From the Guidelines
Myofascial pain syndrome (MPS) and temporomandibular joint disorder (TMJD) are distinct conditions with different primary focuses: MPS on muscle dysfunction and TMJD on joint mechanics, despite potential overlap in symptoms and coexistence. The key difference between MPS and TMJD lies in their underlying causes and areas of focus. MPS is characterized by pain originating from trigger points in muscles and their surrounding fascia, typically causing localized pain that can radiate to other areas [ 1 ]. In contrast, TMJD specifically involves dysfunction of the temporomandibular joint, which connects the jawbone to the skull, with symptoms including jaw pain, difficulty or discomfort while chewing, clicking or popping sounds when opening the mouth, and sometimes limited jaw movement.
Key Characteristics of MPS and TMJD
- MPS:
- Characterized by trigger points in muscles and fascia
- Can affect any muscle, including those of the jaw and face
- Typically responds to trigger point release techniques, stretching, and muscle relaxants
- TMJD:
- Involves dysfunction of the temporomandibular joint
- Symptoms include jaw pain, chewing difficulties, and joint sounds
- Often requires splints or bite adjustments to correct jaw alignment
Treatment Approaches
Treatment strategies for MPS and TMJD differ based on whether the primary issue is muscular or joint-related. For TMJD, recent clinical practice guidelines recommend conservative approaches first, including reassurance, education, avoidance of aggravating activities, soft diet, jaw exercises, massage, NSAIDs, heat and/or cold, and bite plate in the presence of bruxism [ 1 ]. Surgery should be considered only after non-response to conservative therapy. For MPS, trigger point release techniques, stretching, and muscle relaxants are typically effective.
Importance of Proper Diagnosis
Proper diagnosis is essential to determine the appropriate treatment strategy, as the conditions can coexist and influence each other. Muscle tension from MPS can affect jaw alignment and function, while TMJD can cause compensatory muscle patterns leading to trigger points [ 1 ]. Therefore, a comprehensive evaluation considering both muscular and joint factors is necessary for effective management of these conditions.
From the Research
Difference between Myofascial Pain Syndrome and TMJD
- Myofascial pain syndrome (MPS) is a regional musculoskeletal pain disorder characterized by trigger points within the muscle or fascia 2.
- Temporomandibular joint disorder (TMJD) is a term that encompasses disorders of both the temporomandibular joint and masticatory musculature, including myofascial pain in the jaw and face area 3.
- The primary difference between MPS and TMJD is that MPS can occur in any muscle or fascia, whereas TMJD is specific to the temporomandibular joint and surrounding muscles 4.
- MPS is thought to be related to sustained muscle contraction from under- or overuse, whereas TMJD can be caused by a variety of factors, including jaw injury, arthritis, and teeth grinding 2, 3.
Diagnostic Criteria
- MPS is diagnosed based on a physical examination finding of at least one localized trigger point that, when palpated, recreates the pain at the site or produces pain away from the site in a referral pattern 2.
- TMJD is diagnosed based on a comprehensive clinical evaluation, including a thorough history, physical examination, and diagnostic workup, such as imaging studies or serological testing 3.
- A thorough history and clinical examination are the gold standards for diagnosis of both MPS and TMJD 3, 4.
Treatment Options
- Treatment for MPS typically involves a multimodal approach, including patient education, exercise, behavior modification, pharmacotherapy, and procedural interventions, such as manual therapy, dry needling, and trigger point injections 2, 5.
- Treatment for TMJD also involves a multimodal approach, including conservative modalities, such as home care regimens, pharmacotherapy, intraoral appliance therapy, and physiotherapy, as well as complementary modalities, such as acupuncture and massage 3.
- Both MPS and TMJD can be challenging to treat, and additional studies are warranted to get a better understanding of managing these conditions 5, 6.