Masseter – Pain & Trigger Points

The Masseter is one of your muscles of mastication and can cause pain in the jaw, ear and head.

In a lot of cases, tensions and trigger points are responsible for the pain.

On this page you will learn how you can free yourself of these pains.

Tensions and trigger points can be “eliminated” with a self-massage. You will find instructions for this below.

I will also explain the areas where the muscle can cause pain, where it is located, its function, and how you may have overloaded it.

I would like to encourage you to study this page carefully and invest some time in your body – You will not regret it.

Let’s go!

1. Pain Patterns, Symptoms & Differential Diagnoses

1.1 Pain patterns

Tensions in the masseter can cause local sensitivity of pressure of the muscle and jaw pain.

Trigger points might transmit pain to adjacent regions – see chapters below.

In the next sections, I distinguish between superficial and deep lying fibers of the muscle. Don’t let this confuse you. All this is explained in detail in the chapter “Origin & Insertion”.

1.1.1 Jaw Pain & Toothache

Trigger points in the superior portion of the masseter’s superficial fibers may cause the following kinds of pain:

  • Pain in the upper jaw that (often) feels like sinusitis.
  • Toothache, especially pain in the upper molars (not shown).

Trigger points slightly below the center of the superficial fibers of the muscle can lead to:

  • Pain in the lower jaw.
  • Toothache, especially in the lower molars (not shown).

1.1.2 Jaw pain and headaches

Trigger points in the lowest area of the superficial fibers often result in:

  • Pain in the lower jaw.
  • Headaches that feel like tension headaches.
  •  Pain on/over the eyebrow.

1.1.3 Pain in the temporomandibular joint and earache

If trigger points are located in the deep fibers of the masseter, among the symptoms there’s often pain in the jaw joint or earache (deep in the ear).

1.2 Symptoms, differential diagnoses & movement restrictions

Besides the pain described above, trigger points in the masseter can also lead to the following ailments.

1.2.1 Pain & difficulties opening the jaw

If your masseter is tense, you may no longer be able to completely open your jaw or you experience pain during the action.

When the temporomandibular joint is opened, the muscle is stretched, and a tense muscle is usually “reluctantly” loosened or stretched by the nervous system.

1.2.2 Masseter pain & tinnitus

If there are trigger points in the masseter, these can lead to unilateral (on one side) tinnitus. The responsible points are located in the upper deep fibers of the muscle.

Tinnitus with systemic causes usually occurs bilaterally (on both sides). However, consider that the masseter naturally develops trigger points on both sides and can thus lead to bilateral tinnitus.

This may then change in its intensity, so that you hear the sound one time louder on the left, one time louder on the right.

1.3 Differential diagnoses

Jaw pain or pain in the jaw joint caused by trigger points in the masseter can feel like rheumatic pain in the jaw joint.

So it’s important to investigate this possibility. Of course, trigger points and rheumatic pain are not mutually exclusive.

Above all, you should know that rheumatic pain in the jaw area results in tensions of the muscles in this area and can therefore turn into a second cause for pain.

The reason why is that pain can lead to a higher muscle tension. If the pain persists, the increased muscle tension usually remains.

Sooner or later, this results in muscular problems – for example trigger points.

2. Origin & Insertion

This muscle contains superficial and deep fibers.

Origin of superficial & deep fibres

  • Lower jaw

Insertion of superficial fibres

  • Anterior two-thirds of the zygomatic arch

Insertion deep fibers

  • Posterior third of the zygomatic arch

Trigger points are marked with an X.

3. Function

The masseter is responsible for closing your jaw firmly and/or moving it to the sides.

4. Masseter – Trigger Point Activation

Many factors can lead to an activation of trigger points in the masseter. Below you will find some of them.

4.1 Active overload

Concerning this muscle, active overloads often occur acutely or chronically.

Active chronic overload due to constant chewing on objects:

  • Chewing gum
  • Nail biting
  • Bruxism or teeth grinding

Active acute overloads due to firm bite:

  • Crunching a nut
  • Crunching an ice cube
  • Eating hard bread

4.2 Stress: Active, “subconscious” overload

The masseter (as like as the jaw muscles in general) reacts sensitively to emotions and mental tensions, especially to “negative” ones.

Stress, inner tension, restlessness, despair, fierce determination – all these emotions result in a mostly unconscious tension of the masseter.

Very often the muscle remains tense for a long time, even if the triggering factor is no longer present.

This is how the muscle is overloaded – especially if you cannot perceive these tensions (mental and muscular) well and if you don‘t provide relaxation.

Listen to your body!

Listen to your body and your feelings and “take care” of them. Otherwise your body will remind you, and usually in a very unpleasant way – through pain.

4.3 Unfavourable postures

All postures in which your head is “moved forward” bring your jaw into a position that puts the masseter under strain.

This causes constant tension, which can overload it.

Examples of postures in which the head is (often) moved forward.

  • Rounded back
  • Sitting in a car
  • Sitting at a desk
  • Reading

4.4 Stretching for a long period of time

Keeping the mouth wide open for a long time, might cause tensions. Especially if you don‘t “let go” and can’t relax.

