As the body’s most mobile joints, the shoulders are surrounded by muscles, tissues, and ligaments that help support the shoulders and the rotator cuff in mobility function, thus ensuring the shoulders remain in a stable, normal position. As a complex structure that is made up of three bones: the humerus (upper arm bone), the scapula (shoulder blades), and the clavicle (collarbone), the shoulders provide a wide range of motion without feeling pain. When injuries affect the muscles, tissues, and joints of the shoulders, they can potentially develop tiny knots along the muscle fibers and invoke pain-like symptoms on the upper extremities of the body. To that point, it affects not only the shoulders but also the arms and the hands. Today’s article looks at the infraspinatus muscle, how shoulder joint pain is associated with trigger points, and various treatments to manage trigger points related to the shoulder joint. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from trigger points related to the shoulder joints and the infraspinatus 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
What Is The Infraspinatus Muscle?
Do you feel stiffness along your shoulders or upper arms? Does it hurt when you rotate your shoulders? Or have you been experiencing a tingling or numbing sensation traveling down your arms? Many people who experience shoulder pain might be due to trigger points affecting their infraspinatus muscles. The infraspinatus muscle is a muscle that looks like a thick triangle that covers the front of the scapula. The infraspinatus is a part of the rotator cuff muscles or commonly referred to as SITS:
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
These four muscles provide the functionality to the rotator cuffs in the shoulders to allow the arms full range of motion. Studies reveal that rotator cuff activity from these muscles is crucial for normal shoulder motion. To that point, the infraspinatus plays a vital role by providing dynamic stability while producing external rotation at the shoulder. However, traumatic forces can affect the infraspinatus muscles causing lesions and other conditions to affect the shoulders and rotator cuffs, causing pain-like symptoms to the upper half of the body.
Shoulder Joint Pain Associated With Trigger Points
Since shoulder pain is the third most common musculoskeletal disorder, the underlying causes are rotator cuff disorders and referred pain in the neck. When traumatic factors begin to affect the shoulder muscles and the rotator cuff muscles, it can potentially lead to the development of myofascial pain syndrome or trigger points along the muscle fibers of the shoulders. Referred pain causes pain in one area of the body when in actuality is affecting the other side of the body. For trigger points associated with shoulder joint pain, studies reveal that myofascial pain from trigger points in the infraspinatus may give rise to referred pain in the arms, shoulders, or even the cervical spine in some patients. To that point, trigger point pain associated with the shoulder joint may mimic carpal tunnel symptoms around the wrist. When trigger points mimic other chronic conditions, it often makes it a bit harder to diagnose the symptoms.
Treating Trigger Point Release On The Infraspinatus Muscle-Video
Have you been dealing with pain-like symptoms in your wrist? Do you feel muscle stiffness when rotating your shoulders? Or have you been experiencing numbness or tingling sensations from the shoulders to the fingertips? If you have been experiencing any of these symptoms, it could be referred to pain from trigger point pain associated with the infraspinatus muscle on the shoulder joint. Trigger points form tiny nodules along the taut muscle fibers of the affected muscle area. The video above explains where the trigger points are located on the infraspinatus muscle on the scapula (shoulder blades) and how to release the trigger points. All is not lost, as various treatments can help manage trigger points associated with the shoulder joint. Studies reveal that chronic musculoskeletal disorders in the shoulder joint are often associated with myofascial trigger points, causing referred pain along the arm down to the fingertips. To that point, pain specialists incorporate and apply acupuncture or dry needling on the trigger point can help improve pain and disability for many individuals with shoulder pain.
Treatments Managing Trigger Points Associated With The Shoulder Joint
When many individuals are dealing with trigger point pain associated with the shoulder joint, they sometimes believe that it could be something that is affecting their heart. Now, why would the heart be associated with the shoulder joint? This is due to somato-visceral pain (the affected muscle is causing issues to the corresponding organ) that is causing referred pain to affect the heart. When patients go to their primary doctors, they go through an examination to see what the issue is, and this allows the doctor to go through a clinical process to come up with a diagnosis of what is going on, which in this case is trigger points associated with the shoulder joint. Once the doctor diagnoses the issue, they can refer their patients to a pain specialist like a chiropractor, massage therapist, or a physiotherapist to manage the trigger points in the affected muscle area. Chiropractors, massage therapists, and physiotherapists utilize various techniques to relieve trigger points from the infraspinatus muscle in the shoulder joints. Some of the available treatments that are used to manage trigger points associated with the shoulder joint include:
Stretching
Ice/Heat Compress
Spinal Adjustments
Acupuncture
Trigger Point Injection
Conclusion
The muscle known as the infraspinatus is part of the rotator cuff that works along the shoulder and looks like a thick triangle on the scapula or shoulder. This muscle helps the rotator cuff activity for normal shoulder motion by providing dynamic stability while performing external rotation on the shoulder. When traumatic factors affect the infraspinatus muscle, it can develop trigger points along the muscle fibers of the infraspinatus muscle and cause referred pain along the shoulders and down to the arms. Fortunately, various treatments available can manage trigger points and relieve the pain from producing more issues along the shoulder. To that point, many individuals can have normal shoulder function without pain.
