Masticatory myofascial pain syndrome provoked by SARS-COV-2 infection in a patient with orofacial pathology (clinical case)
Abstract. Myofascial pain syndrome (MFPS) is a chronic pain condition characterised by the appearance of myofascial trigger points (MTP) in muscles. The condition can be caused by various factors and is diagnosed through clinical examination and palpation of MTPs. Recent studies have shown that infections like SARS-CoV-2 can cause MFPS, along with other symptoms. Dentists often encounter the problem of MFPS in patients with temporomandibular joint dysfunction, but it can also develop in patients with a normally functioning joint. Symptoms include pain, sensitivity, and abnormalities in mandible mobility. In this article, the case of MFPS in a person with orofacial pathology after SARS-CoV-2 diagnosis is presented. Materials and methods of research. Describes a person who has the instability of the bite caused by the absence, destruction and disposition of the chewing teeth led to disorders of the chewing muscles. The patient was found to have appearing MFPS symptoms after COVID-19. The systematic online search of articles utilising the search terms «Coronavirus, SARS-COV-2 and Myofascial pain syndrome», published between January 2020 and October 2023, was performed. Results. The patient was diagnosed with SARS-CoV-2 in October 2021 and was hospitalised for 10 days. After discharge, she went to the dentist with complaints of headache and stiffness in the area of masticatory muscles, absence and destruction of lateral teeth, difficulty in chewing food, mobility and displacement of individual teeth, periodic bleeding gums, as well as aesthetic disorders. During the objective examination, secondary partial adentia was revealed, which led to instability of the bite, defects of the hard tissues of the chewing teeth, pathological wear of the frontal group, and traumatic occlusion phenomena. During palpation, trigger points were found in the area of the masticatory and temporal muscles. The patient underwent a series of ten trigger point injections (dry needling) in her chewing muscles, with about 30 % immediate relief. Conclusion. MFPS can be caused by various factors, including infections like SARS-CoV-2. The diagnosis is based on clinical examination and palpation of MTPs, and treatment may include trigger point injections, physical therapy, and non-invasive therapy methods. In the presented case, the patient had partial adentia, leading to instability of the bite and MFPS symptoms after SARS-CoV-2 diagnosis. Prompt diagnosis and management of MFPS are necessary to improve the patient’s quality of life.
Barbero M, Schneebeli A, Koetsier E, Maino P. Myofascial pain syndrome and trigger points: evaluation and treatment in patients with musculoskeletal pain. Curr Opin Support Palliat Care. 2019;13(3):270-6. DOI: https://doi.org/10.1097/spc.0000000000000445
Duarte FCK, West DWD, Linde LD, Hassan S, Kumbhare DA. Re-Examining Myofascial Pain Syndrome: Toward Biomarker Development and Mechanism-Based Diagnostic Criteria. Curr Rheumatol Rep. 2021;23(8):69. DOI: https://doi.org/10.1007/s11926-021-01024-8
Li LQ, Huang T, Wang YQ, Wang ZP, Liang Y, Huang TB, et al. COVID-19 patients' clinical characteristics, discharge rate, and fatality rate of meta-analysis. J Med Virol. 2020;92(6):577-83. DOI: https://doi.org/10.1002/jmv.25757
Willi S, Lüthold R, Hunt A, Hänggi NV, Sejdiu D, Scaff C, et al. COVID-19 sequelae in adults aged less than 50 years: A systematic review. Travel Med Infect Dis. 2021;40:101995. DOI: https://doi.org/10.1016/j.tmaid.2021.101995
Elbarbary M, Oren A, Goldberg M, Freeman BV, Mock D, Tenenbaum HC, et al. Masticatory Myofascial Pain Syndrome: Implications for Endodontists. J Endod. 2022;48(1):55–69. DOI: https://doi.org/10.1016/j.joen.2021.10.004
Golanska P, Saczuk K, Domarecka M, Kuć J, Lukomska-Szymanska M. Temporomandibular Myofascial Pain Syndrome-Aetiology and Biopsychosocial Modulation. A Narrative Review. Int J Environ Res Public Health. 2021;18(15). DOI: https://doi.org/10.3390/ijerph18157807
