Myofascial Pain
Struggling with jaw or facial muscle pain and headaches?
At Advanced TMJ Maxillofacial Pain & Sleep Center, we specialize in diagnosing and treating this underrecognized condition with targeted, non-surgical care.
We treat myofascial pain and trigger points affecting the TMJ, face, neck, and head. We serve patients from Seattle, Bellevue, Everett, Kent, and surrounding areas with personalized, evidence-based care.
Learn About Myofascial Pain
Myofascial Pain vs TMJ vs Other Facial Pain
Myofascial pain is a chronic pain condition that originates in the muscles and fascia—the connective tissue surrounding muscles—particularly those involved in chewing, speaking, and head and neck movement. It is one of the most common causes of non-dental facial pain and is frequently overlooked or misdiagnosed.
In the orofacial region, myofascial pain often affects the masseter, temporalis, sternocleidomastoid (SCM), and trapezius muscles, leading to symptoms such as jaw tightness, facial tenderness, headaches, and referred pain to the ear, temple, teeth, or neck.
The pain is usually described as deep, dull, aching, and persistent, and often worsens with jaw movement, prolonged posture (like sitting at a desk), or emotional stress.
How is Myofascial Pain Different from TMJ Disorders or Other Causes of Jaw Pain?
While myofascial pain often overlaps with temporomandibular disorders (TMD), they are not the same:
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Myofascial pain originates in muscles and soft tissue, typically without structural damage to the joint.
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TMJ disorders (TMD) often involve the jaw joint (TMJ) itself—such as disc displacements, joint degeneration, or arthritis.
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Other causes of facial pain may include dental issues, sinus infections, neuropathic pain, or headaches, which must be ruled out.
Unlike conditions that require surgery or dental treatment, myofascial pain is best managed conservatively—with targeted therapies that address muscle tension, posture, habits, and stress.
At Advanced TMJ Maxillofacial Pain & Sleep Center, we specialize in identifying the subtle signs of muscle-based pain patterns. Accurate diagnosis is key to avoiding unnecessary treatments and getting patients the relief they need through non-invasive, evidence-based care.
What are trigger points, and why do they matter?
Trigger points are small, hypersensitive areas within tight bands of muscle or fascia (the connective tissue around muscles). These spots feel like firm “knots” when touched and are often painful—not just at the site, but also in areas far from the trigger point itself.
This phenomenon is known as referred pain. For example, a trigger point in the masseter muscle (one of the main chewing muscles) may cause pain in the ear, temple, teeth, or jaw, even though the actual problem lies in the muscle.
Common Features of Trigger Points:
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Localized tenderness at the site of the knot
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Referred pain to other regions (often mistaken for toothaches, headaches, or ear pain)
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Muscle stiffness or weakness
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Limited range of motion
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Worsening pain with use or stress
In the head and neck region, trigger points are frequently found in the:
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Masseter
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Temporalis
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Sternocleidomastoid (SCM)
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Trapezius
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Medial and lateral pterygoid muscles
These muscles are critical to jaw and head movement, and when they become overloaded—by clenching, poor posture, or emotional tension—trigger points can form and persist, leading to chronic myofascial pain.
Why Trigger Points Matter in Diagnosis & Treatment
Trigger points are not just a symptom—they are a central feature of myofascial pain. Identifying and treating them effectively is essential to long-term pain relief.
At Advanced TMJ Maxillofacial Pain & Sleep Center, we use a variety of evidence-based techniques to locate and deactivate trigger points, including:
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Manual palpation and mapping of pain patterns
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Trigger point injections (with local anesthetics and/or vitamins)
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Low-level laser therapy to reduce inflammation and tension
This targeted approach provides significant relief for patients who’ve often been in pain for months—or even years—without a clear diagnosis.
Who is affected by myofascial pain?
Myofascial pain can affect virtually anyone, but it's especially common in individuals who are exposed to physical stress, emotional tension, poor posture, or repetitive jaw use. Despite being one of the most frequent causes of chronic head, neck, and jaw pain, it is often misdiagnosed or overlooked, particularly in healthcare settings that are not specialized in orofacial pain.
Studies estimate that up to 85% of people with chronic pain have some component of myofascial pain. Unfortunately, many patients are incorrectly treated for TMJ disorders, sinus conditions, or dental problems before getting a proper diagnosis.
