Myofascial Pain Syndrome and Its Relation to Trigger Points, Facial Form, Muscular Hypertrophy, Deflection, Joint Loading, Body Mass Index, Age and Educational Status.

Introduction: Myofascial pain (MFP) is a type of pain characterized by the presence of a trigger point (TrPs) in taut band of skeletal muscles or its fascia. Based on the current literature, the prevalence of head and neck myofascial pain (HNMFP) varies among different communities. To better understand this condition and its relation to facial form, muscular hypertrophy, deflection, and joint loading, the study aimed at evaluating the prevalence of HNMFP among the population of Jeddah, Saudi Arabia.

Materials and methods: This was a cross-sectional study to survey a sample of Jeddah residents, Saudi Arabi between the ages of 18-65 for HNMFP who were attending a public event in December 2019. Participants were asked to complete a questionnaire for demographics and history of HMFP signs and symptoms followed by a comprehensive clinical examination including facial form, muscular hypertrophy, maximum vertical opening, and joint loading. In addition, examination of upper quarter muscles was completed using flat or pincer palpation as needed. Data were collected and summarized as frequencies and percentages and group differences were tested using the chi-square statistical method.

Results: A total of 197 participants were examined in this study, in which 136 (69.0%) had signs and symptoms consistent with HNMFP. Study subjects' educational status was significantly associated with HNMFP (P = 0.008). Older subjects were more likely to report spontaneous pain whereas younger subjects were more likely to report pain following trauma (P = 0.049). Older subjects were more likely to have muscular hypertrophy (P = 0.011), while Younger subjects were more likely to have symmetrical facial form (P = 0.004). In terms of gender, males were more likely to experience pain aggravation with pressure and cold application whereas females were more sensitive to jaw function (P = 0.015). Distribution of joint loading showed a statistically significant difference between males and females (P = 0.008) with females having deflection on opening more frequently compared to males (P = 0.001). Furthermore, female subjects showed a significantly higher frequency of positive TrPs compared to males.

Conclusion: Based on the current data, HNMFP is a common condition among the population of Jeddah. Factors such as body mass index and educational level were found to be linked to HNMFP. Younger subjects were more likely to have symmetrical facial form while older subjects were more likely to have muscular hypertrophy. The distribution of joint loading showed a statistically significant difference between males and females with females having deflection on opening more frequently compared to males. Further studies with a larger group of patients are needed to confirm these findings.