TMJ (Jaw)
TMD Myofascial Pain
턱관절 근막통증
Face and jaw pain from masticatory muscle overuse and tension
- How common
- Very common (most common TMD subtype)
- Typical age
- Ages 20–40, female predominant
What is it?
Sustained hypertonicity and microtrauma of masticatory muscles (masseter, temporalis) form trigger points with referred pain.
Commonly affected: Masseter and temporalis most commonly involved
How it develops
- Stress/BruxismPsychosocial stress and nocturnal clenching activate muscles
- Muscle HypertonicitySustained masseter/temporalis contraction
- Trigger Point FormationLocal ischemia and metabolite accumulation create trigger points
- Referred PainReferred pain to temple, ear, teeth
Symptoms
- Masticatory muscle painDull tenderness of masseter/temporalis
- Morning jaw stiffnessJaw fatigue and stiffness on waking
- Temporal headacheTension-type headache from temporalis
- Chewing fatigueDifficulty chewing hard food
- Periauricular painDull pain anterior to ear (referred)
How it is examined
- Muscle palpation tendernessTenderness of masseter, temporalis, pterygoids
- Trigger pointsTaut bands with referred pain on palpation
- Mild opening limitationMax opening 35–40 mm (normal >40 mm)
- Dental attritionOcclusal wear facets suggesting bruxism
Imaging
Panoramic X-ray usually normal; excludes other pathology.
- Usually normal
- Normal joint structures
- Rules out dental pathology
MRI usually normal; performed to exclude disc/joint pathology.
- Normal disc position
- No effusion
- Muscle findings not well seen on MRI
Non-surgical care
- Patient education/behaviorSoft diet, jaw rest, avoid clenching
- NSAIDs + muscle relaxantsShort-term pain and spasm control
- Occlusal splint (night guard)Nightly stabilization splint protects against bruxism
- PT and heat therapyStretching, massage, trigger point injection
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 — myofascial pain is non-surgical
Procedures that may be discussed
- Conservative care only
Outlook
80–90% improve with conservative care; stress management is key.