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Myofascial Pain Syndrome (Muscle Pain) Explained
Aug 03, 2022
Pain comes in many forms. This is why people often hear adjectives used to describe certain types of pain and wonder what they are. Some pain is easy to understand. For example, most people know what aching pain feels like and might even have experienced it themselves. Other types are not as simple or obvious.
We often discuss orofacial pain, which is just one of the results of temporomandibular joint dysfunction (TMD). This pain occurs in various places on the face. With all the talk about muscle tension, you might have also heard the term myofascial pain. But what is myofascial pain?
Myofascial pain is a type of pain that causes muscles to develop hypersensitive spots, called trigger points. These trigger points cause referred pain, which means you will feel discomfort in a body part that does not have any trigger points. When this myofascial pain persists for longer than 6 months, it develops into a chronic condition called myofascial pain syndrome.
What Is Myofascial Pain Syndrome?
Someone with myofascial pain syndrome might experience overly sensitive trigger points in their muscles. This often develops after a person has sustained trauma, such as repeated injury or strain to a certain muscle. Someone who has myofascial pain syndrome will often explain their pain as a feeling of knots or kinks in their muscles that do not go away on their own.
If you feel a painful area that you think might be a trigger point, it’s likely that this is due to a taut band or tight muscle. These will continue to be tender and painful until they are diagnosed and treated by a professional.
How Common Is Myofascial Pain Syndrome?
Myofascial pain syndrome is a very common condition that occurs in about 85% of people over the course of their life. Trigger points related to myofascial pain syndrome can affect anyone (both men and women). However, they most often impact middle-aged inactive women between the ages of 27 and 50.
As is the case with most chronic pain conditions, myofascial pain is misunderstood and underdiagnosed. Many professionals will overlook symptoms of myofascial pain syndrome or mistake them for other medical conditions.
What Causes Myofascial Pain?
Myofascial pain and myofascial pain syndrome can result from a variety of medical conditions and factors. People are more likely to develop this condition if they have injured or placed excessive strain on the muscle in question. Even if you have not sustained a direct injury to that area, smaller injuries (called microtraumas) to individual muscle fibers can also be the cause of myofascial pain.
Movement can also trigger myofascial pain. You might think that major, harmful movements are the only type of action that can lead to myofascial pain, but this isn’t the case. While repetitive motions can result in trigger points over time, a lack of activity or a sedentary lifestyle can also prompt the development of muscle tension leading to trigger points.
Where Are the Symptoms of Myofascial Pain Syndrome?
To the person living with them, myofascial pain symptoms are usually more recognizable (and more debilitating) than other types of pain. Myofascial pain might impact the back, neck, mouth, or face. Someone who has myofascial pain syndrome can be expected to experience some of the following symptoms:
- Pain that is described as deep, aching, throbbing, tight, or stiff - This type of constant pain might feel as if one of your body parts is being held in a vice that won’t let up. The pain does not go away with time or short-term treatments such as ice or heat packs.
- Trigger points, which are painful and small bumps, nodules, or knots in muscles - When overly tight muscle fibers don’t have the opportunity to relax or loosen up, they become trigger points. People often report that these feel like small balls or marbles just under the skin.
- Muscles that are tender or sore - Most people report excess tenderness or soreness when these trigger points are pressed or overworked. This isn’t exclusive to the trigger points, since the soreness can also impact entire muscles.
- Weakness in the affected muscles - When muscles are in pain or any sort of discomfort, they will feel weak. This often leads someone to expend extra effort to get them moving, which might also cause fatigue.
- Reduced range of motion in the affected areas - Symptoms such as pain, tightness, and stiffness can lead someone to experience less motion in certain body parts. Additionally, if someone tries to push past this discomfort and move a painful limb, their nervous system might attempt to block that motion to protect the body. This can cause even less movement, which can impair a person’s ability to function.
How Is Myofascial Pain Syndrome Treated?
Depending on the specific myofascial pain symptoms someone presents with, they might benefit from any of the following treatment modalities:
- Low-level laser therapy - Low-level laser therapy involves the non-invasive use of small light beams to address areas of inflammation. There are mixed reviews about the efficacy of this treatment, but it has been shown to relieve pain and muscle tension in some people who have myofascial pain syndrome.