References
Ha, Sung-Min, et al. “Selective Activation of the Infraspinatus Muscle.” Journal of Athletic Training, National Athletic Trainers Association, 2013, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655748/.
Kamali, Fahimeh, et al. “Comparison of Upper Trapezius and Infraspinatus Myofascial Trigger Point Therapy by Dry Needling in Overhead Athletes with Unilateral Shoulder Impingement Syndrome.” Journal of Sport Rehabilitation, U.S. National Library of Medicine, 30 Nov. 2018, https://pubmed.ncbi.nlm.nih.gov/29364040/.
Meder, Marek A, et al. “Reliability of the Infraspinatus Test in Carpal Tunnel Syndrome: A Clinical Study.” Journal of Clinical and Diagnostic Research : JCDR, JCDR Research and Publications (P) Limited, May 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483796/.
Williams, Jeslin M, et al. “Anatomy, Shoulder and Upper Limb, Infraspinatus Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 13 Aug. 2021, https://www.ncbi.nlm.nih.gov/books/NBK513255/.
Chiropractic care focuses on whole-body health, restoring optimal body function, helping injuries heal/rehabilitate, and maintaining musculoskeletal health. Yoga is one of the most popular forms of fitness because it is not overly physically demanding but still increases flexibility and muscle tone, helps with weight loss, improves cardiovascular and circulatory health, and enhances breathing and energy levels. Yoga provides benefits that directly relate to chiropractic, making the treatment more effective.
Yoga and Chiropractic
Yoga is an exercise focusing on mindfulness combined with deep stretches and focused breathing. Yoga focuses on balance, flexibility, and strength.
It helps to lower blood pressure and stress levels by releasing built-up tension.
Helps to activate the body’s natural healing process.
It stretches the muscles, ligaments, and tendons, keeping them loose and flexible, enhancing chiropractic adjustments.
Chiropractic
Chiropractic is multi-faceted,restoring the wellness of the neuromusculoskeletal system that involves the nerves, muscles, and bones. It works holistically with the body’s natural processes to restore balance and overall health.
Realigns the spine.
Returns the natural shape of the body’s structure.
Clears interference from the nervous system.
Rejuvenates the body.
Customized chiropractic adjustments, spinal decompression, and traction treatment plans help shift spinal deformities back toward proper balance.
Strengthen Soft Tissues
Yoga and chiropractic work and strengthen all the:
Connective tissues
Muscles
Ligaments
Tendons
Increasing the strength of the joints throughout the body reduces stress and the risk of injury.
Promote Healing
Yoga and chiropractic:
Prepare the body for healing.
Stretch and elongate the body.
Release built-up tension and stress.
Activate the body for healing.
Prevent Injury
Yoga and chiropractic:
Maintain body alignment.
Increase balance.
Stretch and relieve tense muscles.
Ensure proper joint operation.
Make the body less susceptible to injury.
Educate Individuals About The Body
Chiropractors and yoga teachers can educate individuals on how the body works, maintaining muscle strength, teaching posture awareness, and nervous system function for a healthier life.
