Cervical Myofascial Pain Is Associated with an Imbalance of Masticatory Muscle Activity

Michał Ginszt; Jacek Szkutnik; Grzegorz Zieliński; Magdalena Bakalczuk; Małgorzata Stodółkiewicz; Monika Litko-Rola; Apolinary Ginszt; Mansur Rahnama; Piotr Majcher

doi:10.3390/ijerph19031577

Cervical Myofascial Pain Is Associated with an Imbalance of Masticatory Muscle Activity

Int J Environ Res Public Health. 2022 Jan 29;19(3):1577. doi: 10.3390/ijerph19031577.

Authors

Michał Ginszt¹, Jacek Szkutnik², Grzegorz Zieliński³, Magdalena Bakalczuk², Małgorzata Stodółkiewicz², Monika Litko-Rola², Apolinary Ginszt¹, Mansur Rahnama⁴, Piotr Majcher¹

Affiliations

¹ Department of Rehabilitation and Physiotherapy, Medical University of Lublin, 20-093 Lublin, Poland.
² Independent Unit of Functional Masticatory Disorders, Medical University of Lublin, 20-093 Lublin, Poland.
³ Department of Sports Medicine, Medical University of Lublin, 20-093 Lublin, Poland.
⁴ Department of Oral Surgery, Medical University of Lublin, 20-093 Lublin, Poland.

Abstract

This study aimed to assess the relationship between the occurrence of cervical myofascial pain with active myofascial trigger points (MTrPs) within the upper trapezius muscle and the electromyographic asymmetry index (AsI) of masticatory muscles: temporalis anterior (TA), superficial part of the masseter muscle (MM), and anterior belly of the digastric muscle (DA). The study group comprised 100 subjects (80 women and 20 men) aged 18 to 30 years (mean 23 ± 2.6 years) reporting pain in the neck muscles, diagnosed with myofascial pain with active MTrPs only within the upper trapezius muscle. The control group comprised 60 healthy, pain-free subjects (42 women and 18 men) aged 20 to 30 years (mean 22.8 ± 2.6 years) without MTrPs in the upper trapezius muscle. The palpation measurement, based on the diagnostic criteria of Travell and Simons, was used to diagnose active MTrPs. The masticatory muscle activity was recorded using an 8-channel device for surface electromyography-BioEMG III^TM. Significant differences in electromyographic patterns between the group with MTrPs in the right side of upper trapezius muscle and the control group were observed within resting activity for the AsI TA (MTrPs: 8.64 vs. controls: -3.22; p = 0.001) and AsI MM (MTrPs: 7.05 vs. controls: -2.09; p = 0.018). Controls presented different electromyographic patterns during maximum voluntary clenching with cotton rolls between teeth within masseter muscle compared to the MTrPs group (MTrPs: 9.27 vs. controls: -0.43 vs. p = 0.041). Participants with MTrPs in the left side of upper trapezius muscle presented predomination of left-sided electromyographic patterns at rest within temporalis anterior in comparison to controls (MTrPs: -19.22 vs. controls: -3.22; p = 0.001). MTrPs within the trapezius muscle may be related to asymmetry within the masticatory muscle activity, suggesting that the presence of myofascial pain within the cervical muscles plays a role in the imbalance of the stomatognathic system. A unilateral active MTrPs within the trapezius muscle may increase the sEMG activity on the same side of the temporalis anterior and masseter muscles.

Keywords: balance; electromyography; masticatory muscles; myofascial pain; neck muscles.

MeSH terms

Adolescent
Adult
Electromyography
Female
Humans
Male
Masseter Muscle*
Masticatory Muscles / physiology
Myofascial Pain Syndromes*
Neck Pain
Young Adult