Temporalis Trigger Points

Introduction

The temporalis is a key jaw muscle responsible for chewing, jaw movement, and head stabilization. When trigger points develop in this muscle, they can cause headaches, jaw tightness, and temple pain, often mimicking migraines, sinus pressure, or TMJ dysfunction.

Name and Area

  • Name: Temporalis

  • Area: Located on the side of the head, running from the temporal bone to the coronoid process of the mandible (jawbone).

Indications

Temporalis trigger points may contribute to:

  • Pain in the temples and side of the head (mistaken for migraines or tension headaches)

  • Pain that radiates to the jaw and teeth (can mimic dental issues or TMJ dysfunction)

  • Jaw tightness or clicking when chewing or speaking

  • Increased sensitivity to light and screens (common in chronic headache sufferers)

  • Pain or discomfort when clenching the jaw or grinding the teeth (bruxism)

  • Pain that worsens with stress, poor posture, or prolonged talking or eating

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

Muscle Action

  • Elevates the Jaw: Closes the mouth for chewing and biting.

  • Retracts the Jaw: Moves the mandible backward, helping with jaw alignment and stability.

  • Assists in Side-to-Side Jaw Movements: Works with other muscles to control jaw motion during chewing.

The temporalis is crucial for jaw movement, facial expressions, and head posture.

Signs and Symptoms

Individuals with temporalis trigger points often report:

  • Pain in the Temples That Feels Like a "Squeezing" or "Throbbing" Sensation

  • Pain That Spreads to the Jaw, Teeth, or Side of the Head (Can Resemble TMJ Dysfunction or Toothache)

  • Tightness or Tenderness When Chewing, Clenching, or Yawning

  • Headaches That Worsen with Stress, Poor Posture, or Jaw Clenching

  • Pain or Discomfort in the Forehead or Around the Eyes (Can Mimic Sinus Pressure or Eye Strain)

  • Morning Jaw Soreness or Headaches Due to Nighttime Teeth Grinding (Bruxism)

Pain worsens with jaw tension, chewing, clenching, or emotional stress.

Perpetuating Factors

Common causes of temporalis trigger points include:

  • Chronic Teeth Clenching or Grinding (Bruxism, Often Due to Stress or Anxiety)

  • Frequent Chewing or Excessive Talking (Overuse of the Temporalis and Jaw Muscles)

  • Forward Head Posture (Puts Excess Strain on the Jaw and Neck Muscles)

  • Excessive Screen Time or Poor Ergonomics (Can Lead to Increased Jaw and Head Tension)

  • Jaw Imbalances or TMJ Dysfunction (Can Cause Overuse of the Temporalis for Stability)

Trigger Point Referral Pattern

Trigger points in the temporalis refer pain to:

  • The temples and side of the head (Can Mimic Tension Headaches or Migraines)

  • The jaw and upper teeth (Mistaken for Tooth Pain or Dental Issues)

  • The forehead and around the eyes (Can Resemble Sinus Pressure or Eye Strain)

Pain from this muscle is often confused with TMJ dysfunction, migraines, or sinus-related pain.

Differential Diagnosis

Temporalis trigger points may be mistaken for:

  • Tension Headaches (Dull, Aching Pain That Wraps Around the Head, Worsens with Stress or Poor Posture)

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

  • TMJ Dysfunction (Jaw Pain, Clicking, and Limited Movement, Common in Those Who Clench Their Jaw or Grind Their Teeth)

  • Sinus Headaches (Pain and Pressure in the Temples and Forehead, Often Accompanied by Congestion)

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

A thorough jaw, neck, and head examination is necessary to rule out these conditions.

Associated Trigger Points

Temporalis trigger points often co-exist with:

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

  • Sternocleidomastoid (SCM) (Neck and Head Pain, Can Mimic Migraines or Sinus Pressure)

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

  • Pterygoid Muscles (Inner Jaw and Ear Pain, Affects Chewing and Jaw Opening)

Anatomy and Innervation

Muscle Origin Insertion Innervation
Temporalis Temporal fossa Coronoid process of mandible Mandibular branch of the trigeminal nerve (CN V3)

The temporalis is innervated by the mandibular branch of the trigeminal nerve (CN V3), which also controls chewing, jaw movement, and facial sensation.

Patient Examination

A comprehensive examination should include:

  • Palpation: Identify tender nodules along the temples, jawline, and side of the head.

  • Resisted Jaw Closing Testing: Assess pain and tightness when clenching the jaw against resistance.

  • TMJ Function Testing: Look for jaw clicking, popping, or restricted movement.

  • Postural and Facial Expression Assessment: Rule out habitual clenching or forward head posture.

Corrective Actions

Dry Needling

  • Dry needling can release trigger points in the temporalis, reducing jaw tightness and improving headache symptoms.

Manual Therapy

  • Trigger Point Release: Apply deep sustained pressure along the temples and jawline.

  • Myofascial Release: Helps improve circulation and reduce tension in the head and jaw.

Stretching

  • Temporalis Stretch: Open the mouth gently while pressing the fingers on the temples to stretch the muscle.

  • Jaw Relaxation Techniques: Move the jaw side to side and gently stretch it downward to reduce tightness.

Strengthening Exercises

  • Tongue-to-Roof-of-Mouth Exercises: Encourages proper jaw alignment and reduces excessive temporalis activation.

  • Controlled Jaw Opening Drills: Helps improve jaw mobility and prevent excessive tension buildup.

Postural and Behavioral Adjustments

  • Avoid Excessive Jaw Clenching or Grinding (Use a Night Guard if Necessary)

  • Maintain Good Head and Neck Posture (Reduces Jaw Strain and TMJ Overuse)

  • Limit Excessive Talking, Chewing Gum, or Nail Biting (Prevents Overuse of the Temporalis)

Conclusion

The temporalis plays a crucial role in jaw movement, facial expressions, and head posture, but trigger points in this muscle can cause significant headaches, jaw pain, and temple discomfort. By incorporating dry needling, manual therapy, stretching, and relaxation techniques, individuals can reduce pain, improve mobility, and prevent TMJ 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.