Therapeutic management of a case of chronic myofacial pain
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Myofacial pain
temporomandibular disorders

How to Cite

ABDELKOUI, A., ELAOUD, J., ABDEDINE, A., & MERZOUK, N. (2022). Therapeutic management of a case of chronic myofacial pain. International Arab Journal of Dentistry (IAJD), 13(2), 116-122. Retrieved from


Myofacial pain is a common form of temporomandibular disorders. It is manifested by a sensory, motor and autonomous symptoms caused by trigger points. These pains can significantly affect patients’ quality of life, when they persist. Several etiological factors have been implicated in the genesis of the myofacial pain: muscle overload, emotional tension, harmful postural habits, fatigue, and hypovitaminosis... The diagnosis of myofacial pain is based on a pertinent history and clinical examination. Several therapeutic options alone or in combination have proven their effectiveness. This article aims, through a clinical case, to focus on myofacial pain, possible therapeutics, by focusing on the contribution of the occlusal appliance in the management of these pains.
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Références bibliographiques
1- Travell JG, Rinzler SH: e myofascial genesis of pain, Postgrad Med 11:425–434, 1952.
2- Schiman E, Ohrbach R, Truelove E, et al.: Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the international RDC/TMD consortium network and orofacial pain special interest group dagger, J Oral Facial Pain Headache 28(1): 6–27, 2014.
3- Gerwin R-D. Diagnosis of Myofascial Pain Syndrome. Phys Med Rehabil Clin N Am 25 (2014) 341–355 .
4- Urits I et al., « Treatment and management of myofascial pain syndrome », Best Pract. Res. Clin. Anaesthesiol., vol. 34, no 3, p. 427‑448, sept. 2020. doi: 10.1016/j.bpa.2020.08.003.
5- Shah J. P, Thaker N, Heimu J.R, Aredo J. V, Sikdar S., Gerber L. « Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective », PM&R, vol. 7, no 7, p. 746‑761, juill. 2015, doi: 10.1016/j.pmrj.2015.01.024
6- Edwards J. The importance of postural habits in perpetuating myofascial trigger point pain. Acupuncture in Medicine: Journal of the British Medical Acupuncture Society 2005; 23(2): 77-82. [PUBMED: 16025788]
7- Fricton JR, Kroening R, Haley D, Siegert R. Myofascial
pain syndrome of the head and neck: a review of clinical characteristics of 164 patients. Oral Surgery 1985;60: 615-23.
8- Simons DG, Travell JG, Simons LS. Travell and Simons' Myofascial Pain and Dysfunction: The Trigger Point Manual. 2nd Edition. Vol. 1: Upper Half of the Body, Baltimore: Lippincott, Williams & Wilkins, 1999.
9- Laskin DM. Etiology of the pain-dysfunction syndrome. Journal of the American Dental Association 1969; 79:147-53.
10- Bron C., Dommerholt J. D. « Etiology of Myofascial Trigger Points », Curr. Pain Headache Rep., vol. 16, no 5, p. 439‑444, oct. 2012, doi: 10.1007/s11916-012-0289-4.
11- Costa Y. M et al., « Muscle hardness and masticatory myofascial pain: Assessment and clinical relevance », J. Oral Rehabil., vol. 45, no 8, p. 640‑646, août 2018, doi: 10.1111/joor.12644.
12- Giamberardino MA, Affaitati G, Fabrizio A, et al. Myofascial pain syndromes and their evaluation. Best Pract Res Clin Rheumatol 2011 Apr;25(2):185e98. 

13- Fricton J. Myofascial pain: Mechanisms to management. Oral Maxillofac Surg Clin North Am 2016, Aug; 28(3): 289e311.
14- Shah JP, Gilliams EA. Uncovering the biochemical milieu of myofascial trigger points using in vivo microdialysis: an application of muscle pain concepts to myofascial pain syndrome [cited 2018 Nov 19] Available from: J Bodyw Mov Ther 2008 Oct;12(4):371e84. 

15- Bourgaize S, Newton G, Kumbhare D, et al. A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management. J Can Chiropr 
Assoc 2018; 62(1): 26e41. 

16- Saxena A, Chansoria M, Tomar G, and Kumar A. Myofascial Pain Syndrome: An Overview. Journal of Pain & Palliative Care Pharmacotherapy. 2015;Early Online:1–6.
17- Borg-Stein J et Iaccarino M. A. « Myofascial Pain Syndrome Treatments », Phys. Med. Rehabil. Clin. N. Am., vol. 25, no 2, p. 357‑374, mai 2014, doi: 10.1016/j.pmr.2014.01.012.
18- Sturdivant J, Fricton JR. Physical therapy for temporomandibular disorders and orofacial pain [review]. Curr Opin Dent 1991; 1(4):485–96. 

19- Halkovich LR, Personius WJ, Clamann HP, et al. Effect of Fluori-Methane spray on passive hip flexion. Phys Ther 1981; 61(2):185–9. 

20- Travell J, Simons DG. Myofascial pain and dysfunction: the trigger point manual. Baltimore (MD): Wil- liams & Wilkins; 1998.
21- Cooper AL. Trigger point injection: its place in physical. Arch Phys Med Rehabil 1961;42: 704–9.
22- Jaeger B, Skootsky SA. Double blind, controlled study of different myofascial trigger point injection techniques. Pain 1987;4(Suppl):S292. 

23- Dionne RA. Pharmacologic treatments for temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997; 83(1):134–42
24- Fricke JR Jr, Hewitt DJ, Jordan DM, et al. A double-blind placebo-controlled comparison of tramadol/acetaminophen and tramadol in patients 
with postoperative dental pain. Pain 2004; 109(3): 250–7.

25- Dubner R. Hyperalgesia in response to injury to cutaneous and deep tissues. In: Fricton J, Dubner R, editors. Orofacial pain and temporo- mandibular disorders. New York: Raven Press; 1995. p. 61–71.
26- Aronoff GM, Evans WO, Enders PL. A review of follow-up studies of multidisciplinary pain units. Pain 1983; 16(1): 1–11.