Postural Disharmony Causing Myofacial Pain: A Case Report and Review of Literature of the Treatment

  • B. R. Rajanikanth
  • Kavitha Prasad
  • Sujatha S. Reddy
  • Divya GuptaEmail author
  • N. Rakesh
  • V. Shwetha
  • T. Pavan Kumar
Case Report


Myofacial pain, a chronic painful condition of muscle origin, has numerous precipitating factors, if undiagnosed or left untreated could lead to compromised function and poor quality of life. In this case report, a female patient giving a history of 10 years of pain in the head and neck region was eventually diagnosed with myofacial pain secondary to bowing posture. The patient was successfully treated with combination of treatment modalities (TENS therapy, exercises, occlusal splint, etc.), which resulted in relief from chronic pain and improvement in quality of life.


Myofacial pain Postural disharmony TENS Occlusal splint Case report 




Compliance with ethical standards

Conflict of interest



  1. 1.
    Rev O (2015) HHS Public Access 14(11):871–882Google Scholar
  2. 2.
    Toseef M, Kumar S, Maheshwari S (2013) Neuromuscular dentistry: occlusal diseases and posture. J Oral Biol Craniofacial Res 3(3):146–150. CrossRefGoogle Scholar
  3. 3.
    Yashoda NRBK, Deepa D, Patil J (2013) Assessment of cervical spine postural disorders in patients with temporomandibular dysfunction: a radiographic evaluation. Oral Radiol 30:38–44Google Scholar
  4. 4.
    De Rossi SS, Stern I, Sollecito TP (2013) Disorders of the masticatory muscles. Dent Clin N Am 57(3):449–464. CrossRefGoogle Scholar
  5. 5.
    Da Costa DRA, De Lima Ferreira AP, Pereira TAB, Porporatti AL, Conti PCR, Costa YM et al (2015) Neck disability is associated with masticatory myofascial pain and regional muscle sensitivity. Arch Oral Biol 60(5):745–752CrossRefGoogle Scholar
  6. 6.
    Kraus S (2007) Temporomandibular disorders, head and orofacial pain: cervical spine considerations. Dent Clin N Am 51(1):161–193CrossRefGoogle Scholar
  7. 7.
    Costa YM, Conti PCR, de Faria FAC, Bonjardim LR (2017) Temporomandibular disorders and painful comorbidities: clinical association and underlying mechanisms. Oral Surg Oral Med Oral Pathol Oral Radiol 123(3):288–297. CrossRefGoogle Scholar
  8. 8.
    Clark GT (2008) Classification, causation and treatment of masticatory myogenous pain and dysfunction. Oral Maxillofac Surg Clin N Am 20(2):145–157CrossRefGoogle Scholar
  9. 9.
    Kalra A, Urban MO, Sluka KA (2001) Blockade of opioid receptors in rostral ventral medulla prevents antihyperalgesia produced by transcutaneous electrical nerve stimulation (TENS). J Pharmacol Exp Ther 298(1):257–263.
  10. 10.
    Johnson M. Electrical nerve stimulation (TENS). 259–86Google Scholar
  11. 11.
    Mykletun A, Stordal E, Dahl AA (2001) Hospital anxiety and depression (HAD) scale: factor structure, item analyses and internal consistency in a large population. Br J Psychiatry 179(6):540–544CrossRefGoogle Scholar
  12. 12.
    Vasudeva S, Iyengar A, Seetaramaiah N (2014) Correlation of anxiety levels between temporomandibular disorder patients and normal subjects. J Oral Dis 2014:579674. Google Scholar
  13. 13.
    Castelli L, De Santis F, De Giorgi I, Deregibus A, Tesio V, Leombruni P et al (2013) Alexithymia, anger and psychological distress in patients with myofascial pain: a case-control study. Front Psychol 4:1–8CrossRefGoogle Scholar
  14. 14.
    Nielsen AJ (1981) Case study: myofascial pain of the posterior shoulder relieved by spray and stretch. J Orthop Sport Phys Ther 3(1):21–26.

Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2019

Authors and Affiliations

  1. 1.Department of Oral and Maxillofacial Surgery, Faculty of Dental SciencesRamaiah University of Applied SciencesBengaluruIndia
  2. 2.Department of Oral Medicine and Radiology, Faculty of Dental SciencesRamaiah University of Applied SciencesBengaluruIndia

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