- Ultrasound - Therapeutic ultrasound is a non-invasive modality that uses sound waves to stimulate the healing of deep and superficial muscle tissues. In some cases, ultrasound can be combined with medicated lotions such as hydrocortisone to offer added benefit. Ultrasound is often known as a way to “massage” the deeper tissues that cannot be accessed with traditional, hands-on massage techniques.
- Transcutaneous electrical nerve stimulation (TENS) - This treatment uses very low levels of electric current to lower pain levels. Since our nerves all operate and communicate using electricity, TENS helps interrupt the signal that causes us to experience chronic pain.
- Heat - Heat is known to soothe aching muscles. This is why moist heat (such as the heat from warm towels) and hot packs can be a great way to relieve muscle tension and resulting pain.
- Acupuncture and relaxation therapies - A range of relaxation techniques, including acupuncture, deep breathing, meditation, and guided imagery can assist with managing chronic pain. Acupuncture focuses on improving bodily circulation and, therefore, muscle function to ease pain from trigger points. The other methods are intended to lower stress levels, which can help with the distress someone often experiences as a result of prolonged pain.
- Exercise - Gentle stretching and, eventually, exercising the painful muscles can help release the trigger points and restore normal movement.
- Dietary changes - Eating a balanced diet with whole grains, lean meats, and plenty of fruits and vegetables will help anyone experiencing myofascial pain. Additionally, consider taking supplemental Vitamin B1, B6, B12, and Vitamin C, since these can help someone manage pain and inflammation.
- Massage - Massage therapy is one of the most effective ways to manage trigger points that result from myofascial pain syndrome. Providers use their hands to manipulate the soft tissues and gradually break up the trigger point so it does not cause as much pain. This often takes several sessions to do, but is regarded highly among practitioners who provide treatment for trigger points.
- Oral appliance - If your myofascial pain is the result of sleep apnea or TMJ, wearing an oral appliance such as a mouthguard can help. In particular, oral appliances can stop teeth grinding, snoring, jaw pain, and lapses in breathing, which can all contribute to myofascial pain in the face and neck. Finding the root cause of your myofascial pain is important, since an oral appliance will only help if your myofascial pain stems from the tension and trigger points in the orofacial area.
- Dry needling - Similar to acupuncture, dry needling involves thoughtful placement of small, nearly painless needles into certain points in the skin. This is intended to boost circulation, decrease muscle tension, ease stiffness of tight muscle bands, and lower inflammation. These outcomes can all help someone better manage trigger points that result from myofascial pain syndrome.
- Wet needling or trigger point injections - Wet needling uses the same technique as dry needling except with the addition of medications such as lidocaine and other pain relievers. This is typically one step up if someone does not experience results from dry needling.
In some cases, the above treatments for myofascial pain syndrome can be implemented by physical medicine and rehabilitation professionals, such as physical therapy providers and massage therapists. If you wish to pursue this type of treatment, you should see your primary care doctor (often one who practices family medicine or internal medicine).
They can complete a physical exam to look more closely at your myofascial pain and write a physical therapy referral for you. The physical therapists will then complete their own exam, which often includes assessing where the pain is coming from and how it impacts your movement. Once this is done, they will formulate a treatment plan to best help you.
If your myofascial pain is due to the symptoms of TMJ, it’s best to consult a board-certified orofacial pain specialist like Dr. Katherine Phillips. This is the best way to receive an accurate diagnosis followed by comprehensive treatment that addresses the root cause of your myofascial pain. Click here to schedule an appointment with Dr. Phillips.
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Medical Reviewer:
Dr. Katherine Phillips, DDS, MS
About The Author
Dr. Katherine Phillips, DDS, MS received her undergraduate degree from the University of Michigan and her dental degree from the University of Detroit Mercy School of Dentistry. She currently serves as the Secretary/Treasurer on the American Board of Dental Sleep Medicine (ABDSM) Board of Directors and treats TMD and sleep disordered breathing at Restore TMJ & Sleep Therapy in the Houston, TX area.
