Patients complain about their headaches as they trace the headache in their eyebrow. This referral pattern is directly in the eyebrow. On the other hand, similar patterns happen above or below the eyebrow. Further assessment is needed to pinpoint this trigger point. The sure sign is when I press into the corner of the jaw (where the green asterisks are), and the headache intensifies.
When I’m working, I may ask about pain in the teeth or jaw when I find this trigger point. They usually associate it with a tooth problem. Of course, they think it is something that the dentist should address instead of the massage therapist. They often brush off the tooth pain as something they have had. So, they need to get their teeth checked. I am sure to ask about the teeth before and after treatment. Again, in the following session, I ask to help them understand that it is part of the trigger point referral. I always encourage them to follow up with the dentist, even if I have eliminated the pain and discomfort.
The trigger points, indicated in green, are near the angle of the mandible and are usually very sensitive when pressed. It also reveals a more complete sensation of the pattern. Usually, the patients don’t report the whole pattern unless the trigger point is very active and I ask about details.
This example brings up an interesting note about the trigger point illustrations. The darker areas are darker because of how often they are a part of the pattern, not because of the intensity of the referral.
Wow. Look at that jaw. That hairstyle is pretty shocking too. Yes, I was into computers.
I was hospitalized for a week with migraines during one Christmas season in my 20s. By the way, I worked for that hospital as the IT manager of one of their billing companies. My boss assured me that they would take good care of me. But, unfortunately, I paid to hear that they did not know what caused the headaches.
Those headaches were awful. They would start as a dull ache in the morning, and I would shut down by the evening. Sadly, several months after the hospital incident, the headache returned. I had a toothache in the roots of those molars as well. Finally, I got out the yellow pages. I had gotten my first massage a few months earlier from a guy who had recently taken neuromuscular classes. A neuromuscular therapist gave me a great deal of relief in an hour for $40. I saw her weekly for a while. Check out the “after” picture below.
Like other masseter trigger points, this is often activated by unusual jaw activity, like crunching ice, busting popcorn kernels, or chewing on toothpicks. Nearby joint problems, especially the upper neck joints, are also a part of perpetuating this pattern. This one, however, is usually intensified by clenching, chewing.
A crack or a cavity on a tooth can cause this trigger point to flare up. You may get a bit of relief from the self-care post, but you need to see a dentist. I’ve been there and used the self-care to tide me over for the weekend. Larger problems develop when dental care is avoided.
A bad tooth can also cause a deviant chewing pattern that aggravates this trigger point. Additionally, this trigger point irritates the tooth and jaw. Often, this leads to cracked teeth and irritation.
Here is a picture of me, 31 years later. Different hair. Very different jaw. No headache in the eyebrow. I remember taking a cranial / trigger point course and feeling how much more space I had behind my back teeth. The size of the jaw shrank over a week. Later, I rewrote that course and taught it with craniostructural techniques.
I created my TMJ issue by grinding my teeth while weight-lifting and chewing on pens at work. I’ve had people come to me with similar problems, from chewing on toothpicks or grinding their teeth at night. Notably, most people do not understand why their jaw is so large or tight. This problem usually develops as a problem that is secondary to imbalances in the skull and neck.
This post on anatomy contains standard information about the origin, insertion, function, and innervation of muscles. Additionally, it includes information on functional considerations and anomalies.
Anatomy posts have a grid of all related posts. This includes posts on pain patterns, self-care, therapy notes, NMT protocols, cranial techniques, and cases.
Self-Care Posts have common sections to make them easy to follow and understand:
Therapy Notes provide details for cranial, spinal, and local joint work. These notes also link to a traditional neuromuscular protocol.
By treating integrative components first, direct work on the muscle becomes less intense while providing longer-lasting relief.
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Tony Preston has a practice in Atlanta, Georgia, where he sees clients. He has written materials and instructed classes since the mid-90s. This includes anatomy, trigger points, cranial, and neuromuscular.
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*This site is undergoing significant changes. We are reformatting and expanding the posts to make them easier to read. The result will also be more accessible and include more patterns with better self-care. Meanwhile, there may be formatting, content presentation, and readability inconsistencies. Until we get older posts updated, please excuse our mess.