Etiology and Management of Masticatory Myofascial Pain

SUMMARY

Myofascial pain [MP] is a regional muscle pain disorder characterized by localized muscle tenderness and pain and the most common cause of persistent regional pain. The affected muscle may also display an increased fatigability, stiffness, subjective weakness, pain in movement, and slight restricted range of motion that is unrelated to joint restriction. Although the exact etiology of MP in unclear, recent research has improved our understanding of factors that contribute to the development and progression of MP. Understanding these factors can help to validate an explanatory model for etiology and treatment of masticatory myofascial pain [MMP]. This model includes peripheral mechanisms from local biomechanical strain leading to the onset of early cases of MMP while central mechanisms associated with psychosocial factors lead to increased chronicity of MMP. As MP persists, chronic pain characteristics often precede or follow its development. Management of the syndrome naturally follows from this model with therapy to rehabilitate the trigger points while focusing effort on reducing all contributing factors. However, the difficulty in managing MP lies in the critical need to match the level of complexity of the management program with the complexity of the patient.

KEYWORDS:

• Myofascial pain
• muscles
• pain
• etiology