A Case Report of Ultrasound-Guided Fascia Release for Masseter Muscle Pain

Abstract

Patient: A 38-year-old man suffered from pain of the right lower molar and difficulty with mouth opening. No abnormal findings were observed in the panoramic radiography and periodontal tissue examinations. No conspicuous pain of the right mandibular molar was observed, and there was no abnormal finding of the temporomandibular joint. Although several marked tender points were observed at the right masseter muscle, it was difficult to palpate the obvious muscle induration. Referred pain was recognized in the right first molar due to compression of the right masseter muscle. The pain was diagnosed as myofascial pain of the right masseter muscle. Observations of the right masseter muscle using the ultrasound diagnostic equipment showed findings that appeared to be adhesions of the fascia. We injected 1％ mepivacaine into the site believed to be an adhesion of the fascia under ultrasound guidance, and adhesion release was confirmed. Pain was relieved after this injection, and the extent of mouth opening was also increased.
Discussion: This case describes myofascial pain without obvious muscle induration. Symptom improvement was observed by releasing the adhesion of the fascia under ultrasound guidance.
Conclusion: This report suggests that ultrasound-guided fascia release is an effective treatment for myofascial pain without muscle induration.