Yoga Body Flow
References
Biman, Saranga, et al. “Effects of yoga on stress, fatigue, musculoskeletal pain, and the quality of life among employees of the diamond industry: A new approach in employee wellness.” Work (Reading, Mass.) vol. 70,2 (2021): 521-529. doi:10.3233/WOR-213589
da Costa, Fernanda Mazzoni, et al.”“Effects of an intervention program with health education and hatha yoga on the health of professionals with musculoskeletal symptoms”” Revista brasileira de medicina do trabalho : publicacao oficial da Associacao Nacional de Medicina do Trabalho-ANAMT vol. 18,2 114-124. 11 Dec. 2020, doi:10.47626/1679-4435-2020-492
Hawk, Cheryl, et al.” Best Practices for Chiropractic Management of Patients with Chronic Musculoskeletal Pain: A Clinical Practice Guideline” Journal of alternative and complementary medicine (New York, N.Y.) vol. 26,10 (2020): 884-901. doi:10.1089/acm.2020.0181
Kolasinski, Sharon L et al.” 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee” Arthritis care & research vol. 72,2 (2020): 149-162. doi:10.1002/acr.24131
Urits, Ivan et al.” A Comprehensive Review of Alternative Therapies for the Management of Chronic Pain Patients: Acupuncture, Tai Chi, Osteopathic Manipulative Medicine, and Chiropractic Care” Advances in therapy vol. 38,1 (2021): 76-89. doi:10.1007/s12325-020-01554-0
Spinal nerves send motor, sensory, and autonomic signals between the central nervous system and the body and are part of the peripheral nervous system. They are essential for carrying information that controls body movements and sensations to the brain. When a nerve gets injured, compressed, or damaged, it can cause discomfort, increased sensitivity, numbness, muscle weakness, and pain.
Damaged Nerve Roots
Nerve root pain is often caused by other underlying conditions that have caused compression or damage to the nerve root. Causes of nerve root pain can include:
Spinal nerves impacted by injuries or infection can lose their ability to control the body areas, lose their functional capacity, lose sensation, and die.
Spinal Imaging
Nerve damage can be diagnosed on a neurological exam and correlated with MRI and X-ray imaging. Conditions that MRI can identify include herniated discs, spinal cord compression or fracture, arthritic development, tumors, or cysts pressing on a nerve.
MRI images are obtained with a magnetic field and radio waves.
MRI shows spine images from the side/sagittal view and cross-sectional/axial views.
This allows the chiropractic doctor to see the vertebrae and discs and identify abnormalities.
The spinal cord is a gray area in the middle surrounded by the spinal fluid, which appears white.
Little white channels on either side of the spinal cord are where the nerve roots branch off.
X-rays can show the alignment of the bones along the spine and determine any narrowing or damage to the discs.
It is important to be evaluated and diagnosed for signs and symptoms of nerve injury as soon as possible, as nerve damage accelerates and worsens.
Function Restoration
Sometimes, the symptoms improve by themselves and do not require treatment. Nonetheless, physicians begin with conservative, non-surgical approaches to treat nerve root pain. Chiropractic and physical massage therapy involves specific movements, stretches, and exercises to keep the affected muscles and joints active,prevent stiffness and help restore function and feeling. Treatment can include:
Therapeutic massage
Manual adjustment/resistance treatment
Trigger point therapy
Instrument-assisted soft tissue therapy
Decompression
Traction
Joint stretching
Electrical stimulation
Ultrasound
Specialized exercise
Activity modification
Anti-inflammatory diet
Nerve Chiropractor
References
Liu, Yan, and Huan Wang. “Peripheral nerve injury-induced changes in the spinal cord and strategies to counteract/enhance the changes to promote nerve regeneration.” Neural regeneration research vol. 15,2 (2020): 189-198. doi:10.4103/1673-5374.265540
Menorca, Ron M G, et al. “Nerve physiology: mechanisms of injury and recovery.” Hand clinics vol. 29,3 (2013): 317-30. doi:10.1016/j.hcl.2013.04.002
Shehab, Safa Al-Deen Saudi. “Fifth lumbar spinal nerve injury causes neurochemical changes in corresponding and adjacent spinal segments: a possible mechanism underlying neuropathic pain.” Journal of chemical neuroanatomy vol. 55 (2014): 38-50. doi:10.1016/j.jchemneu.2013.12.002
Stoll, G, and H W Müller. “Nerve injury, axonal degeneration, and neural regeneration: basic insights.” Brain pathology (Zurich, Switzerland) vol. 9,2 (1999): 313-25. doi:10.1111/j.1750-3639.1999.tb00229.x
Ye, Xuan, et al. “Nerve fascicle transfer using a part of the C-7 nerve for spinal accessory nerve injury.” Journal of neurosurgery. Spine vol. 28,5 (2018): 555-561. doi:10.3171/2017.8.SPINE17582
Having headaches can affect anyone at any time, and various issues (both underlying and non-underlying) can play a part in the development. Factors like stress, allergies, traumatic events, or anxiety can trigger the causes of headaches to develop and can affect a person’s day-to-day schedule. Headaches can come in various forms and be the cause or symptom of other conditions. Many complain about headaches affecting their forehead, where the occipitofrontalis muscle resides, and explain to their doctors about a dull ache affecting them. To that point, the cause of the headache could affect them differently. Today’s article examines the occipitofrontalis muscle, how myofascial trigger pain affects this muscle, and ways to manage myofascial trigger pain associated with headaches. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from myofascial trigger pain associated with headache symptoms affecting the occipitofrontalis 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 Occipitofrontalis Muscle?
