dealing with a dull or sharp ache on the side of your head? What about the tension that is along your jawline? Or have you been dealing with tooth pain throughout the entire day? Encountering these symptoms can be difficult as they affect the facial region of the head and might overlap with the temporal muscle. The temporalis muscle is part of the mastication muscles, which includes the medial pterygoid, lateral pterygoid, and masseter muscles. The temporalis muscle is a flat, fan-shaped muscle that spans from the temporal fossa to the inferior temporal line of the skull. This muscle converges to form a tendon that surrounds the jaw bone and helps stabilize the jaw and its function by extending and retracting. Studies reveal that the temporalis muscle has two tendons: superficial and deep, in the back of the molars to aid chewing and are attached to the coronoid process (the skin and subcutaneous tissues that cover the superficial tendon of the temporalis muscle and the masseter muscle.) To that point, traumatic and ordinary factors can affect the temporalis muscle and cause symptoms associated with the muscle.

 

How Do Trigger Points Affect The Temporalis Muscle?

When traumatic or ordinary factors begin to affect the body, including the oral-facial region, it can cause unwanted symptoms to develop over time and, if not treated, make a person’s life miserable. Studies reveal that individuals dealing with chronic tension-type headaches have intense pain from the temporalis muscle. When the temporalis muscle becomes sensitive to the touch, the pain can travel to different body areas. These are known as myofascial or trigger points, and they can be a bit challenging for doctors to diagnose because they can mimic various pain symptoms. Trigger points along the temporalis muscles may potentially affect the teeth and cause headaches to form. Active trigger points in the temporalis muscle could potentially evoke local and referred pain while constituting one of the contributing sources of headache pain. Now how can the temporalis muscle induce chronic tension-type headaches? Well, trigger points are caused when the muscles are overused and can develop tiny knots along the muscle fibers.

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Trigger points along the temporalis muscle could potentially induce abnormal dental pain. Studies reveal that abnormal dental pain can be referred to as neurovascular headaches associated with tension on the temporalis muscle. Since trigger points often mimic other chronic conditions that confuse many people about why they are experiencing pain from one section of their body, there are no signs of traumatic encounters. Since trigger points can cause pain to travel from one area of the body to another, many individuals try to find therapeutic ways to alleviate their pain.


An Overview Of The Temporal Muscle- Video

Have you been experiencing headaches that affect your daily activities? Does your jaw seem stiff or tender to the touch? Or have your teeth become extra sensitive when eating certain foods? Many of these symptoms may involve trigger points affecting the temporalis muscle. The video above gives an overview of the anatomy of the temporalis muscle in the body. The temporalis is a fan-shaped muscle that converges into tendons that help make the jaws move. When factors affect the body, especially the temporalis muscle, it can potentially develop trigger points along the muscle fibers. To that point, trigger points can mimic conditions affecting the body, like chronic tension-type headaches and tooth pain. Studies reveal that the pain pressure associated with trigger points along the temporalis muscle is consistently higher when there are different amounts of tooth clenching or jaw gaps. As luck would have it, there are ways to manage temporal muscle pain associated with trigger points.


Ways To Manage Temporal Muscle Pain Associated With Trigger Points

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Since trigger points along the temporalis muscle could potentially cause pain in the oral facial region, the surrounding muscles like the upper trapezius and the sternocleidomastoid with their trigger points may cause jaw motor dysfunction and tooth pain. Fortunately, musculoskeletal specialists like chiropractors, physiotherapists, and massage therapists can find where the trigger points are located and use various techniques to alleviate trigger point pain along the temporalis muscle. Studies reveal that soft tissue manipulation can help release the trigger point pressure off of the temporalis muscle and cause relief. Utilizing soft manipulation on myofascial temporalis pain affecting the neck, jaw, and cranial muscles can help reduce headache pain symptoms and help many people feel relief.

 

Conclusion

The temporalis in the body is a flat, fan-shaped muscle that converges down to the jawline and works with the other mastication muscles to provide the motor function to the jaw. When ordinary or traumatic factors affect the temporalis muscle, it can develop trigger points along the muscle fibers. To that point, it causes pain-like symptoms and even causes referred pain like tension headaches and toothaches in the oral-fascial region of the head. This can make many people suffer in pain unless there are ways to manage the associated symptoms. Fortunately, many musculoskeletal specialists can incorporate techniques that target trigger-point pain related to the affected muscle. When people utilize treatment for myofascial trigger pain, they can get their lives back together.

 

References

Basit, Hajira, et al. “Anatomy, Head and Neck, Mastication Muscles – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 June 2022, www.ncbi.nlm.nih.gov/books/NBK541027/.

