Myofascial pain syndromes in the maxillofacial area: a common but underdiagnosed cause of head and neck pain.

Abstract

Myofascial pain syndromes (MPS) are a large group of muscular disorders, characterized by the presence of hypersensitive spots called trigger points (TP). The maxillofacial region is a high-frequency area for developing TPs. The aim of this paper was to review and summarize the most important methods of management. A literature review was carried out from Medline and database sources. A range of study types were selected for analysis. TP formation and activity result in a reverberating circuit of sustained neural activity. Central mechanisms, primarily associated with psychosocial factors, lead to chronicity. Other synergistic factors are metabolic disorders, nutritional imbalances and regional anatomic disorders. A detailed history and physical examination are important for proper diagnosis. The aim of MPS management is pain relief and restoration of full muscle function. Treatment may require enhancing central inhibition, using pharmacological and/or behavioural techniques, and reducing peripheral inputs, using physical therapy. There are various effective methods of inactivation of TPs. Recognition and reduction of synergistic factors may be important. MPS have a very high prevalence in the general population, despite low awareness among physicians, affecting patients' quality of life. There is a need for interdisciplinary teams of health professionals to achieve proper diagnosis, management and sustainable outcomes.