Palpation was performed with progressive and continuous deep pressure with a finger on the skin surface to identify latent MTrPs in the medial or lateral pterygoid muscles. Patients were instructed to remain seated and to immobilized the head and shoulders to maximize relaxation of the muscle being palpated (18 (link)). Once the trigger points were identified, the thumb of one hand of the therapist remained in a fixed position on the skin, disinfected the surrounding skin, had the patients keep their mouths open (to prevent the needle from blocking in the temporomandibular joint) and with the other hand inserted the syringe into the muscle, adjusted the depth of the needle, and when the patients felt a referred pain indicating that the needle had been inserted into the latent MTrPs, 3â5âmL of a liquid medication was then injected. There were many small blood vessels near the muscles. To avoid intravascular injection, it was necessary to withdraw before injection. The other side was injected using the same technique.
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