Kalladka M, Young A, Khan J. Myofascial pain in temporomandibular disorders: Updates on etiopathogenesis and management. J Bodyw Mov Ther. 2021;28:104-13. DOI: https://doi.org/10.1016/j.jbmt.2021.07.015
Urits I, Charipova K, Gress K, Schaaf AL, Gupta S, Kiernan HC, et al. Treatment and management of myofascial pain syndrome. Best Pract Res Clin Anaesthesiol. 2020; 34 (3): 427–48. DOI: https://doi.org/10.1016/j.bpa.2020.08.003
Pires RE, Reis IGN, Waldolato GS, Pires DD, Bidolegui F, Giordano V. What Do We Need to Know About Musculoskeletal Manifestations of COVID-19?: A Systematic Review. JBJS Rev. 2022;10(6). DOI: https://doi.org/10.2106/jbjs.Rvw.22.00013
Dotan A, David P, Arnheim D, Shoenfeld Y. The autonomic aspects of the post-COVID19 syndrome. Autoimmun Rev. 2022;21(5):103071. DOI: https://doi.org/10.1016/j.autrev.2022.103071
Ursini F, Ciaffi J, Mancarella L, Lisi L, Brusi V, Cavallari C, et al. Fibromyalgia: a new facet of the post-COVID-19 syndrome spectrum? Results from a web-based survey. RMD Open. 2021;7(3). DOI: https://doi.org/10.1136/rmdopen-2021-001735
Charles D, Hudgins T, MacNaughton J, Newman E, Tan J, Wigger M. A systematic review of manual therapy techniques, dry cupping and dry needling in the reduction of myofascial pain and myofascial trigger points. J Bodyw Mov Ther. 2019;23(3):539-46. DOI: https://doi.org/10.1016/j.jbmt.2019.04.001
Zha M, Chaffee K, Alsarraj J. Trigger point injections and dry needling can be effective in treating long COVID syndrome-related myalgia: a case report. J Med Case Rep. 2022; 16 (1): 31. DOI: https://doi.org/10.1186/s13256-021-03239-w
Batres-Marroquín AB, Medina-García AC, Vargas Guerrero A, Barrera-Villalpando MI, Martínez-Lavín M, Martínez-Martínez LA. Effect of COVID-19 Pandemic Lockdown on Fibromyalgia Symptoms. J Clin Rheumatol. 2022;28(1):e289-e91. DOI: https://doi.org/10.1097/rhu.0000000000001685
Khan M, Nishi SE, Hassan SN, Islam MA, Gan SH. Trigeminal Neuralgia, Glossopharyngeal Neuralgia, and Myofascial Pain Dysfunction Syndrome: An Update. Pain Res Manag. 2017;2017:7438326. DOI: https://doi.org/10.1155/2017/7438326
Devlikamova FI. Results of the post-registration clinical study «PARUS» on efficiency and safety assessment of Mydocalm-Richter for local injection therapy of a myofascial trigger zone. Ter Arkh. 2018;90(6):81-8. DOI: https://doi.org/10.26442/terarkh201890681-88
Serrera-Figallo MA, Ruiz-de-León-Hernández G, Torres-Lagares D, Castro-Araya A, Torres-Ferrerosa O, Hernández-Pacheco E, et al. Use of Botulinum Toxin in Orofacial Clinical Practice. Toxins (Basel). 2020;12(2). DOI: https://doi.org/10.3390/toxins12020112
Mendieta D, De la Cruz-Aguilera DL, Barrera-Villalpando MI, Becerril-Villanueva E, Arreola R, Hernández-Ferreira E, et al. IL-8 and IL-6 primarily mediate the inflammatory response in fibromyalgia patients. J Neuroimmunol. 2016;290:22-5. DOI: https://doi.org/10.1016/j.jneuroim.2015.11.011
Arunachalam PS, Wimmers F, Mok CKP, Perera RAPM, Scott M, Hagan T, et al. Systems biological assessment of immunity to mild versus severe COVID-19 infection in humans. Science. 2020;369(6508):1210-20. DOI: https://doi.org/10.1126/science.abc6261
Mathew D, Giles JR, Baxter AE, Greenplate AR, Wu JE, Alanio C, et al. Deep immune profiling of COVID-19 patients reveals patient heterogeneity and distinct immunotypes with implications for therapeutic interventions. bioRxiv. 2020. DOI: https://doi.org/10.1101/2020.05.20.106401
Fernández-de-Las-Peñas C, Palacios-Ceña D, Gómez-Mayordomo V, Cuadrado ML, Florencio LL. Defining Post-COVID Symptoms (Post-Acute COVID, Long COVID, Persistent Post-COVID): An Integrative Classification. Int J Environ Res Public Health. 2021;18(5). DOI: https://doi.org/10.3390/ijerph18052621
Fialho MFP, Brum ES, Oliveira SM. Could the fibromyalgia syndrome be triggered or enhanced by COVID-19? Inflammopharmacology. 2023:1-19. DOI: https://doi.org/10.1007/s10787-023-01160-w
Hu B, Huang S, Yin L. The cytokine storm and COVID-19. J Med Virol. 2021;93(1):250-6. DOI: https://doi.org/10.1002/jmv.26232
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