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Syndrome of muscular-facial pain
Last reviewed: 20.11.2021
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Syndrome of muscular-facial pain can be observed in patients without pathology from the temporomandibular joint. It can be caused by stress, fatigue or spasm of the masticatory muscles (medial and lateral wing, jaw and temporal). Symptoms include bruxism, pain and soreness in and around the chewing apparatus or spreading to adjacent areas of the head and neck and often pathologies of jaw mobility. The diagnosis is based on anamnesis of the disease and clinical examination. Conservative treatment, including analgesics, muscle relaxation, habit change and tire application, is usually effective.
This syndrome is the most frequent condition localized in the temporomandibular region. Most often it is observed in women aged 20 years or in menopause. Muscle spasm is a consequence of nocturnal bruxism (clenching and gnashing of teeth). The question of the cause of bruxism is controversial (wrong dental contact, emotional stress or sleep disturbance). With bruxism, several etiological factors are observed. The syndrome of muscular-facial pain is not limited to chewing muscles. It can be observed in other parts of the body, usually the muscles of the neck and back are involved.
Symptoms of musculo-facial pain syndrome
Symptoms include pain and tenderness of the chewing musculature, usually pain and restriction of mouth opening. Nighttime bruxism can lead to a headache that decreases throughout the day. Daytime symptoms, including a headache, can worsen if bruxism occurs during the day.
The jaw is displaced when the mouth opens, but usually not so unexpectedly and always at a given point, as is observed with internal damage to the joint. With pressure on the jaw, the doctor can open the mouth 1-3 mm more than the self-opening maximum.
A simple test can help diagnose: the surface of the tongue is placed on the inner surfaces of the molars and the patient is asked to gently close the jaws. Soreness at one point is a symptom. X-ray examination does not provide data, but allows to exclude arthritis. If an arteritis is expected, an ESR measurement is required.
Where does it hurt?
How to examine?
Treatment of muscular-facial pain syndrome
A stalk plate or kappa, made by a dentist, can protect the teeth from mutual contact and prevent bruxism. Convenient kappa, which when heated becomes plastic. They are sold in many sports stores and pharmacy stores. Small doses of benzodiazepine at night are often effective in exacerbating the disease to reduce the symptoms of the disease. Mild painkillers such as NSAIDs or acetaminophen may be given. Because the disease is chronic, opiates should not be used, except in cases of acute exacerbation of the disease. The patient should control the clenching of the jaws and the grinding of teeth. Rough food and chewing gum should be ruled out. Some patients can be assisted by physiotherapy and psychotherapy for relaxation of the muscles. Physiotherapy involves a percutaneous electrical effect on the nerve or cooling of the skin at a painful point when the mouth is opened with ice or sprayed onto the skin, for example, ethyl chloride. The botulinum toxin can be used to reduce muscle spasm in the muscle-facial pain syndrome. In most patients, even if they did not receive treatment, the main signs of the disease disappear after 2-3 years.