Populations Commonly Affected by Myofascial Pain:
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Adults aged 20–60: Especially those in high-stress or sedentary jobs, or with poor sleep quality
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Women: More frequently affected than men, possibly due to hormonal and musculoskeletal differences
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People with high stress or anxiety: Stress often leads to clenching and muscle tension, which overloads the jaw and neck muscles
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Bruxers and those with parafunctional habits: Clenching, grinding, nail-biting, gum chewing, and other repetitive habits are risk factors
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Individuals with poor posture: Forward head posture and extended screen time strain neck and jaw muscles
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Those with sleep disturbances: Non-restorative sleep impairs muscle recovery and increases pain sensitivity
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Patients with chronic fatigue, fibromyalgia, or overlapping pain conditions
These individuals often experience widespread myofascial pain and muscle tenderness -
Athletes, singers, and public speakers: Repetitive jaw and vocal use can contribute to muscle overload
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People with a history of trauma or dental work: Whiplash, facial injuries, or extensive procedures can trigger lingering muscle dysfunction
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Those with coexisting TMD or cervical spine dysfunction: Myofascial pain often overlaps with joint problems or neck-related pain syndromes
Because myofascial pain presents differently in each person and frequently overlaps with other conditions, it requires specialized evaluation by an Orofacial Pain provider. At our Seattle clinic, we take the time to assess the full picture—your pain patterns, risk factors, and lifestyle—to guide accurate diagnosis and individualized care.
What causes myofascial pain in the jaw and neck?
Myofascial pain develops when muscles and the surrounding fascia (connective tissue) become irritated, overused, or strained—leading to tight bands and trigger points. In the head, neck, and jaw region, this can result in persistent pain, limited mobility, and referred symptoms like headaches or ear pain.
Unlike injury-based pain, myofascial pain often builds gradually, influenced by daily habits, posture, emotional stress, or poor sleep. In many cases, both the jaw and neck muscles are involved—a pattern called cervical-masticatory myofascial pain—which requires a comprehensive treatment approach.
Common Causes of Myofascial Pain:
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Jaw clenching or teeth grinding (bruxism)
Often unconscious, this overloads the jaw muscles, especially during sleep or stress -
Poor posture
Forward head posture, slouching, or prolonged screen time can chronically strain neck and jaw muscles -
Repetitive muscle use
Excessive gum chewing, prolonged talking, chewing on pens, or singing -
Emotional stress and anxiety
Stress increases muscle tension and pain sensitivity, often without the person realizing they are clenching -
Acute trauma
Whiplash, facial injuries, or past dental or surgical procedures may lead to persistent muscle dysfunction -
Microtrauma from habits
Nail-biting, cheek-chewing, or holding the phone between the neck and shoulder -
Sleep disturbances or poor sleep quality
Reduces muscle recovery and increases sensitivity to pain -
Nutritional imbalances
Low levels of magnesium or vitamin D may increase muscular tension in some cases -
Physical deconditioning or inactivity
Sedentary lifestyles can weaken stabilizing muscles and make them prone to overuse -
Underlying TMJ disorders
Dysfunction in the jaw joint can alter how the muscles work, leading to overload and trigger points
Since myofascial pain is often multifactorial, successful treatment involves not just relieving symptoms, but identifying and addressing the root causes. At Advanced TMJ Maxillofacial Pain & Sleep Center, we take a holistic approach to evaluating these factors so we can build a plan that truly works - for your body, your lifestyle, and your long-term comfort.
What are the symptoms of myofascial pain?
Myofascial pain in the orofacial region can present with a wide range of symptoms—some local to the muscles, and others referred to areas like the ears, teeth, or temples. Because these symptoms often mimic dental, sinus, or neurologic issues, many patients go misdiagnosed for months or even years.
Patients frequently describe the pain as deep, dull, and aching, with episodes of increased intensity during jaw movement, stress, or poor posture. The discomfort may come and go—or persist chronically—and is often aggravated by daily activities like chewing, talking, or using screens for long periods.
Common Symptoms of Myofascial Pain in the Head & Neck:
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Facial pain – Often dull, aching, and centered in the jaw, cheeks, or temples
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Jaw fatigue or tightness – Especially noticeable after chewing, talking, or waking up
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Referred pain – Sensations felt in the ears, teeth, temples, forehead, or behind the eyes
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Headaches – Commonly tension-type, located in the temples or across the forehead
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Morning discomfort – From clenching or grinding during sleep
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Tender trigger points – Painful, taut bands in the jaw, neck, or shoulder muscles
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Limited mouth opening or jaw stiffness – Especially during flare-ups
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Pain that worsens with stress, chewing, or poor posture
Because myofascial pain can closely mimic conditions like TMJ disorders, toothaches, sinus infections, or migraines, it’s crucial to receive a thorough evaluation from a provider who specializes in Orofacial Pain.
