Platysma Trigger Points

Introduction

The platysma is a thin, superficial neck muscle responsible for facial expressions, jaw movement, and neck tension regulation. When trigger points develop in this muscle, they can cause neck pain, jaw tightness, and facial tension, often mimicking TMJ dysfunction, tension headaches, or cervical spine issues.

Name and Area

  • Name: Platysma

  • Area: Located on the front of the neck, spanning from the lower jaw (mandible) to the upper chest (clavicle and pectoral fascia).

Indications

Platysma trigger points may contribute to:

  • Pain in the front of the neck and jaw (mistaken for TMJ dysfunction or throat issues)

  • Tightness that extends to the lower face and chest (can mimic trigeminal nerve pain or neck strain)

  • Difficulty swallowing or a "lump in the throat" sensation (common in stress-related muscle tension)

  • Pain that worsens with talking, singing, or holding the jaw open for long periods (e.g., during dental visits)

  • Facial tightness or twitching, especially in high-stress situations

  • Neck and jaw discomfort that increases with forward head posture or clenching the jaw

Pain from this muscle is often mistaken for TMJ dysfunction, cervical spine tightness, or throat problems.

Muscle Action

  • Tenses the Skin of the Neck: Assists in facial expressions such as frowning and grimacing.

  • Depresses the Jaw: Helps lower the mandible, assisting in opening the mouth.

  • Supports Neck Movement: Works with other neck muscles to stabilize the cervical spine.

The platysma is essential for facial movement, jaw mobility, and stress-related tension regulation.

Signs and Symptoms

Individuals with platysma trigger points often report:

  • Tightness or Pain in the Front of the Neck and Jaw, Worsens with Talking or Chewing

  • Feeling of Restricted Jaw or Neck Movement (Difficulty Stretching the Neck or Opening the Mouth Wide)

  • Pain That Extends to the Chest and Lower Face (Can Resemble TMJ or Nerve Pain)

  • Sensation of a Lump in the Throat (Common in Anxiety or Chronic Neck Tension)

  • Jaw Clenching or Facial Twitching, Especially in Stressful Situations

  • Pain That Increases with Forward Head Posture or Poor Neck Alignment

Pain worsens with excessive talking, clenching, jaw tension, or emotional stress.

Perpetuating Factors

Common causes of platysma trigger points include:

  • Forward head posture (common in desk workers, gamers, and smartphone users)

  • Jaw clenching or teeth grinding (bruxism, often due to stress or anxiety)

  • Excessive talking or singing (can lead to muscle fatigue and tension in the neck and jaw)

  • Holding the neck in a fixed position for long periods (e.g., looking down at a screen, reading, or driving)

  • Repetitive facial expressions or jaw movements (common in public speakers, actors, or those with high facial expressivity)

Trigger Point Referral Pattern

Trigger points in the platysma refer pain to:

  • The front of the neck and jaw (Can Mimic TMJ Dysfunction or Throat Issues)

  • The lower face and chin (Mistaken for Nerve Pain or Jaw Tension)

  • The upper chest and collarbone (Can Resemble Neck Strain or Pectoral Tightness)

Pain from this muscle is often confused with TMJ dysfunction, throat tension, or cervical spine disorders.

Differential Diagnosis

Platysma trigger points may be mistaken for:

  • TMJ Dysfunction (Jaw Pain, Clicking, and Limited Movement, Common in Clenchers and Bruxers)

  • Trigeminal Neuralgia (Sharp, Shooting Facial Pain That Can Resemble Nerve Compression)

  • Cervical Spine Dysfunction (Neck Pain That Extends to the Jaw and Chest, Can Limit Mobility)

  • Throat Infections (Pain and Tightness in the Throat, Often Without Signs of Infection)

  • Tension Headaches (Pain That Starts in the Neck and Radiates to the Temples or Behind the Eyes)

A thorough jaw, throat, and cervical spine examination is necessary to rule out these conditions.

Associated Trigger Points

Platysma trigger points often co-exist with:

  • Sternocleidomastoid (SCM) (Neck and Jaw Pain, Can Mimic Migraines or Sinus Issues)

  • Masseter (Cheek and Jaw Pain, Common in Teeth Clenchers and TMJ Sufferers)

  • Temporalis (Temple and Head Pain, Can Resemble Tension Headaches or Migraines)

  • Upper Trapezius (Neck and Shoulder Tension, Common in Postural Strain and Stress-Related Pain)

Anatomy and Innervation

Muscle Origin Insertion Innervation
Platysma Fascia covering pectoralis major and deltoid Lower mandible, skin of the lower face Facial nerve (CN VII)

The platysma is innervated by the facial nerve (cranial nerve VII), which also controls facial expressions and jaw movement.

Patient Examination

A comprehensive examination should include:

  • Palpation: Identify tender nodules along the front of the neck, jawline, and upper chest.

  • Jaw and Neck Mobility Testing: Assess pain or tightness when tilting the head backward or opening the mouth wide.

  • Swallowing and Speech Function Testing: Rule out tightness-related swallowing discomfort.

  • Postural Assessment: Look for forward head posture or excessive neck tension.

Corrective Actions

Dry Needling

  • Dry needling can release trigger points in the platysma, reducing neck tightness and improving jaw mobility.

Manual Therapy

  • Trigger Point Release: Apply gentle pressure along the jawline, neck, and upper chest.

  • Facial and Neck Massage: Helps improve circulation and reduce muscle tension.

Stretching

  • Chin Lift Stretch: Tilt the head back gently to relieve tension in the platysma.

  • Neck Side Stretch: Gently tilt the head to one side while pressing the opposite hand downward.

Strengthening Exercises

  • Chin Tucks (Deep Neck Flexor Activation): Helps reduce forward head posture and improve neck stability.

  • Jaw Relaxation Exercises: Encourages proper jaw alignment and reduces clenching.

Postural and Behavioral Adjustments

  • Avoid Prolonged Forward Head Posture (Keep Screens at Eye Level to Reduce Neck Strain)

  • Use Proper Ergonomic Support (Ensure Good Posture While Working at a Desk or Reading)

  • Practice Stress Management and Relaxation Techniques (Reduces Chronic Neck and Jaw Tension)

Conclusion

The platysma plays a crucial role in facial expressions, jaw mobility, and posture, but trigger points in this muscle can cause significant neck tension, jaw pain, and headaches. By incorporating dry needling, manual therapy, stretching, and posture correction, individuals can reduce pain, improve mobility, and prevent tension-related dysfunction.

➡️ Learn more about Trigger Points

➡️ Explore our Trigger Point Index

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.