Trigger Points as a Cause of Orofacial Pain

SUMMARY

Orofacial pain is a common symptom experienced by approximately one-quarter of the adult population and is most often caused by myofascial pain. In contrast to other postural body muscles, trigger points are not often found in the jaw elevator muscles. Therefore, the term myofascial pain used in this article refers to a muscle pain condition characterized by the presence of muscle tenderness.

The masticatory myofascial pain, that may be triggered by oral parafunction during the awake state, often fluctuates with pain episodes followed by pain-free intervals. Especially non-chronic light to mild masticatory myofascial pain often resolves spontaneously. In each case non-chronic pain can be easily treated by a therapeutic plan that includes patient education, self-care, physiotherapy, pharmacotherapy, and eventually an occlusal appliance. Only in a small percent of patients does the masticatory myofascial pain become chronic. These patients need a multimodal therapeutic approach that addresses both the somatic and non-somatic, i.e., the emotional, affective, and behavioral pain component. Tricyclic antidepressants can be prescribed for the treatment of the somatic component while the therapy of the non-somatic component requires a cognitive-behavioral therapy.

KEYWORDS:

• Myofascial pain
• orofacial pain
• masticatory myofascial pain