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Explore treatments for sleep apnea: symptoms, remedies, and more. Improve your sleep with our expert guide from Restore TMJ.
Discover how oral appliances can enhance your sleep quality. Dr. Phillips, a dental sleep medicine specialist, offers custom-fit devices for sleep apnea, TMJ, snoring, and bruxism.
Discover how sleep studies can diagnose TMJ disorders and sleep issues with Dr. Katherine S. Phillips. Enhance your sleep quality and overall health at Restore TMJ & Sleep Therapy.
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Explore the differences between TMJ and TMD with REstore TMJ & Sleep Therapy. Get to know the causes, symptoms, and treatment options for jaw pain and disorders. Call 281-296-6797 for a consultation.
Teeth grinding is the most common cause of jaw pain. Grinding your teeth also results in fractured teeth and the destruction of dental work, which can even change how you look. People who grind their teeth during the day can make conscious changes to reduce their teeth grinding for those who grind their teeth at night . Fortunately, with a visit to Dr. Phillips, you can discover how to stop grinding your teeth. What is Teeth Grinding, and What Causes it? Grinding or clenching your teeth, or bruxism , is a common condition affecting millions of people and, if left untreated, can lead to broader health issues. According to the American Dental Association (ADA), a 2020 ADA Health Policy Institute report stated that half of the dentists saw a rise in clients with stress-related dental problems, primarily due to teeth grinding and jaw clenching. It can happen during the day or night and often goes unnoticed until the person is alerted by a partner or family member. Treating bruxism can prevent further damage to the teeth and relieve any symptoms associated with the condition, and there are several steps you can take to stop grinding your teeth and protect your oral health. People grind and clench their teeth for various reasons, including stress and anxiety, misalignment of the teeth and jaw, or an abnormal bite. In adults, teeth grinding is often caused by emotional tension and stress and can become a subconscious habit. In children, teeth grinding is usually due to an immature bite and can be triggered by new teeth erupting or the recent placement of braces. How Do You Know if You're Grinding or Clenching Your Teeth? Grinding or clenching your teeth can be challenging to identify since it usually happens when you are unconscious or sleeping. However, several signs could indicate you are grinding your teeth. Common symptoms of teeth grinding include: Waking up with a sore jaw Frequent headaches Increased sensitivity or pain in your teeth Tired or tight jaw muscles Pain that feels like an earache, but there is nothing wrong with your ear A locked jaw that is difficult to open or close completely Neck or face pain Noticing that your teeth feel different or worn down You or your sleep partner may also notice that you make clenching or grinding sounds during the night. At a dental appointment, your dentist may suspect teeth grinding if you have the following: Teeth that are chipped, loose, flattened, or fractured Worn enamel on your teeth Gum recession Possible Causes of Teeth Grinding Many people grind their teeth and tighten their jaws without realizing it, especially at night. Although stress and anxiety can lead to teeth grinding, other common causes are: Posture. Poor posture is not only horrible for your back; it's also bad for your teeth. When the body's joints aren't in proper alignment, it can result in jaw clenching and grinding. Misaligned teeth. If the upper and lower teeth don't fit together correctly, the misalignment may result in the tendency to grind teeth or clench jaw muscles. Sleep disorders. Sleep habits and sleep disorders can lead to teeth grinding at night. Chronic obstructive sleep disorder , also known as sleep apnea , is a known cause of sleep bruxism. Resolving sleep apnea can help stop teeth grinding. Sleep terrors and insomnia may also result in grinding teeth at night. Joint disorders. The temporomandibular region is around the jaw, mouth, and ears. This area contains the temporomandibular joints and jaw muscles, which allow the jaw to open and close. Disorders in this area can affect teeth grinding and a sore jaw. Stimulants. Stimulants like caffeine, nicotine, and alcohol can trigger teeth grinding. Avoiding these can help prevent teeth grinding. Stress. Stress is a common cause of teeth grinding and clenching. Finding ways to manage and reduce stress can help decrease teeth grinding. These can include relaxation techniques such as progressive muscle relaxation, yoga, deep breathing, meditation, and guided imagery can help relax the jaw muscles and stop teeth grinding. Chewing on Objects. Chewing on objects