Muscles
Medial Pterygoid Trigger Points
Symptom Area: Head and Neck
Medial Pterygoid Trigger Points are explored here through their location and referred pain pattern. Muscle knots is an everyday term used for tender muscular spots; myofascial pain describes pain involving muscle and its surrounding connective tissue. Inner jaw elevator; protrudes and laterally shifts the mandible.
Where you feel it
When the Medial Pterygoid holds active trigger points, you usually notice it as cheek pain (like sinusitis), difficulty swallowing, drooling in sleep, earaches/tinnitus (ringing)/itch and post nasal drip. Where the pain spreads: Tongue, hard palate, lower jaw, ear and TMJ — often felt as deep ear pain with chewing. What often sets it off: Bruxism, malocclusion, prolonged dental work, jaw clenching under stress.
Overview
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.
Trigger point locations
Deep inside the mandibular angle, palpated intraorally with a gloved finger.
Referred pain pattern
Tongue, hard palate, lower jaw, ear and TMJ — often felt as deep ear pain with chewing.
Palpation & testing
Palpate the muscle belly along its accessible course. Reproduction of the patient's familiar pain on palpation supports involvement.
Common causes
Bruxism, malocclusion, prolonged dental work, jaw clenching under stress.
Self-care & clinical treatment
Soft-diet phase, jaw relaxation drills. Clinically: intraoral release and dry needling by a trained clinician.
Treatment protocol
For Medial Pterygoid, the general protocol applies: sustained pressure release on the taut band, then stretch and active movement in the newly gained range.
Position and palpation: Palpate the muscle belly along its accessible course.
Regional precaution for clinicians: In the neck and jaw, needle placement must respect the carotid sheath, the external jugular vein, the vertebral artery in the suboccipital region and the lung apex behind the lower scalenes and the medial supraclavicular fossa.
Primary Symptoms
Secondary Symptoms
Often confused with
These muscles cause the same primary symptoms, so they are checked together:
Related muscles in this region
Related articles
- Jaw pain, clicking and morning tightness: the chewing-muscle trigger points behind it
- Cheek Pain (like Sinusitis): which trigger points cause it and how to treat them
- Temporomandibular Joint Disorders (TMJ): which trigger points cause it and how to treat them
- Earaches/Tinnitus (Ringing)/Itch: which trigger points cause it and how to treat them
References
- • Travell & Simons — Myofascial Pain and Dysfunction
- • Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis — J Orthop Sports Phys Ther 2013;43(9):620-34
- • The 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
- • Effectiveness of trigger point dry needling for multiple body regions: a systematic review — J Man Manip Ther 2015;23(5):276-93
- • A 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
- • Physiologic effects of dry needling — Curr Pain Headache Rep 2013;17(8):348
- • Trigger point dry needling for the treatment of myofascial pain syndrome: current perspectives within a pain neuroscience paradigm — J Pain Res 2019;12:1899-911
- • Myofascial trigger points then and now: a historical and scientific perspective — PM R 2015;7(7):746-61
- • Pertinent dry needling considerations for minimizing adverse effects — Int J Sports Phys Ther 2016;11(5):651-62
- • Adverse events associated with therapeutic dry needling — Int J Sports Phys Ther 2020;15(1):103-13
- • Lidocaine 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
- • Myofascial Pain and Dysfunction: The Trigger Point Manual (2nd ed.) — Williams & Wilkins, Baltimore
Medically reviewed by: Marco Aruffo — physiotherapist since 2006, specialised in myofascial pain · Last reviewed:
