Why Does My Face, Neck, or Head hurt? A Guide to Myofascial Pain

Have you been ignoring dull but chronic head and neck pains for years?

You may be suffering from “Myofascial pain dysfunction syndrome.” Myofascial pain-dysfunction (MPD) syndrome is a muscle-contraction, headache-like, pain of the face. In the past this has also been called temporomandibular joint syndrome.

MPD is a fairly common, but misunderstood, condition characterized by pain in the head (headaches), face, neck, shoulders, and other structures. Over a prolonged period of time, the muscles maintain themselves in an altered state of hyperfunction which is perceived in the brain as a “balanced position.”

Myofascial Pain Dysfunction can be present in early teens, as well as in adult men and women, with women experiencing it more often.


Causes of MPD:

The first basic cause is an abnormal relationship of the upper teeth to the lower teeth. This may be due to various reasons like missing teeth, broken teeth, rotated teeth, misaligned teeth, or unilateral chewing.

The second cause of MPD is stress (or better stated “distress”) from a continually stressful environment. All of us are exposed to stress daily. While most of us respond in positive ways to allow the body/mind to handle stress without going into distress, prolonged and constant overload ultimately results in the body’s distress. Then the mind inputs the stress into muscular contractions that tighten jaw and neck muscles.

For instance, a clenched jaw is a response to stress. MPD sufferers maintain a forward head position, causing the muscles of the head, neck, and shoulders to be tender and sore, due to their unbalanced position.

Associated causes that support these 2 basic culprits include:

• Poor nutrition
• Lack of exercise
• Trauma to the jaw joint
• Poor sleeping habits
• Psychological problems
• Trauma to the head or neck
• Pathology or trauma to the joint, like arthritis
• Hormonal imbalances during puberty, child bearing years, or menopause
• Medications, which may have the side effect of clenching
• Malocclusion (jaws which do not line up correctly); for example, after orthodontics, after wisdom tooth extraction, or teeth which interfere with correct closure of the jaw
• Trigger points in the neck and shoulder region.


The symptoms may be any one of, or a combination (allowing it to be named a syndrome) of all of the following:

• Morning headaches and migraines
• Jaw pain
• Restricted mouth opening
• Clicking, popping, grinding when chewing or opening mouth
• Locking jaws
• Worn & temperature sensitive teeth
• Ear pain & noises (ringing or buzzing)
• Eustachian ear tube symptoms (like when flying in an airplane)
• Fullness or stuffy feeling in ear without infection
• Neck and shoulder pain
• Rotator cuff (inner shoulder) pain
• Arm & wrist pain
• Tingling or numbness in fingers
• Snoring (with negative Sleep Apnea diagnosis)
• Light-headedness or dizziness when walking
• Pain behind eyes
• Difficulties swallowing
• Negative MRI or CAT Scan of jaw joints
• Exacerbation of symptoms when wearing a non-customized splint (Mouth Guard)


Treatment of MPD:
As with TMJ therapy, the goal of treatment for MPD is to prevent clenching, and to correct the occlusion (bite), allowing the teeth to come together comfortably and completely without any interferences. Treatment of MPD usually entails the use of a jaw splint or night guard. The splint is usually worn 24 hours a day and when eating (when the teeth/jaw are used most). It is only removed for cleaning.
Stress management training is essential in the treatment of MPDS. Physical therapy is usually suggested, to relieve the symptoms of MPD and bring the head, neck, and facial muscles back into a normal balanced position.

Modern dentistry utilizes low-level lasers in tissue healing acceleration, pain alleviation, and in reducing inflammation and physiotherapy in the orofacial region. The application of low-level laser reduces pain; however, in order to maintain these therapeutic effects, the elimination of etiologic factors is essential.

Hypnorelaxation has a potentially beneficial effect in the treatment of MPD. However, there is no data regarding the efficacy of hypnorelaxation, in the treatment of MPD, compared with above mentioned modes of treatment.


Cure is complex, since the primary reasons for clenching are stress, and the inability of the individual to cope with the stress. As long as you live, stress is unavoidable. What you can do is increase their tolerance for stress by doing yoga, exercising, and performing other stress relieving activities you love to do!

About Mark C. Marchbanks, D.D.S.

Dr. Mark Marchbanks has practiced dentistry in Arlington Texas since 1983. He enjoys caring for patients young and old. You can find Dr. Marchbanks on
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