Fernández-de-Las-Peñas, César, et al. “The Local and Referred Pain from Myofascial Trigger Points in the Temporalis Muscle Contributes to Pain Profile in Chronic Tension-Type Headache.” The Clinical Journal of Pain, U.S. National Library of Medicine, 2007, pubmed.ncbi.nlm.nih.gov/18075406/.

Fukuda, Ken-Ichi. “Diagnosis and Treatment of Abnormal Dental Pain.” Journal of Dental Anesthesia and Pain Medicine, The Korean Dental Society of Anesthsiology, Mar. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5564113/.

Kuć, Joanna, et al. “Evaluation of Soft Tissue Mobilization in Patients with Temporomandibular Disorder-Myofascial Pain with Referral.” International Journal of Environmental Research and Public Health, MDPI, 21 Dec. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7767373/.

McMillan, A S, and E T Lawson. “Effect of Tooth Clenching and Jaw Opening on Pain-Pressure Thresholds in the Human Jaw Muscles.” Journal of Orofacial Pain, U.S. National Library of Medicine, 1994, pubmed.ncbi.nlm.nih.gov/7812222/.

Yu, Sun Kyoung, et al. “Morphology of the Temporalis Muscle Focusing on the Tendinous Attachment onto the Coronoid Process.” Anatomy & Cell Biology, Korean Association of Anatomists, 30 Sept. 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC8493017/.

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Myofascial Pain Affecting The Jaw Muscles

Myofascial Pain Affecting The Jaw Muscles

Introduction

The head has many functions that provide the body with functionality. The head consists of the skull, which protects the brain, the eyes to make the host see, and the jaw, which has teeth and the tongue to taste and chew food. The neck supports the head to ensure that it is stabilized and functions appropriately. Below the eyes, the jaw has muscles and joints that help stabilize the jaw from hyperextending out while providing motor function. To that point, factors that can affect the jaw could potentially affect the surrounding muscles and joints on the head and neck, causing the individual to be in pain. Today’s article looks at the masseter muscles, how myofascial pain affects the masseter muscles, and ways to relieve myofascial pain associated with the masseter muscles. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from myofascial pain associated with masseter muscle pain along the jaw. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

What Is The Masseter Muscle?

 

Have you been experiencing headaches located near your temples? Does your jaw feel sore throughout the entire day? Or have tooth pain or ear pain seems to bother you constantly? Some of these symptoms may affect your jaw joints, especially in the masseter muscles. The masseter muscles are powerful quadrangular muscles on each side of the jaw with three divisions: superficial, intermediate, and deep. The masseter muscles are also part of the mastication muscles in the jaw which include:

  • Temporalis
  • Medial pterygoid
  • Lateral pterygoid
  • Masseter muscles

The masseter muscles also help the jaw function properly, as studies reveal that this quadrangular muscle participates in various activities like mastication (chewing), swallowing, and talking. To that point, the masseter muscles have a relationship with the trigeminal nerve, which provides sensory-motor stimulation for the jaw to move. However, when factors (traumatic or ordinary) begin to affect the masseter muscles and the surrounding muscles associated with the neck and head, pain can either slowly or quickly depending on the severity the muscles have endured.

 

How Myofascial Pain Affects The Masseter Muscle?

Studies reveal that chronic pain in the orofacial region of the body is common worldwide and can cause disorders affecting jaw motor control. When painful symptoms affect the jaw, many individuals begin to feel pain in the top or bottom of their jaws that cause tooth pain and the brows, causing them cluster-like headaches or experiencing tinnitus (ringing in the ears). These symptoms are associated with myofascial pain affecting the masseter muscles in the jaw. Myofascial pain or trigger points are where the muscle fibers in the body become sensitive after being injured or overused. To that point, the muscle fibers developed tiny knots along the taut muscle bands and caused pain throughout the entire muscle. Myofascial pain can be tricky to diagnose due to mimicking other pain symptoms. For trigger pain to affect the masseter muscles, studies reveal that temporomandibular disorders that involve the oral-facial region may be multifactorial while affecting the masticatory muscles and the temporomandibular joints. To that point, myofascial masseter pain could potentially involve ailments like migraines, toothaches, TMJ (temporomandibular joint) dysfunction, and ear pain.

 

According to Dr. Janet G. Travell, M.D., complex symptoms and overlapping patterns of facial pain might be referred from multiple trigger points in the head and neck muscles, which can be more easily traced back to the individual’s muscles. By finding the root cause of these symptoms, many doctors can develop a clinical process to assess their patients dealing with myofascial trigger pain and develop a plan that caters to their wants and needs.