such as pencils or fingernails can trigger teeth grinding. You may also need to avoid chewing gum, which can exacerbate teeth grinding. Finding out how to stop grinding teeth at night takes getting to the root cause of grinding. Discovering the cause provides clues, pointing to the appropriate solutions. Prevent teeth grinding during the day. It is crucial to identify triggers that cause teeth grinding if you intend to stop grinding them during the day. Pay attention to your habits during the day and see if you notice when and if your grinding or clenching is worse. A TMJ specialist or dentist specializing in bruxism can provide you with exercises or relaxation techniques you can do throughout the day if you notice yourself clenching and, in some cases, offer medical treatment like muscle relaxants or Botox for bruxism. Prevent teeth grinding and clenching at night/in your sleep. You'll have to make changes during the day to stop grinding or clenching your teeth at night or in your sleep. Start by talking to your dentist or doctor to determine if you have underlying medical issues that could be causing the grinding. Additionally, your dentist may suggest you wear a mouthguard, splint, or other oral appliance. At the same time, you sleep to protect your teeth from further damage and keep your mouth in the proper alignment, helping your TMJ to relax. A custom-fitted mouthguard also helps lessen the impact of teeth grinding by covering the teeth to create a physical barrier that reduces damage. How To Stop Child/Baby Grinding Teeth Many children grind their teeth at night, but most grow out of it. If your child or baby grinds their teeth, the first thing to do is identify what might be causing the behavior. Stress, anxiety, or an underlying medical condition can cause your child to grind their teeth. If the grinding is stress-related, identifying and addressing the source of the stress, such as an overly demanding school schedule or peer pressure, may help. If a medical or dental condition causes the grinding, your child's dentist or doctor can help you determine the best action. If the grinding results from a habit, it can help redirect your child's attention when they start to grind and provide them with other activities that may help reduce their stress and anxiety. Side Effects of Teeth Grinding Grinding your teeth may seem like a harmless habit. After all, it's easier to notice this behavior if you're not on the lookout for it. And unless your significant other or family members complain about the noise from your nighttime teeth grinding, it's difficult to find proof of the act. However, long-term grinding of teeth at night can lead to significant side effects like: Pain in the jaw. The pressure and movement from teeth can lead to tenderness in the muscles, causing jaw pain . For some people, the pain may become chronic and severe. Headaches. The constant back-and-forth movement and clenching can impact the muscles around the neck and head, resulting in headaches due to muscle fatigue and tension. Wearing down teeth. Like sandpaper eventually smooths a surface, the repetitive motion from teeth grinding can flatten teeth and wear the enamel down over time. Teeth grinding can change the appearance of your teeth, causing them to look shorter and making chewing more difficult. Damage or fractured teeth. Grinding can destabilize teeth, making them shift and feel wobbly. The force from grinding may also crack teeth, causing pain and affecting oral health. Misalignment and cracked teeth can result in gum disease, cavities, and tooth loss — leading to poor overall health. Chronic ear pain. The temporomandibular area is closely connected. If the muscles around the ear become affected due to teeth grinding, chronic ear pain may occur. Facial muscle changes. Most people need to be aware that teeth grinding can change the shape of your face. Long-term bruxism can cause shorter teeth. Shorter teeth, in turn, change the structure of the face and jaw — leading to a sunken appearance. In addition, other muscles around the face can enlarge to compensate for dental changes. If you're concerned about your appearance, you may want to note that chronic teeth grinding can change the way you look. Remedies for Teeth Grinding The methods for how to stop teeth grinding at night versus teeth grinding when you are awake are typically the same. Although some treatments aren't quite possible when you're asleep, their benefits can last even after you've gone to bed. Reductive coronoplasty. Reductive coronoplasty directly involves changing or leveling the biting surface of teeth. This procedure reshapes crowded or crooked teeth, improving teeth alignment. Conversely, additive coronoplasty can add to the surface of teeth to help treat bruxism. Dental Appliances: Mouthguards, night guards, and splints. A mouthguard does just that — it