A classic example would be a visit at the dentist.

If you are stressed or afraid before the appointment or if you experience pain or feel uncomfortable during the treatment, your masseter will contract.

That’s why it is stretched “against its will” when it comes to keep the mouth open.

4.5 External force impact

Strong force impacts on the jaw, especially from the side, can result in tensions in this muscle.

  • Boxing
  • Slapping (strike)
  • Punches

4.6 Infections or inflammations

In the cases of infections or inflammations, our musculature contracts reflexively.

Chronic infections and inflammations are therefore possible reasons for overloading this muscle.

4.7 Structural changes in the oral cavity

Years of teeth grinding can lead to structural changes of the teeth (height of the teeth decreases).

This results in a disharmonious jaw closure and can overload the masseter.

Thus, in this example, the muscle is overloaded in two ways. On one hand due to the constant tension during teeth grinding and, on the other hand, due to the different jaw closure (after a few years).

4.8 Key trigger points in other muscles

Trigger points in muscles that can cause pain in the area of the masseter represent often a decisive factor.

These trigger points are called key trigger points, because they can cause the activation of trigger points in other muscles as a result of pain transmission.

These newly activated trigger points are called satellite trigger points.

If pain occurs in a certain area of the body, the muscles located there tense reflexively. This can overload them and cause them to develop dysfunctions themselves.

In this case, the two muscles involved are:

  • Sternocleidomastoid
  • Trapezius – superior portion

5. Palpation

The best way to palpate the muscle is to feel it under contraction. In the following, palpation is described in text and picture.

5.1 Palpation of the superficial fibres

  • Place two to three fingers on your jaw.
  • Close your jaw and repeatedly clench your teeth.
  • Feel the muscle that contracts with every bite.
  • Feel its extension from the zygomatic arch (horizontal bone line under the eye) to the mandible.

5.2 Palpation of the deep fibres

It’s only directly at your temporomandibular joint possible to feel the deep fibres of the muscle, because it’s the only spot where they are not covered by the superficial fibres.

  • Place your index finger on your temporomandibular joint.
  • Open and close your mouth a few times and feel the movements of the joint.
  • Now place your fingers a little further “forward” where you will find soft tissue.
  • Your index finger’s phalanx rests on soft tissue, while your fingertip presses against the joint.
  • Clenching your teeth, you feel a contraction in the surrounding area – these are the superficial fibers that you have already palpated.
  • If you now clench a little harder, you will feel a muscle contracting directly under your index finger – these are the deep fibers of your masseter muscle.

6. Self-massage

In the following, I will show you some massage techniques for this muscle.

You can massage the masseter with your fingers or with the Trigger Fairy. Both variants have their advantages.

With your fingers you can also massage the muscle in the oral cavity and identify the slightest tension. Of course, this can be unpleasant or stressful for your fingers, especially if you have long nails or no strong fingers.

With the Trigger Fairy you protect your fingers and massage the muscle very well, but only from the exterior. You will not reach the areas in your oral cavity.

You have the choice between the ischemic compression, the precise massage strokes and the pressure-motion technique. I’ll explain these techniques in a moment.

General remarks concerning the massage:

  • Press your fingers or the Trigger Fairy into the masseter and seek for painful tensions.
  • Take your time and proceed slowly. Examine the entire muscle – from the cheekbone down to the mandible.

You can massage the tensions as follows.

  •  Ischemic compression: Maintain pressure for 30 – 60 seconds.
  • Precise massage strokes: Stroke from just before a painful point to just behind it. In this case you only move the skin over the muscle, but do not slide with your fingers over the skin.
  • Pressure-motion technique: Push into the muscle and open and close your jaw. Clench your teeth and relax again. You can also move your jaw to the side.

Assure to massage the most painful spots, but without increasing the pain.

6.1 External self-massage of the superficial fibres with the fingers

  • Shape your hand like a shovel
  • Press your fingertips into the masseter.
  • All three massage techniques are suitable here.

6.2 Self-massage of the superficial fibres with the Trigger Fairy

  • Hold the arc of the Trigger Fairy in front of your face.
  • Place the arc in one of your palms and gently enclose it.
  • Make sure that thumb and index finger are stretched and lie on the arc.
  • Your other hand embraces the Fairy’s grip – also lightly.
  • All massage her hand embraces the fesible to feel the deep fibres of the muscletechniques are suitable here.
1
2
3
4

References

  • Calais-German, Blandine. Anatomy of Movement. Seattle: Eastland Press, 1993. Print
  • Davies, Clair, and Davies, Amber. The Trigger Point Workbook: Your Self-Treatment Guide For Pain Relief. Oakland: New Harbinger Publications, Inc., Print
  • Simons, David G., Lois S. Simons, and Janet G. Travell. Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore, MD: Williams & Wilkins, 1999. Print.
  • Schünke, Michael., Schulte, Erik, and Schumacher, Udo. Prometheus: Lernatlas der Anatomie. Stuttgart/New York: Georg Thieme Verlag, 2007. Print