Have you been experiencing unexplainable headaches that seem to affect your daily life? Do you feel muscle tension in your head or neck? Or do certain areas in your upper body seem tender to the touch? Many individuals suffer from headaches, and it could be due to myofascial trigger pain associated with the occipitofrontalis muscle. The occipitofrontalis muscle surprisingly plays an important part in the facial muscles. The occipitofrontalis muscle is the only muscle that can raise eyebrows, convey emotions, and provide non-verbal communication as part of its functionality to the head. The occipitofrontalis muscle has two different sections in the head that play different roles. Studies reveal that the occipital and frontal bellies have other actions but work together despite being connected to the galea aponeurotica. However, like all muscles in different body sections, various factors can affect the muscles to become tender and form multiple symptoms associated with pain.
How Does Myofascial Trigger Pain Affect The Occipitofrontalis?
When various factors begin to affect the occipitofrontalis muscle, it could potentially be at risk of developing myofascial trigger pain associated with headaches in the muscle. Studies reveal that myofascial trigger pain is a musculoskeletal disorder associated with muscle pain and tenderness that can be identified as latent or active. When the occipitofrontalis is affected by myofascial pain, it could potentially lead to tension-type headaches as a symptom. Studies reveal that headaches, especially tension headaches, are associated with trigger points in the head and neck muscles. Myofascial pain occurs when the muscles become overused and sensitive to the touch. The affected muscle then develops small nodules along the muscle fibers and can cause referred pain in a different body section. To that point, the affected muscle becomes hypersensitive due to an excess of nociceptive inputs from the peripheral nervous system, thus eliciting referred pain or muscle contraction. When this happens to the individual, they experience constant, throbbing pain in their forehead and try to find relief to diminish the pain.
Myofascial Exercises For Headaches-Video
Have you been feeling tension and pain in your neck or head? Do headaches seem to affect your daily activities? Does the slightest pressure seem to cause you pain in your muscles? Experiencing these symptoms may be a sign that you may have myofascial trigger pain associated with the head and neck that is causing headache-like pain along the occipitofrontalis muscle. The video above demonstrates various stretching exercises for headaches and migraines associated with myofascial trigger pain. Myofascial trigger pain associated with headaches can cause overlapping issues in the upper extremities of the body since myofascial trigger pain can mimic other conditions that affect the head and neck muscles. Known as referred pain, the underlying cause of pain affects a different body part than the actual location. Luckily, there are ways to manage myofascial trigger pain associated with headaches along the occipitofrontalis muscle.
How To Manage Myofascial Trigger Pain Associated With Headaches
There are many ways to manage headache symptoms associated with myofascial trigger pain along the occipitofrontalis muscle. Many people will take over-the-counter medicine to dull the pain, while others use a cold/hot pack to be placed on their forehead to relieve the tension caused by the headache. Those experiencing trigger point pain along the affected muscles that are not responding to the at-home treatments will go to a specialist that uses various techniques to manage myofascial trigger pain associated with headaches. Studies reveal that manual trigger point therapies for the head and neck may reduce the frequency, intensity, and duration of various headaches affecting the occipitofrontalis muscle. Other treatments that help manage myofascial pain associated with the occipitofrontal muscle include:
Chiropractic care: Spinal misalignment or spinal subluxation in the cervical spine can potentially lead to the development of myofascial trigger pain associated with muscle pain
Acupuncture: Dry needles are placed on the trigger points associated with the affected muscle to relieve pain
Hot/cold compress: Ice or heat packs are placed on the affected muscle to relieve tension.
Massage therapy: Deep tissue massage can relieve the inflamed area, reduce pain, and prevent trigger points from reemerging.
Utilizing these treatments can help prevent myofascial pain and manage headache symptoms associated with the muscle.
