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Muscle deep-dives

Medial Pterygoid trigger points: referred pain, palpation and release

A clinical deep-dive on Medial Pterygoid: trigger point locations, the referred pain pattern they produce, palpation landmarks, activating factors and an evidence-based release protocol.

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Medial Pterygoid trigger points: referred pain, palpation and release
Medial pterygoid — trigger point deep inside the mandibular angle with referred pain to the ear, TMJ, tongue and hard palate; often felt as deep ear pain with chewing.

Why this muscle causes pain

Inner jaw elevator; protrudes and laterally shifts the mandible. Trigger points here are common in everyday and athletic populations and frequently contribute to the referred pain patterns described below.

Where the trigger points sit

Deep inside the mandibular angle, palpated intraorally with a gloved finger.

The referred pain pattern

Tongue, hard palate, lower jaw, ear and TMJ — often felt as deep ear pain with chewing.

How to find it by palpation

Palpate the muscle belly along its accessible course. Reproduction of the patient's familiar pain on palpation supports involvement.

What sets it off

Bruxism, malocclusion, prolonged dental work, jaw clenching under stress.

Self-care that actually helps

Soft-diet phase, jaw relaxation drills. Clinically: intraoral release and dry needling by a trained clinician.

Symptoms this muscle produces

Clinically, this muscle turns up in the workup of cheek pain (like sinusitis), difficulty swallowing, drooling in sleep, earaches/tinnitus (ringing)/itch, post nasal drip and runny nose. Those are the complaints its referral zone overlaps, which is why a patient may present with any of them and never mention the muscle itself.

Muscles covered

Studies cited

Every claim in this article traces back to one of the sources below.

  1. Kietrys 2013Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis. J Orthop Sports Phys Ther 2013;43(9):620-34
  2. Gattie 2017The effectiveness of trigger point dry needling for musculoskeletal conditions by physical therapists: a systematic review and meta-analysis. J Orthop Sports Phys Ther 2017;47(3):133-49
  3. Boyles 2015Effectiveness of trigger point dry needling for multiple body regions: a systematic review. J Man Manip Ther 2015;23(5):276-93
  4. Charles 2019A systematic review of manual therapy techniques, dry cupping and dry needling in the reduction of myofascial pain and myofascial trigger points. J Bodyw Mov Ther 2019;23(3):539-46
  5. Cagnie 2013Physiologic effects of dry needling. Curr Pain Headache Rep 2013;17(8):348
  6. Fernández-de-las-Peñas 2019Trigger point dry needling for the treatment of myofascial pain syndrome: current perspectives within a pain neuroscience paradigm. J Pain Res 2019;12:1899-911
  7. Shah 2015Myofascial trigger points then and now: a historical and scientific perspective. PM R 2015;7(7):746-61
  8. Halle 2016Pertinent dry needling considerations for minimizing adverse effects. Int J Sports Phys Ther 2016;11(5):651-62
  9. Boyce 2020Adverse events associated with therapeutic dry needling. Int J Sports Phys Ther 2020;15(1):103-13
  10. Hong 1994Lidocaine injection versus dry needling to myofascial trigger point: the importance of the local twitch response. Am J Phys Med Rehabil 1994;73(4):256-63
  11. Simons & TravellMyofascial Pain and Dysfunction: The Trigger Point Manual (2nd ed.). Williams & Wilkins, Baltimore

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