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| Hopefully your patients won't look like this when you treat them! |
Facial pain case: A 42 year old woman presents to your clinic with complaints of pain in her cheek and preauricular area on the right side. She also has had frequent right sided headaches. What muscles would you palpate and what would be your rationale?
Coming from a Neuromuscular Therapy standpoint, my brain goes straight to trigger point pain patterns. This woman could have TMJ Dysfunction, or she could just have trigger points that mimic TMJ and are referring pain into her preauricular area and causing headaches. Here are some images of common pain patterns demonstrated by likely muscles:
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| The SCM |
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| Masseter |
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| Temporalis |
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| Medial/Lateral Pterygoid |
Wow!! I really like how you talked about trigger points for being the cause of the pain. Excellent job of thinking outside the box.
ReplyDeleteThanks Mike! I appreciate the sentiment but, trigger points are ME thinking INSIDE the box! I'll check out your page now! I was really wishing I had your background for our ex phys assignment this week!
ReplyDeleteJennifer,
ReplyDeleteThank you for adding the additional information into your answer. The diagrams are helpful to illustrate the concept of a trigger point to others who may not be familiar. For those such people here is what a trigger point is: "an area of tissue that is tender when compressed and may give rise to referred pain (pain in a separate place) and tenderness." - Taber's cyclopedic medical dictionary. Trigger points are things you can come into contact with during palpation, and the head and neck can be full of them.