Conclusion
Headaches can affect anyone, and various issues can affect their development. Whether it is an underlying or non-underlying cause, multiple problems can trigger a headache to form and cause a dull ache in the affected muscle. One of the most common forms of headaches occurs in the occipitofrontalis muscle located in the forehead and near the base of the skull. The occipitofrontalis muscle is the only muscle that controls eyebrow movement, conveys emotions, and provides non-verbal communication as part of head functionality. However, like all muscles, the occipitofrontalis can become affected and potentially risk developing myofascial trigger pain. When this happens, the occipitofrontalis could develop tension-type headaches associated with myofascial trigger pain. Luckily available treatments are there to manage myofascial trigger pain associated with the occipitofrontalis muscle and alleviate headaches from the affected muscle.
References
Bérzin, F. “OCCIPITOFRONTALIS Muscle: Functional Analysis Revealed by Electromyography.” Electromyography and Clinical Neurophysiology, U.S. National Library of Medicine, 1989, https://pubmed.ncbi.nlm.nih.gov/2689156/.
Chatchawan, Uraiwan, et al. “Characteristics and Distributions of Myofascial Trigger Points in Individuals with Chronic Tension-Type Headaches.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, Apr. 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6451952/.
Falsiroli Maistrello, Luca, et al. “Effectiveness of Trigger Point Manual Treatment on the Frequency, Intensity, and Duration of Attacks in Primary Headaches: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” Frontiers in Neurology, Frontiers Media S.A., 24 Apr. 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5928320/.
Moraska, Albert F, et al. “Responsiveness of Myofascial Trigger Points to Single and Multiple Trigger Point Release Massages: A Randomized, Placebo Controlled Trial.” American Journal of Physical Medicine & Rehabilitation, U.S. National Library of Medicine, Sept. 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561477/.
Pessino, Kenneth, et al. “Anatomy, Head and Neck, Frontalis Muscle – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 31 July 2021, https://www.ncbi.nlm.nih.gov/books/NBK557752/.
Individuals that have experienced a muscle strain, pull, spasm, etc., that has healed can begin to behave overly cautious, avoiding putting full weight on the area or using full motion out of fear of re-injuring it. This can and does strain other body areas because of the imbalance and awkward positioning. It also leads to anxiety, emotional distress, and decreased self-confidence in everyday movement. Adjustments, massage, and decompression therapy can maintain musculoskeletal health, and a chiropractor can help retrain individuals on healthy posture and confident movement.
Muscle Guarding
Muscles can be held in a position of readiness to act, like the stress response of fight or flight. When this happens, the muscles are partially contracted in preparation for action and is a form of muscle-guarding. But once the fight or flight passes, the muscles relax into their normal position. With injury muscle guarding, the fears and stresses after recovering from an injury can cause the injured and non-injured muscles to stay in the guarded/semi-contracted position. The longer the muscle guarding continues, fatigue begins to set in, decreasing function, restricting mobility, and making the body more vulnerable to damage and injury.
The Brain
The discomfort, pain, or just the thought reinforces the need to guard the area. The brain will find a way to move without causing pain and create compensating but unhealthy movement patterns that strain the other areas of the body. The body adapts to not using the formerly injured muscles and now relies on the other muscles to perform the functions in a non-relaxed state that can become normal, causing stiffness, soreness, tenderness, tendon tension, and pain.
An example is a hip strain, pull or spasm that has been treated and has healed, but the individual is fearful of another injury or going through the painful experience again and begins walking by shifting all their weight to the other side and steps with a limp or some abnormal motion that strains and/or injures the rest of the body.
Chiropractic Treatment and Retraining
Individuals experiencing muscle guarding can find help through chiropractic to retrain their muscles to return to their normal position and regain confidence in their movements. The body will be rebalanced by releasing and relaxing the tight muscles. Then therapeutic repetitive movements, specialized exercises, stretches, and relaxation techniques will help the individual relearn to use the muscles without fear.
Protective Muscle Guarding
References
Hanlon, Shawn et al. “Examining Ankle-Joint Laxity Using 2 Knee Positions and With Simulated Muscle Guarding.” Journal of athletic training vol. 51,2 (2016): 111-7. doi:10.4085/1062-6050-51.3.06
Olugbade, Temitayo et al. “The relationship between guarding, pain, and emotion.” Pain reports vol. 4,4 e770. 22 Jul. 2019, doi:10.1097/PR9.0000000000000770
Prkachin, Kenneth M et al. “Pain behavior and the development of pain-related disability: the importance of guarding.” The Clinical journal of pain vol. 23,3 (2007): 270-7. doi:10.1097/AJP.0b013e3180308d28
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, https://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, https://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, https://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, https://www.ncbi.nlm.nih.gov/books/NBK549799/.
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, https://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, https://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, https://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, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7791579/.
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