Corrugator Supercilii Trigger Points

Introduction

The corrugator supercilii is a small but powerful facial muscle that plays a key role in facial expressions, particularly frowning and squinting. When trigger points develop in this muscle, they can cause deep forehead pain, eye strain, and tension headaches, often mimicking migraines, sinus pressure, or eye fatigue.

Name and Area

  • Name: Corrugator Supercilii

  • Area: Located beneath the eyebrows, running from the frontal bone to the skin of the forehead.

Indications

Corrugator supercilii trigger points may contribute to:

  • Pain in the Forehead and Near the Eyes (Mimicking Sinus Headaches)

  • Tension Headaches That Wrap Around the Forehead

  • Eye Strain or Sensitivity to Light

  • A Constant Feeling of Tension Between the Eyebrows (Frowning Sensation)

  • Involuntary Eyebrow Twitching or Frequent Squinting

  • Increased Wrinkling Between the Eyebrows (Deep Vertical Lines, "11s")

Pain from this muscle is often mistaken for migraines or sinus pressure.

Muscle Action

  • Draws the Eyebrows Downward and Inward: Creates the furrowing expression seen in frowning.

  • Assists in Reducing Light Sensitivity: Works with the orbicularis oculi to shield the eyes from bright light.

  • Contributes to Facial Tension: Can increase forehead wrinkles and tension-related headaches.

The corrugator supercilii is one of the main muscles involved in stress and emotional expressions.

Signs and Symptoms

Individuals with corrugator supercilii trigger points often report:

  • Deep, Aching Pain in the Forehead or Between the Eyebrows

  • Pain That Radiates to the Eyes, Causing a Tired or Heavy Feeling

  • Frequent Headaches That Feel Like a Band Around the Forehead

  • Increased Wrinkling Between the Eyebrows ("Worry Lines")

  • Tightness or Discomfort in the Forehead After Long Periods of Reading or Screen Time

  • Difficulty Relaxing the Eyebrows or Forehead Muscles

Pain worsens with prolonged frowning, squinting, or stress-related facial tension.

Perpetuating Factors

Common causes of corrugator supercilii trigger points include:

  • Frequent Frowning or Squinting (Reading, Driving, Using a Computer or Phone for Long Periods)

  • Chronic Stress or Anxiety (Leading to Constant Forehead Tension)

  • Bright Light Exposure (Squinting in Sunlight or Poorly Lit Environments)

  • Uncorrected Vision Problems (Straining to See Without Glasses or Contacts)

  • Excessive Use of Facial Muscles (Performing Expressions That Involve Furrowing the Brows)

Trigger Point Referral Pattern

Trigger points in the corrugator supercilii refer pain to:

  • The forehead, particularly between the eyebrows

  • The inner corners of the eyes, causing eye strain

  • The upper nose bridge, resembling sinus pressure

Pain from this muscle is often confused with migraines, sinus headaches, or tension headaches.

Differential Diagnosis

Corrugator supercilii trigger points may be mistaken for:

  • Tension Headaches (Forehead Pressure, Often Triggered by Stress or Eye Strain)

  • Migraines (Severe, Pulsating Headaches That May Include Light Sensitivity and Nausea)

  • Sinus Pressure Headaches (Pain Near the Eyes and Nasal Area, Especially With Congestion)

  • Eye Fatigue (Pain and Tiredness From Staring at Screens or Poor Lighting Conditions)

  • Trigeminal Neuralgia (Sharp, Shooting Pain in the Face, Often Misinterpreted as Headache Pain)

A thorough forehead, eye, and sinus assessment is necessary for correct diagnosis.

Associated Trigger Points

Corrugator supercilii trigger points often co-exist with:

  • Frontalis (Forehead Pain and Wrinkling of the Forehead)

  • Orbicularis Oculi (Eye Fatigue, Twitching, and Tension Around the Eyes)

  • Temporalis (Side Headaches and Jaw Tension Related to Clenching or Grinding Teeth)

  • Sternocleidomastoid (SCM) (Neck Tightness That Can Contribute to Headaches and Eye Pain)

Anatomy and Innervation

Muscle Origin Insertion Innervation
Corrugator Supercilii Frontal bone (above the nasal bridge) Skin above the middle of the eyebrows Facial nerve (CN VII)

The corrugator supercilii is controlled by the facial nerve (cranial nerve VII), which also governs facial expressions.

Patient Examination

A comprehensive examination should include:

  • Palpation: Identify tender nodules in the eyebrow region, near the nose bridge.

  • Forehead Mobility Testing: Assess pain or tightness when raising and lowering the eyebrows.

  • Visual Strain Testing: Determine if prolonged reading or screen use worsens symptoms.

  • Light Sensitivity Testing: Check for discomfort when exposed to bright light.

Corrective Actions

Manual Therapy

  • Trigger Point Release: Apply gentle pressure along the eyebrow ridge and forehead.

  • Facial Massage and Myofascial Release: Loosens tight forehead and eye muscles.

Stretching

  • Forehead Relaxation Exercise: Place fingertips on the eyebrows and gently push outward while relaxing the face.

  • Eye Relaxation Techniques: Close the eyes, take deep breaths, and let the forehead muscles release tension.

Strengthening Exercises

  • Eyebrow Control Drills: Raise and lower the eyebrows without engaging the forehead too much to promote relaxation.

  • Blinking Exercises: Helps reduce excessive eye strain and maintains natural lubrication.

Postural and Behavioral Adjustments

  • Avoid Excessive Frowning or Squinting (Use Sunglasses or Corrective Lenses if Needed)

  • Take Frequent Breaks From Screen Time or Reading (Follow the 20-20-20 Rule: Every 20 Minutes, Look 20 Feet Away for 20 Seconds)

  • Use Relaxation Techniques to Reduce Stress-Induced Facial Tension (Deep Breathing, Meditation, or Face Yoga)

Field Details
Name & Area Corrugator Supercilii; Located beneath the eyebrows, spanning from the frontal bone to the forehead skin
Indications Forehead pain, tension headaches, eye strain, frowning discomfort
Muscle Action Pulls the eyebrows downward and inward, assists in reducing light sensitivity, contributes to facial expressions
Signs & Symptoms Deep forehead pain, sensitivity to light, eye fatigue, involuntary frowning
Perpetuating Factors Frequent frowning, stress, prolonged screen use, bright light exposure, uncorrected vision problems
Trigger Point Referral Forehead, inner corners of the eyes, upper nose bridge
Differential Diagnosis Tension headaches, migraines, sinus pressure, eye fatigue, trigeminal neuralgia
Associated Trigger Points Frontalis, orbicularis oculi, temporalis, sternocleidomastoid (SCM)
Anatomy & Innervation Facial nerve (CN VII)
Corrective Actions Manual therapy, stretching, eye relaxation techniques, stress management

Summary Table: Corrugator Supercilii Trigger Points

Sources:

  • Travell, J. G., & Simons, D. G. (1983). Myofascial Pain and Dysfunction: The Trigger Point Manual (2nd ed.). Williams & Wilkins.

  • Simons, D., & Travell, J. (1999). The Trigger Point Manual, Volume 2: The Lower Extremities. Williams & Wilkins.