Myofacial pain dysfunction syndrome


Published on

it's about MPDS in guyzz check it out.

  • Be the first to comment

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

Myofacial pain dysfunction syndrome

  1. 1. ByManash Bora
  3. 3.  The Myofacial Pain Dysfunction Syndrome (MPDS) is a pain disorder, in which unilateral pain is referred from the trigger points in myofascial structures, to the muscles of the head and neck. Pain is constant, dull in nature, in contrast to the sudden sharp, shooting, intermittent pain of neuralgias. . Myofascial pain syndrome typically occurs after a muscle has been contracted repetitively. This can be caused by repetitive motions used in jobs or hobbies or by stress-related muscle tension.
  4. 4.  MPDS is the most common cause of masticatory pain & limited function for which patient’s seek dental consultation & treatment.  the source of the pain & dysfunction is muscular with masticatory muscle developing tenderness and pain as a result of abnormal muscular function on hyperactivity. This abnormal muscular function is frequently but not always associated with daytime clenching on nocturnal bruxism. The cause of MPD is controversial although it is generally considered to be multifactorial.
  5. 5. The MPDS can be visualized as a vicious cycle of several contributing factors such as :1. Muscular hyper function. 2. Bruxism secondary to stress & anxiety with occlusion. 3. Internal Joint Problems such as Disk Displacement disorders or Degenerative Joint Disease(DJD). 4. Physical disorders. 5. Injuries to the tissues. 6. Para functional habits. 7. Disuse. 8. Nutritional problems. 9. Physiological stress. 10. Sleep disturbances.
  6. 6. Signs and symptoms of MPDS may include:- Cardinal symptoms of MPDS :1. 2. 3. 4. Pain or discomfort anywhere about the head or neck. Limitation of motion of the jaw. Joint noises– grating,clicking,snapping. Tenderness to palpation of the muscles of mastication.
  7. 7. Neurologic • Tingling • Numbness • Blurred vision • Twitches • Lacrimation Gastrointestinal tract • • • • • Nausea Vomiting Diarrhea Constipation indigestion Musculoskeletal • • • • Fatigue Tension tiredness weakness
  8. 8. Myofascial pain syndrome is caused by a stimulus, such as pressure, that sets off trigger points in your muscles. Factors that may increase your risk of muscle trigger points include: Muscle injury. An acute muscle injury or continual muscle stress may lead to the development of trigger points. For example, a spot within or near a strained muscle may become a trigger point. Repetitive motions and poor posture also may increase your risk. Stress and anxiety. People who frequently experience stress and anxiety may be more likely to develop trigger points in their muscles. One theory holds that these people may be more likely to clench their muscles, a form of repeated strain that leaves muscles susceptible to trigger points.
  9. 9. Physical examination consists of an evaluation of entire masticatory system along with head and neck region :• Articular •Muscular •Dental •cervical
  10. 10. 1. 2. 3. 4. 5. Amount of oral opening and the excursions.. Extent of movement i) ROM – Range of motion ii) AROM – Active range of motion iii) PROM – Passive range of motion Palpation for tenderness. Grading of click or crepitation- noises evaluation. Auscultation(stethoscopic evaluation),if needed.
  11. 11. Systemic palpation of the muscles and their tendons is the best way to ascertain both subclinical and clinical existing levels of dysfunction. The areas responsive to palpation have been called trigger points. The muscles are palpated bilaterally and simultaneously with frim but gentle pressure lasting for 1 or 2 minutes. It is helpful for the following: 1. Location of muscle pathology. 2. Evaluation of muscle tone. 3. Location of trigger points. 4. Evaluation of temperature change. 5. Location of swelling. 6. Identification of anatomic landmarks.
  12. 12. •Gross occlusal diskrepancies, prematurities or interferences shoud be noted. •Anterior open bite, collapsed bite, cross bite, reduced vertical dimension, etc. should also be noted. Attrition, wear facets, mobility of teeth, missing teeth should be checked. Type of malocclusion, skeletal, dentofacial deformities should be looked for.
  13. 13. Here, the neck group of muscles are palpated and neck range of motion should also be checked. Shoulder & neck muscles are palpated as they control anteroposterior & lateral position of the head. A few examinations that are done are as follows :1. Hyoid bone palpation 2. Radiographic evaluation : it is helpful in diagnosis of the following i) Intra-articular pathologies. ii) Osseous pathological process. iii) Soft tissue pathologies. 3. Panoramic radiography. 4. Tomograms. 5. Transcranial radiographs.
  14. 14. TMJ arthrography. II. Computed radiography (CR). III. Computed Tomography (CT) scan & Magnetic Resonance Imaging (MRI). IV. Bone Scintigram—nuclear imaging V. Single Photon Emission Computerized Tomography (SPECT). I.
  15. 15. Complications associated with myofascial pain syndrome may include: Sleep problems. Signs and symptoms of myofascial pain syndrome may make it difficult to sleep at night. You may have trouble finding a comfortable sleep position. And if you move at night, you might hit a trigger point and awaken. Fibromyalgia. Some research suggests that myofascial pain syndrome may develop into fibromyalgia in some people. Fibromyalgia is a chronic condition that features widespread pain. It's believed that the brains of people with fibromyalgia become more sensitive to pain signals over time. Some doctors believe myofascial pain syndrome may play a role in starting this process.
  16. 16. Treatment for MPDS typically includes medications, trigger point injections or physical therapy. Medications Medications used for MPDS include :1. Aspirin : 2 tabs 0.3 to 0.6gm/ 4 hourly. 2. Piroxicam : 10 to 20mg /3 to 4 times a day. 3. Ibuprofen : 200 to 600mg/3 times a day. 4. Pentazocine : 50mg /2 to 3 times a day. 5. Valium/librium : 5 to 10mg /2 to 3 times a day. 6. Methocarbamol : 500mg/2 to 3 times a day. 7. Amitriptyline : 10 to 25mg/ 3 times a day or at bedtime.
  17. 17. 1. 2. 3. 4. 5. 6. 7. 8. 9. Heat application. Ultrasound. Cryotherapy. Massage with counter-irritants & vibrators. Use of vapocoolent spray. Tetanizaing & sinusoidal currents. Electrogalvanic stimulation. Transcutaneous electronic nerve stimulator (TENS). Active stretch exercises.
  18. 18. YOU