At our clinic, we use specialized diagnostic techniques to distinguish muscle-based pain from other sources, so patients get the right diagnosis, and the right treatment, the first time.
How is myofascial pain diagnosed?
Diagnosing myofascial pain in the orofacial region requires more than a quick look at the teeth or jaw—it involves a detailed clinical evaluation of the muscles, posture, habits, and associated conditions. Because the symptoms of myofascial pain can mimic other problems like TMJ disorders, sinus pressure, or nerve pain, accurate diagnosis is essential to avoid ineffective or unnecessary treatments.
At Advanced TMJ Maxillofacial Pain & Sleep Center, we specialize in identifying muscle-based pain patterns using a systematic, hands-on approach supported by advanced training in Orofacial Pain.
Our Myofascial Pain Diagnostic Process Includes:
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Palpation of facial and neck muscles
We examine key muscle groups—such as the masseter, temporalis, SCM, and trapezius—for trigger points and tenderness. -
Assessment of jaw function and movement
We evaluate how your jaw opens, closes, and moves side-to-side to identify muscle guarding, asymmetry, or restriction. -
Postural and habit evaluation
We look at how your head and neck are positioned during daily activities and ask about clenching, grinding, or other muscle-straining behaviors. -
Sleep and stress screening
Sleep disturbances and emotional stress are common contributors, so we assess these as part of your full clinical picture. -
Ruling out overlapping conditions
We differentiate myofascial pain from dental infections, sinus issues, nerve pain (like trigeminal neuralgia), or TMJ disc problems to ensure a precise diagnosis.
This type of pain doesn’t show up on X-rays or routine scans. So the key is expert clinical examination and a deep understanding of orofacial pain patterns. We believe that getting the right diagnosis is the most important step toward long-lasting relief.
Why choose us, and what to expect during a visit?
At Advanced TMJ Maxillofacial Pain & Sleep Center in downtown Seattle, we understand that living with chronic facial or jaw pain can be frustrating, exhausting, and even isolating—especially when you’ve seen multiple providers without answers.
That’s why Dr. Hemamalini Chandrashekhar, a board-certified Orofacial Pain specialist and dual-trained Oral & Maxillofacial Surgeon, takes a whole-person, evidence-based approach to myofascial pain diagnosis and care. Our clinic is uniquely equipped to evaluate complex muscle-related facial pain—and provide targeted, non-surgical treatment options.
What to Expect During Your First Visit
Your initial consultation is all about understanding your unique pain experience and uncovering its root causes. Here's what your visit may include:
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A detailed medical, pain, and sleep history
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Hands-on muscle palpation and trigger point evaluation
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Jaw function and movement assessment
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Postural screening and habit review
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Ruling out overlapping dental, neurologic, or joint conditions
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Patient education about myofascial pain and contributing factors
You’ll leave your appointment with a personalized care plan designed to relieve pain, restore muscle function, and reduce the likelihood of recurrence.
Patients frequently tell us they feel heard and relieved after their first visit, especially after years of being misdiagnosed or told “everything looks fine.” Our goal is to not just manage your pain, but to empower you with knowledge and tools for long-term healing.
How is myofascial pain treated, and will it recur?
Myofascial pain is treatable, and in many cases, patients experience significant improvement or complete resolution with a tailored, non-surgical treatment plan. However, because the condition is often multifactorial and chronic, some individuals may experience flare-ups over time. The key is not just symptom relief, but addressing the underlying causes.
At Advanced TMJ Maxillofacial Pain & Sleep Center, we offer a comprehensive, evidence-based approach to treating myofascial pain. Our goal is to reduce muscle tension, deactivate trigger points, restore function, and help you build long-term strategies for preventing recurrence.
Will Myofascial Pain Come Back?
Flare-ups are possible, especially if underlying factors like stress, poor posture, or bruxism persist. But with the right care, education, and prevention strategies, we help you manage your pain long-term and reduce the risk of recurrence.
Think of our role not just as treating your current symptoms, but as partners in helping you prevent future pain through proactive, holistic care.
