Head / Face
Temporalis Myofascial Pain
측두근 근막통증
Temporalis trigger points referring pain to temple, supraorbital region, and teeth
- How common
- Common (coexists with TTH/TMD)
- Typical age
- Ages 20–50
What is it?
Clenching, poor posture, and stress overload temporalis; trigger points form and refer pain to temple, supraorbital region, and upper teeth.
Commonly affected: Anterior, middle, posterior temporalis fibers
How it develops
- Repetitive OverloadClenching, chewing, postural strain
- Trigger Point FormationTaut bands in anterior/middle/posterior fibers
- Referred PainPain referred to temple, brow, upper teeth
- Sustained SensitizationMaintained by chronic stress and poor sleep
Symptoms
- Throbbing temple painDull ache with intermittent throbbing
- Referred upper tooth painOften misdiagnosed as toothache
- Worse with chewingWorse with tough foods
- Stress-related worseningProportional to psychological stress
- Supraorbital painPressing sensation above eye
How it is examined
- Temporalis trigger pointsPalpable nodules in taut bands of all three fiber groups
- Referred pain reproductionPalpation reproduces patient's pain
- Mild opening restrictionUsually 30–40 mm maximum opening
- Cervical posture assessmentForward head posture and trapezius tension common
Imaging
Usually normal; used to exclude secondary causes (sinusitis, GCA, tumor).
- Mostly normal
- No sinus disease
- Normal cranial structures
US can show hypoechoic TrP nodules in temporalis; MRI excludes secondary causes.
- US: hypoechoic nodules in taut band
- Brain MRI normal
- TMJ usually normal
Non-surgical care
- Clench awareness/habit reversalTongue to palate with teeth apart
- Heat/stretchingMoist heat, then gentle jaw stretch
- TrP dry needling/injectionTargets active trigger points
- Stress/sleep managementRelaxation, sleep hygiene, amitriptyline if needed
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
No surgical indication
Procedures that may be discussed
- Conservative care only
Outlook
Most improve with TrP therapy and stress management.