Stretching The Masseter Muscles-Video

Do headaches seem to be affecting your daily routine? Have you felt that your jaw feels stiff and has a dull ache when you move your mouth open? Or do you feel pain along the sides of your teeth? Many of these symptoms are referred pain associated with myofascial masseter pain. The video above demonstrates stretching the masseter muscles to reduce trigger pain along the muscle structure. Myofascial pain related to the masseter muscles can make it difficult for doctors to diagnose their patients due to the pain traveling to different areas in the body, known as somato-visceral pain. Somato-visceral pain is pain affecting the muscle connected to an affected organ. An example would be jaw pain associated with a toothache while potentially involving the masseter muscles. Thankfully, treatments are available to relieve myofascial pain along the masseter muscle.


Ways To Relieve Myofascial Pain In The Masseter Muscles

 

Myofascial pain affecting the masseter muscle could cause pain in the surrounding muscles and organs in the oral-facial region. The symptoms caused by myofascial pain associated with masseter muscles may be complex and challenging to diagnose due to the pain affecting different body regions. Fortunately, many doctors refer musculoskeletal specialists like chiropractors, massage therapists, and physiotherapists to relieve myofascial muscle pain associated with the masseter muscles by providing pain relief techniques. Some of the various methods that help ease trigger pain from the masseter muscles include:

  • Stretch & Spray: Stretching the jaw slowly to the full extent and spraying coolant along the masseter muscle to relieve pain
  • Jaw Exercising: Yawning, extending, and retracting the masseter muscle to stretch and strengthen the jaw.
  • A warm compress on the cheek: Helps relax the aggravating muscle and releases any tension causing myofascial pain.

Studies reveal that soft tissue mobilization is one of the various techniques that can help relieve trigger pain in masseter muscles. What soft tissue mobilization does is that it allows musculoskeletal specialists to use a pincer method to lengthen the masseter muscle to an extent and release trigger points in slow downward traction to alleviate the pain from the masseter muscles. Utilizing these various treatments can help many people with myofascial pain associated with masseter muscles feel relief from jaw pain and its related symptoms.

 

Conclusion

The masseter is a quadrangular muscle that surrounds each side of the jaw and helps stabilize the jaw’s motor function. When injuries or traumatic factors begin to affect the jaw, over time can lead to the development to trigger point pain associated with masseter muscles. When trigger point pain affects the masseter muscles in the oral-facial region, it can cause somato-visceral pain alongside the jaw affecting the teeth, causing tinnitus symptoms and headaches. Fortunately, various treatments are available to help manage trigger pain and relieve the associated symptoms that affect the masseter muscles. This allows many individuals to get back their health by being pain-free.

 

References

Al Sayegh, Samaa, et al. “Effects of Chronic and Experimental Acute Masseter Pain on Precision Biting Behavior in Humans.” Frontiers in Physiology, Frontiers Media S.A., 29 Oct. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6828929/.

Corcoran, Nicholas M, and Evan M Goldman. “Anatomy, Head and Neck, Masseter Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 June 2022, www.ncbi.nlm.nih.gov/books/NBK539869/.

Kuć, Joanna, et al. “Evaluation of Soft Tissue Mobilization in Patients with Temporomandibular Disorder-Myofascial Pain with Referral.” International Journal of Environmental Research and Public Health, MDPI, 21 Dec. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7767373/.

Maini, Kushagra, and Anterpreet Dua. “Temporomandibular Syndrome.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 28 Apr. 2022, www.ncbi.nlm.nih.gov/books/NBK551612/.

Widmer, C G, et al. “Developmental and Functional Considerations of Masseter Muscle Partitioning.” Archives of Oral Biology, U.S. National Library of Medicine, Apr. 2007, www.ncbi.nlm.nih.gov/pmc/articles/PMC1861846/.

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Trigger Pain Affecting The Sternocleidomastoid Muscle

Trigger Pain Affecting The Sternocleidomastoid Muscle

Introduction

The neck is vital in keeping the head upright in a casual relationship with the cervical spine. The neck is home to the thyroid organ and the surrounding muscles that help support the neck to the rest of the body. One of the muscles that help support the neck is the sternocleidomastoid muscle. When traumatic forces begin to affect the neck, over time can lead to the development of chronic conditions associated with pain. When individuals start to feel pain affecting their neck, it can cause them to be miserable and find ways to relieve the pain they are experiencing. Today’s article focuses on the sternocleidomastoid muscle, how trigger pain affects this muscle, and ways to relieve SCM pain. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from SCM associated with trigger pain along the neck. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

What Is The Sternocleidomastoid Muscle?

Have you been experiencing pain along the sides of your neck? What about limited mobility when you turn your neck from side to side? Or do headaches seem to worsen throughout the entire day? Some of these symptoms are associated with pain along the neck and could affect the surrounding muscles that are connected. One of the surrounding muscles that sit behind the thyroid is known as SCM or sternocleidomastoid muscle. The sternocleidomastoid muscle is a long muscle with dual innervation and multiple functions in the neck. The SCM is connected to the trapezius muscle that helps flex the neck, pulling the head forward while bringing the chin down to the chest. The SCM and the trapezius muscle work together to help stabilize and fix the head position while the host is talking or eating. When factors affect the neck over time, the SCM also gets involved.

