If you have pain in your face and / or jaw and your doctors have ruled out tooth or bone pathology, sinus problems, or trigeminal nerve involvement, your pain may be caused by either a dysfunction of the muscles in your face or a problem within your jaw joint.
Most people who suffer from TMJ (face and jaw pain) don’t have significant joint pathology. In fact, in most TMJ cases, face and jaw pain originates from the muscles and the fascia of the cheeks and small muscles inside the mouth, not from the jaw joint. Because your neck and jaw are functionally interrelated, most TMJ patients also have a neck dysfunction (with resultant pain and tightness of the neck and shoulder muscles). TMJ also frequently co-exists with headaches and tinnitus (ringing in the ear).
If any muscle in your body tightens up and maintains that tension for a long period of time, it will eventually develop knots or nodule-like spots inside it. These knots are easy to find because in addition to having a distinct, nodule-like texture, they are tender when you apply pressure to them. These tender knots within a contracted muscle are called myofascial trigger points. (Myo means muscle, and fascia is the connective tissue that holds it together.)
Although trigger points are sensitive to pressure, they initially don’t cause any problems. Yet over time, myofascial trigger points start producing a sensation of pain in distant sites. That type of pain is called referred pain, because it originates from places outside of where you perceive it.
Pain referred from myofascial trigger points is called myofascial pain. If left untreated, myofacial pain may become chronic and develop into a condition known as myofascial pain syndrome (or myofascial pain disorder).
As we stated earlier, in most cases, TMJ pain is caused by chronically tight face muscles and is myofascial in nature.
Each muscle in the body tends to develop myofascial trigger points in specific locations. And each trigger point has a specific pattern of pain referral. Trigger points in the face muscles refer pain to various areas of the face, jaw, ear, eye, head, and teeth.
Here are some examples of referral patterns for some of the most common trigger points in the muscles of the face. The black x sign indicates a trigger point within a muscle and areas marked in red illustrate where that trigger point sends the referred pain:
Read about what myofascial pain in the face and jaw feels like >
The muscles of the face, just like any muscles in your body, can tighten up in response to stress or trauma (e.g., whiplash injury, direct blow to the face, head, or neck) or because of inflammatory processes within the TMJ and its surrounding tissues.
Face muscles can become abnormally tight as a result of structural problems, e.g. type of bite, neck alignment.
Another common cause of muscular tightness in the face and jaw is habitual over-activation (or overuse) of the jaw and face muscles. This can happen when you clench or grind your teeth, play with your tongue, bite your lips or cheeks, chew gum, etc.
Face and jaw muscles can also tighten up in response to emotional or intellectual stress, poor posture (in particular, your neck and tongue position at rest and during functional activities), and abnormal breathing pattern.
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