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Marshall James Nev, PLC | What is Myofacial Pain? in Richmond

Lexington-Richmond Headache Clinic
Marshall James Ney, DMD, FAAOP
Fellow American Academy of Oral Facial Pain

527 W. Main St.
Richmond, 40475
(859) 623-3761

What is Myofacial Pain?
 

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Myofascial pain is a muscle disorder that is characterized by trigger points in one place that refer pain to a distant site.

Okay, but what does that mean? An extreme example of referred pain is someone having a heart attack and feeling the pain in the left arm.

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Below is a drawing of a trigger point. The trigger point is a taut band of muscle tissue that can be locally sore to squeeze or push on but causes pain in a distant area that is very predictable.

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Notice how the trigger points in the above and below illustrations are activated in the center panels.
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In the illustrations below, X's mark the trigger points and the red indicates the locations where the pain is referred to.

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So What Causes Trigger Points?

Everyone has trigger points, but most trigger points are inactive, or latent. In the head and neck there are many reasons for trigger points to become active and begin referring pain to a distant site:

  1. Poor sleep, in that the patient has trouble falling asleep.
  2. Awakening two or more times per night.
  3. Dreaming a lot.
  4. Sleeping in a room that is too hot or too cold.
  5. Sleeping with animals in bed with you.
  6. Having a bed partner that snores loudly.
  7. Malocclusion; there is a problem with the way a person's teeth come together. This is hard to describe in words. When you visit us we can demonstrate it better.
  8. The bad bite (malocclusion) causses muscles in the back of the neck to contract when they should not.
  9. Weak neck muscles; a person with weak neck muscles will sense that the head feels too heavy for the neck to hold up.
  10. Bad posture.
  11. Oral habits like chewing gum and tongue or cheek biting.
  12. Clenching or grinding your teeth during the day or night.
  13. Sitting at a computer for long periods of time.
  14. Sleeping on your stomach.
  15. Coughing a lot.
  16. Trauma to the head and neck muscles as in a car wreck.
  17. Cold weather.
  18. Air-conditioning.
  19. Bad workplace ergonomics.
  20. Stress.*

* By itself, stress does not cause pain. However, stress does cause some behaviors that cause us pain, such as shrugging our shoulders, clenching our teeth, and not sleeping well. These are areas health psychologists can help us manage this part of our pain.

How do we quiet active trigger points down?

Inactive trigger points are also called latent trigger points.

First we have to identify what aggregates the trigger point and we try to fix or modify the cause.

Example:

Rose was in our treatment program and was pain free. Then she got another job within the same company, and the pain came back. Was it the stress of a new job? Possibly, but it turned out the air conditioning vent was blowing cold air on her. Once the vent was adjusted to direct air elsewhere, Rose got better.

We already know several aggravating factors which are common to almost all oralfacial pain patients. These are sleep, bite, and cervical muscle weakness. Once these factors are managed, if the pain still needs managing, we can figure out the other causes.

 
 
Richmond Dentist | What is Myofacial Pain?. Marshall James Ney is a Richmond Dentist.