guards teeth. Typically used for sports, a mouth guard keeps teeth from injuries sustained during activity. A night guard protects teeth from grinding at night. Lastly, a bit splint guides jaw movement, enabling the jaw to land in the appropriate position. These appliances protect teeth differently, and finding the right one for your situation is essential. Biofeedback. Biofeedback allows a person to train themselves by monitoring auditory and visual stimuli from the body. Although biofeedback needs a person to be alert, the technique can still help sleep bruxism by reducing overall stress. Stress reduction techniques. Though implementing stress reduction techniques such as yoga, exercise, and meditation requires a person to be awake, they can also help with nighttime teeth grinding. Allowing muscles to decompress and relieve tension alleviates stress-induced teeth grinding, even at night. Tongue and jaw muscle exercises. Most people don't stop to think about it, but their faces and mouth are a team of tissue, muscles, bones, and joints that closely affect each other. The tongue, for example, affects how the jaw moves. You reduce teeth grinding by exercising the right muscles — like the tongue and jaw. Behavior changes. Behavioral modifications like changing your posture and avoiding environments that cause stress can reduce instances of teeth grinding. Cognitive Behavioral Therapy (CBT) can help change behavior and thought patterns that lead to teeth grinding. Medications. A doctor can prescribe medication to help treat bruxism if all other treatments don't work. When used for short periods, muscle relaxants can relieve tension in the temporomandibular area. In severe cases of teeth grinding, botox injections can alleviate muscle tension. Antidepressants and anti-anxiety medications assist in decreasing anxiety, allowing jaw muscles to relax and reduce bruxism. How Can a TMJ Specialist Help with Teeth Grinding and Clenching? A TMJ specialist is a dentist board-certified in orofacial pain and conditions affecting the TMJ. TMJ specialists have extensive knowledge and experience regarding the structure, function, and pathology of TMJ. In addition to more thorough diagnostic evaluations, they can often provide more effective and long-term solutions for teeth grinding than your doctor or dentist alone. This is because TMJ specialists use a holistic approach to treatment, focusing on the underlying causes of the teeth grinding, such as stress, anxiety, or misaligned teeth, rather than just treating the symptoms. They often work with other medical experts like dentists or sleep physicians for more comprehensive care and treatment. Protecting Your Oral Health Protecting your teeth is critical to taking care of your overall health. Chronic teeth grinding can result in costly dental work, poor oral health, and chronic pain. If you're experiencing a sore jaw, headaches, or cracked teeth, seeking an expert diagnosis to find the cause is the first step to finding a solution. Get the answers you need on how to stop grinding your teeth at night or keep from grinding in the daytime to protect your oral health. As a TMJ and sleep apnea dentist, Dr. Katherine Phillips specializes in diagnosing and treating bruxism. With her Master of Science in Orofacial Pain From USC and extensive experience in TMJ therapy, Dr. Phillips utilizes proven and effective evidence-based medical interventions to identify bruxism and help find the right treatments to suit your needs. Get in touch today for more information.
The temporomandibular joint, or TMJ, is an anatomically complex joint, composed of muscles, joints, ligaments, bones, and discs. Proper jaw movement requires a high level of interaction and coordination among all these components, especially the articular disc (which absorbs stress), the adductors (jaw-closing muscles), the abductors (jaw-opening muscles), and jaw ligaments. This makes diagnosing problems or dysfunction with the TMJ extremely difficult. Properly diagnosing disorders of the TMJ—collectively referred to as TMD—requires both clinical examinations and medical imaging in order to develop an accurate assessment of the joint, its function, and its surrounding bone and tissue. If you are experiencing pain, discomfort, or dysfunction in your TMJ, you will first have a clinical evaluation. This is when your doctor or TMJ specialist will discuss your symptoms with you and examine your jaw, pressing on areas around it to identify any sensitivity. He or she will also observe the range of motion of your jaw and listen to and feel around your jaw while you open and close your mouth. In some cases, the doctor’s clinical findings are enough to diagnose a TMD and begin treatment. Other times, additional diagnostic imaging will be necessary to confirm the presence of a TMD.
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