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The temporalis muscle is a powerful muscle that connects the jaw bone to the temporal tendon, which spans the side of the head. It is one of the muscles used for chewing and is commonly involved in jaw pain and headaches. Temporal tendonitis, or inflammation of the temporal tendon, can be caused by prolonged mouth opening, tooth grinding, trauma to the head, and excessive gum chewing. While it is not clear if a tight temporalis muscle can cause facial numbness, temporal tendonitis can cause pain in the temporal area, jaw, and headaches, as well as referred pain in the jaw, cheek, and upper teeth. Treatment for temporal tendonitis typically involves conservative therapy with injections of anesthetics and anti-inflammatory medications, or surgical intervention in some cases.
| Characteristics | Values |
|---|---|
| Condition | Temporal Tendonitis |
| Other Names | Tendinitis, Migraine Mimic |
| Cause | Inflammation and tenderness of the temporal tendon |
| Symptoms | Pain in the jaw, cheek, and upper teeth; headaches; pain when biting down; teeth sensitivity to temperature |
| Diagnosis | Patient history, tenderness upon palpation of the temporal tendon, radiographic evaluation, local anesthetic block |
| Treatment | Conservative (anti-inflammatory medication, anesthetic injections, physical therapy) or surgical |
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Temporal Tendonitis
The diagnosis of temporal tendonitis involves four criteria, with three out of four criteria suggesting the presence of the condition:
- Historical reporting by the patient: The patient may recall an incident of prolonged mouth opening during dental or surgical procedures.
- Tenderness upon palpation of the temporal tendon: Palpation of the temporal tendon may reveal tenderness, which is characteristic of temporal tendonitis.
- Radiographic evaluation: Radiographic imaging may show elongation of the coronoid process in chronic cases of temporal tendonitis.
- Local anesthetic block: The most definitive diagnostic test is the injection of a local anesthetic into the deep temporal nerves. If pain relief is experienced, it confirms the presence of temporal tendonitis.
Treatment for temporal tendonitis aims to address the underlying inflammation. Conservative therapy involves injecting a combination of anti-inflammatory medication and long-acting anesthetics into the temporal tendon. Surgical options may also be considered in some cases.
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TMJ dysfunction
The treatment for TMJ dysfunction can be conservative or surgical. Conservative therapy involves injecting a combination of an anti-inflammatory medication and a long-acting anesthetic into the temporal tendon. Surgical options are typically considered when conservative measures have been exhausted or in severe cases where the patient cannot open their jaw, the jaw is dislocated, or has undergone severe degeneration.
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Bruxism
In some cases, bruxism may be related to cerebral operations, as suggested by one individual whose husband developed bruxism after undergoing two cerebral procedures. Certain medications can also contribute to bruxism, and it is important to consider their potential side effects.
The condition can significantly impact an individual's quality of life, leading to constant pain and disrupted sleep. While mouth guards are a common treatment option, they may not always provide sufficient relief. As such, finding effective solutions for bruxism can be challenging, and individuals may need to explore various options before discovering what works best for them.
It is important to consult with medical professionals, such as dentists or doctors, to receive a proper diagnosis and explore personalised treatment options for bruxism. They can help rule out other potential causes and provide guidance on managing the condition effectively. This may include recommendations for stress reduction techniques, medication adjustments, or other therapeutic approaches to alleviate bruxism and its associated symptoms.
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Trauma
In addition to direct trauma, indirect trauma such as forward head posture can also cause issues with the temporalis muscle. This occurs when the head extends out in front of the body, keeping the temporalis muscle in a constant state of stretch and leading to the development of trigger points. These trigger points can refer pain to the jaw, cheek, and upper teeth, as well as cause tension headaches.
Teeth grinding (bruxism), often associated with stress or sleep, can also be considered a form of trauma to the temporalis muscle. The constant clenching and grinding can strain the muscle and lead to the development of trigger points, resulting in similar symptoms as mentioned above.
To treat trauma-related issues with the temporalis muscle, various approaches can be taken. Physical therapy, massage, and the use of sleep tape to reduce tension during sleep are all recommended for managing tension and trigger points. In more severe cases, such as a rupture, computed tomography (CT) and magnetic resonance imaging (MRI) may be required for diagnosis, and in the case of seizures, medical management of the underlying condition is crucial. For conditions like temporal tendinitis, a combination of dental and medical knowledge is necessary for proper treatment, which may include injections of anesthetics and anti-inflammatories.
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Triggers and treatments
The temporalis is one of the muscles used for chewing and is commonly involved in jaw pain and headaches. Tension or trigger points in the temporalis muscle can cause pain in the temporal area, jaw, and tension headaches. This tension can also lead to referred pain in the cheek and upper teeth. Common causes of tension in the temporalis include trauma, such as a fall or a blow to the head, and teeth grinding (bruxism). Many people grind their teeth and clench their jaw when they are under stress, and they may not even be aware they are doing it. Constant gum chewing can also lead to the development of trigger points. Forward head posture can also cause tension in the temporalis, as the muscle stays in a stretched position and is likely to develop trigger points.
Temporal tendonitis is a common craniofacial pain disorder that often goes misdiagnosed as an intra-articular temporomandibular joint disorder, tension-type headaches, or maxillary sinusitis. It is caused by inflammation of the temporal tendon as it inserts into the coronoid process of the mandible. Treatment for temporal tendonitis can be conservative or surgical. Conservative therapy involves injecting a combination of anti-inflammatory medication and a long-acting anesthetic into the temporal tendon. Anti-inflammatory medication is usually also prescribed. Surgical treatment involves making a small incision inside the oral cavity and shaving down the elongated coronoid process to a normal height. Physical therapy is then necessary after the surgery.
Temporomandibular disorders (TMD) are a group of more than 30 conditions that cause pain and dysfunction in the jaw joint and muscles that control jaw movement. TMDs can be caused by excessive strain on the jaw joints and the muscle group that controls chewing, swallowing, and speech, which may be the result of bruxism. Trauma to the jaw, head, or neck may also cause TMD. Treatment for TMDs can be simple, such as eating soft foods, applying heat or cold to the face, and taking over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs). If these steps do not help, physical therapy may be recommended.
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Frequently asked questions
Temporal tendonitis is inflammation and tenderness of the temporal tendon, which connects the jaw bone to the temporal muscle that spans the side of the head.
Temporal tendonitis may cause headaches, jaw pain, or facial pain.
Temporal tendonitis can be caused by prolonged mouth opening, increased stress, tooth grinding, direct trauma to the temporalis muscle, excessive gum chewing, or a rare condition called Coronoid Process Hyperplasia.
Treatment for temporal tendonitis involves conservative therapy or surgery. Conservative therapy includes injecting a combination of anti-inflammatory medication and a long-acting anesthetic into the temporal tendon. Surgery involves making a small incision inside the oral cavity, shaving down the elongated coronoid process, and reattaching the muscle to the new position.
