The place of myofascial syndrome in the genesis of headaches and facial pains

Abstract

The article discusses the patterns of development and the main features of myofascial syndrome. Emphasis is placed on the myofascial syndrome involving head and face muscles with characterization of masks of the syndrome: irradiation zones of trigger point pain in the skeletal muscles of the cervical region are described (important role of the sternocleidomastoid muscle is emphasized), in the facial muscles and masticatory muscles. Trigger point properties are covered in detail, including painful and non-painful manifestations, such as tinnitus and congestion in the ear, dizziness, vertigo and hearing loss; as well as local vegetative symptoms. When diagnosing myofascial syndrome, it is necessary to specify in detail the anamnestic data (the time and conditions for the onset of the first manifestations), as well as to specify as many characteristics of pain as possible (the circumstances of its provocation and relief, the duration of the attack, the pain modality). The most important role belongs to palpation of the muscles with the definition of trigger points and muscle cords. The basic principles of therapy for myofascial syndrome are given: anesthesia, relaxation and stretching. Further, specific methods of drug, physiotherapeutic and manual procedures on the affected muscles are analyzed in detail. Two clinical cases from our own practice are presented, demonstrating the features of the myofascial syndrome clinical picture formation in the face area and the possibility of interrupting the pain phenomenon and non-painful manifestations by inactivating muscle triggers. The importance of joint supervision of a patient with myofascial syndrome by a multidisciplinary medical team, including, if necessary, not only neurologist and osteopath, but also an ENT doctor and a dentist, is emphasized. In conclusion, it was concluded that it is necessary to develop recommendations at the federal level for the diagnosis and treatment of myofascial syndrome.