 

How Does Trigger Pain Affect The Sternocleidomastoid?

 

When factors affect SCM associated with the neck, many issues will start to affect the neck and overlap pain near the eyes, ears, sides of the cheeks, and forehead. Studies reveal that SCM may develop myofascial trigger points in the head, causing referred pain. Trigger points are usually formed when traumatic forces affect certain areas in the body. For SCM to be affected by trigger pain, tiny knots along the taut band of the SCM muscle fibers become sensitive to pressure when compressed, and many people often describe the pain as deep and dull. To that point, the symptoms associated with SCM trigger pain may appear in numerous combinations or together depending on how severe the pain is on the person. Some of the symptoms related to SCM trigger pain include:

  • Headaches (sinus, cluster, or tension)
  • Sore throat
  • Ear pain (popping sounds in the ears)
  • Blurred vision
  • Vertigo
  • Dizzyness
  • Balance issues
  • Muscle soreness

 


SCM Pain & Trigger Points- Video

Have you been dealing with headaches throughout the entire day? What about muscle tenderness in certain areas near your neck or shoulders? Or have you been feeling dizzy that it is affecting your daily activities? Many people with these symptoms may be dealing with SCM pain associated with trigger pain. The video above offers an insightful overview of how does trigger pain may be involved with SCM pain. SCM or sternocleidomastoid muscle is a long muscle that surrounds the sides of the neck and is connected to the trapezius muscle. When factors begin to affect the SCM, the muscle is at risk of developing trigger pain along the muscle fibers. Studies reveal that trigger pain along the SCM may affect SCM’s normal muscle functions, like chewing due to hyperactivity. Fortunately, there are ways to relieve SCM pain associated with trigger pain affecting the neck.


Ways To Relieve SCM Pain In The Neck

 

When it comes to SCM pain associated with trigger pain along the neck, many individuals find ways to relieve the related symptoms that are causing the pain. Some individuals will take over-the-counter medication to relieve their neck, shoulders, and head pain. At the same time, others do stretches to release the tension on their head, neck, and shoulders. However, trigger pain is a bit complex and challenging to diagnose since it mimics other conditions that affect the body. As luck would have it, many doctors will refer musculoskeletal specialists like massage therapists, physical therapists, and chiropractors who can help relieve SCM pain in the neck. Studies reveal that a combination of physiotherapy, classical massages, and stretching exercises can be applied to alleviate SCM pain in the neck. By stretching and massaging the SCM, many individuals can begin to feel pain relief in their neck, increase their range of motion, and have endurance in their neck. Integrating these various treatments for the SCM (sternocleidomastoid muscle) pain in the neck can help revitalize a person’s sense of well-being without being in pain.

 

Conclusion

The SCM, or sternocleidomastoid muscle, is a long muscle that sits behind the thyroid organ and is connected with the trapezius muscle. This muscle helps stabilize and holds the head position while flexing the neck and bringing the chin down to the chest. When environmental or traumatic factors affect the neck muscles, it can lead to chronic conditions over time, thus inflicting pain and tenderness along the SCM. These are known as trigger points and can be hard to diagnose due to them mimicking other chronic symptoms associated with the neck, head, and shoulders. Thankfully, various treatments like physiotherapy, stretching exercises, and classical massages can help relieve the trigger points along the SCM and relieve the neck and surrounding muscles.

 

References

Bordoni, Bruno, and Matthew Varacallo. “Anatomy, Head and Neck, Sternocleidomastoid Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 5 Apr. 2022, www.ncbi.nlm.nih.gov/books/NBK532881/.

Büyükturan, Buket, et al. “The Effects of Combined Sternocleidomastoid Muscle Stretching and Massage on Pain, Disability, Endurance, Kinesiophobia, and Range of Motion in Individuals with Chronic Neck Pain: A Randomized, Single-Blind Study.” Musculoskeletal Science & Practice, U.S. National Library of Medicine, 12 June 2021, pubmed.ncbi.nlm.nih.gov/34147954/.

Kohno, S, et al. “Pain in the Sternocleidomastoid Muscle and Occlusal Interferences.” Journal of Oral Rehabilitation, U.S. National Library of Medicine, July 1988, pubmed.ncbi.nlm.nih.gov/3171759/.

Missaghi, Babak. “Sternocleidomastoid Syndrome: A Case Study.” The Journal of the Canadian Chiropractic Association, Canadian Chiropractic Association, Sept. 2004, www.ncbi.nlm.nih.gov/pmc/articles/PMC1769463/.

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