Pterygoid Muscle Pain and Trigger Points

By Kathryn Merrow

Having a forward head posture puts a lot of strain on the muscles of your neck and jaw. Having a “forward head” means that your head (and often one or both shoulders, too) are in front of your body.

Where should your head be instead? Well, when you were a toddler, it was pretty much directly over your body and that’s still where it should be. Due to habits, furniture, car seats, work and life, sometimes our head moves out in front of us. That causes a lot of symptoms and TMJ pain, or pain and difficulty moving your jaw, can be one of those symptoms.

See the Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief.

If chewing has been painful for you…

or if it’s been hard to open or move your jaw…

or if it feels as though your jaw is dislocated…let’s talk about muscles and joints.

There are muscles all over your body and head including in and around your mouth. There are muscles that let you open and close your jaw, which is a joint. Two of these muscles are on each side of your TMJ (temporomandibular joint.)They are called pterygoid muscles. They are tucked in behind your lower jawbone.

Pterygoid Trigger Points

When the pterygoid muscles get tight, or develop trigger points, they can cause difficulty opening your mouth. They can also cause pain in the TMJ (jaw joint) area, difficulty breathing through your nose, ringing in your ears and “sinus” pain (but it’s really not a sinus issue.) You can release, or relax, these muscles by pressing into them with your fingers. There are two types of pterygoids, the medial or ‘internal’ pterygoid and the lateral or ‘external’ pterygoid. Let’s call them “lower” and “upper.”

pterygoid muscle illustration

Medial Pterygoid Trigger Points

The following image shows the medial or lower pterygoid trigger points. You can press up under your jaw bone with your thumb or finger, at the end of the jaw closest to your ear, and press into the “lower” pterygoid. This might be very painful. That’s a sign that you are in the right place. The pressure from your finger causes the muscle to relax because it improves circulation. You may be tender afterward if the spot is very painful, so take it easy on yourself. (But don’t give up.)

medial pterygoid muscle trigger points
   Medial Pterygoid Trigger Points

The next image shows the lateral or upper pterygoid trigger points. This muscle the major cause of TMJ dysfunction and pain. To get to the upper pterygoid, you need to reach into your mouth with a finger. The muscle you are looking for is way in the back of your upper jaw, beyond your back teeth. Push your finger back as far beyond the teeth as you can and then make tiny massaging movements with your fingertip in (toward your throat) and up (toward the top of your head.) It will be very painful if these muscles are tight or have trigger points.

Lateral pterygoid trigger points illustration
Lateral Pterygoid Trigger Points and Referred Pain

If it is very painful when you press on the spots, you know you have found a cause of your pain. Of course, you need to have very short finger nails to do this work. You must press deeply enough to determine whether these muscles are causing your TMJ issues. Fortunately (or not?) the muscles in your mouth will be tender and that tells you whether they need to be released.

Even though you may have some tenderness, and it might take several sessions of self-treatment, you will see a decrease in your TMJ symptoms. Use your body wisdom to determine how deeply and how often you should do this. If you feel that you have bruising afterward from the pressure (typical when muscles are very tight), you can give your muscles a few days to get past the bruising before you treat them again.

And now I’d like to invite you to discover more ways to relieve your headaches and muscle pain naturally at

Join me, Kathryn Merrow, The Pain Relief Coach, on your journey to a pain-free life. “Because You Deserve to Feel Better!”

For more information on self-massage of myofascial trigger points, see the The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief by Clair Davies.