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Russian Military Medical
SCIENTIFIC REVIEWS Vol. 41 (4) 2022 Academy Reports
430
DOI: https://doi.org/10.17816/rmmar111883
Review Article
The place of myofascial syndrome in the genesis

of headaches and facial pains

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Mikhail V. Tardov , Alexey V. Boldin , Nikolay V. Sturov ,
1
Georgiy N. Kobylyanu , Freire Da Silva Thiago 1
Military Medical Academy, Saint Petersburg, Russia
The article discusses the patterns of development and the main features of myofascial syndrome. Emphasis is placed
on the myofascial syndrome involving head and face muscles with characterization of “masks” of the syndrome: irradiation
zones of trigger point pain in the skeletal muscles of the cervical region are described (important role of the sternoclei-
domastoid muscle is emphasized), in the facial muscles and masticatory muscles. Trigger point properties are covered in
detail, including painful and non-painful manifestations, such as tinnitus and congestion in the ear, dizziness, vertigo and
hearing loss; as well as local vegetative symptoms. When diagnosing myofascial syndrome, it is necessary to specify in
detail the anamnestic data (the time and conditions for the onset of the first manifestations), as well as to specify as many
characteristics of pain as possible (the circumstances of its provocation and relief, the duration of the attack, the pain mo-
dality). The most important role belongs to palpation of the muscles with the definition of trigger points and muscle cords.
The basic principles of therapy for myofascial syndrome are given: anesthesia, relaxation and stretching. Further, specific
methods of drug, physiotherapeutic and manual procedures on the affected muscles are analyzed in detail. Two clinical
cases from our own practice are presented, demonstrating the features of the myofascial syndrome clinical picture forma-
tion in the face area and the possibility of interrupting the pain phenomenon and non-painful manifestations by inactivating
muscle triggers. The importance of joint supervision of a patient with myofascial syndrome by a multidisciplinary medical
team, including, if necessary, not only neurologist and osteopath, but also an ENT doctor and a dentist, is emphasized.
In conclusion, it was concluded that it is necessary to develop recommendations at the federal level for the diagnosis and
treatment of myofascial syndrome.
Keywords: cochleovestibular syndrome; Costen syndrome; facial muscles; myofascial syndrome; muscles of mastication;
skeletal muscles; temporomandibular joint; trigger point.

To cite this article:
Tardov MV, Boldin AV, Sturov NV, Kobylyanu GN, Freire Da Silva Thiago. The place of myofascial syndrome in the genesis of headaches and facial
pains. Russian Military Medical Academy Reports. 2022;41(4):429–437. DOI: https://doi.org/10.17816/rmmar111883

Received: 12.10.2022 Accepted: 19.10.2022 Published: 17.11.2022

The article can be used under the CC BY-NC-ND 4.0 license
© Authors, 2022