Why do I have pain in my masseter, clicking sounds and restricted mouth opening?
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Q. Are pain in the masseter, clicking sounds, and restricted mouth opening suggestive of masseter muscle hypertrophy?

Answered by
Dr. Achanta Krishna Swaroop
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Sep 03, 2022 and last reviewed on: Sep 14, 2022

Hello doctor,

I have pain in my left masseter muscle, a clicking and popping sound in my left TMJ, and restricted mouth opening on the left side.

Kindly advise.

#

Hello,

Welcome to icliniq.com.

I understand your concern.

Masetter muscle hypertrophy is a major cause of TMJ (temperomandibular joint) pain . Usually, we always recommend nonsurgical ways to treat this condition rather than an intraoral surgical approach. I suggest you use the tablet Hifenac MR (Paracetamol, Aceclofenac, and Chlorzoxazone) twice a day for three days. You will have pain relief, and you will be able to stretch your jaw muscle in two to three days. For long-term relief, you must consult a maxillofacial surgeon, who will recommend options like occlusal guards or removal of any occlusal interference that is bothering your bite. You might also be put on a suitable tranquilizer or muscle relaxant for a week to 15 days to deal with the masseter hypertrophy or pain. If the pain persists and you are uncomfortable with the jaw movement or mouth opening, then we need to opt for the surgical strategy.

I hope this helps.

Thank you.

Hello doctor,

Thank you for the response.

#

Hello,

Welcome back to icliniq.com.

You are most welcome.

Hello doctor,

I have restrictions in opening the jaw on the left side where the masseter muscle is hypertrophied. Therefore, I have been taking Hyphenix MR for the last four days.

What is the role of botox in my case? Will this improve my case, and can there be any side effects?

Thank you.

#

Hello,

Welcome back to icliniq.com.

It is good that you started with tablet Hifenac MR (Aceclofenac, Paracetamol, and Chlorzoxazone). However, please continue the medication if you have pain for more days and have a lot of tension in that area.

Botox injections work well, but they must be repeated every four to six months, depending on your muscle inflammation. You might be given a Tranquilizer along with Botox to eliminate the restricted mouth opening. As a specialist doctor, I advise you to go to a nearby clinic for a check-up with an excellent maxillofacial surgeon who you can trust and do further treatment.

Thank you.

Hello doctor,

Thank you for your response.

What are the side effects of botox treatment?

Thank you.

#

Hello,

Welcome back to icliniq.com.

Other than botox treatment, you need an intraoral surgical approach wherein a portion of that masseter muscle layer will be removed to widen your mouth opening range. I recommend you go to a clinic and consult a maxillofacial surgeon only in specific for an initial check-up so that the diagnosis of masseter muscle hypertrophy or masseter thickness is correct. If it is incorrect, see there will be several other causes of trismus, the most common cause being a TMJ (temporomandibular joint) problem that needs to be treated non-surgically. So an excellent maxillofacial surgeon can help you and see you in depth by examining the joint space.

Thank you.

Hello doctor,

Can you suggest any specialist doctors for the same?

Thank you.

#

Hello,

Welcome back to icliniq.com.

I have gone through the images and radiographs you have enclosed (attachments removed to protect the patient's identity)

You can search for a good dental surgeon nearest to your location. Botox injections work really well, which is a recent trend to correct and relax strained joints and masseter muscle. But they must repeat in four to six months, and long-term success is good. You will get a lot of relief because you might be given a Tranquilizer, and simultaneously you will be told to take the muscle relaxant tablets for a few days. The only long-term side effects might be bruising, pain, and swelling at the injection site. They might be only temporary side effects. But my advice is very simple. First, consult a good dentist in a clinic in your city, and then they will refer you to a good surgeon or dermatologist who will do the masseter Botox if needed.

Suppose after a clinical examination at the dentist you go to. If they feel that it is not required and just a muscle tear or a TMJ issue, then they will explain to you the nonsurgical way ahead, which is very simple oral physiotherapy and muscle relaxants.

Also, without straining much, relax and open and close your mouth multiple times a day as normally as possible, and keep taking a tablet of Hifenac MR twice a day till you visit your dentist.

Thank you.


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