Medial Pterygoid: Pain Pattern and Treatment
The medial pterygoid is the masseter's inner twin. It runs down the inside of the jaw from the base of the skull to the angle of the mandible, and it closes the jaw from within. Its documented pattern is pain deep in the ear, in the throat, and at the angle of the jaw, with pain on swallowing and a feeling that the ear is plugged. It is the jaw muscle behind many unexplained ear and throat complaints.
Attachments and action
Origin: Deep head from the inner surface of the lateral pterygoid plate; superficial head from the tuberosity of the maxilla and the pyramidal process of the palatine bone.
Insertion: The inner surface of the ramus and angle of the mandible.
Action: Elevation of the jaw (closing), protrusion, and side-to-side movement toward the opposite side; with the masseter it forms the sling that grips the jaw's angle.
Where the pain is felt: Deep in the ear. In the throat and the roof of the mouth. Below and behind the jaw joint, down to the angle of the jaw. Swallowing hurts. The ear feels plugged or full.
Common causes: Clenching and grinding; chewing gum or tough food on one side; a bite changed by dental work; long dental procedures; anxiety-driven jaw bracing; a blow to the jaw.
Patients say: “My ear hurts and the ENT found nothing.” “It hurts to swallow, but I do not have a sore throat.” A dull ache at the angle of the jaw that pressing from outside does not reach. “My ear feels plugged.”
When to get evaluated: Ear pain with discharge, hearing loss, or fever needs an ear examination first. Throat pain with difficulty breathing or swallowing liquids, or with a lump in the neck, needs medical evaluation before anything else.
How this muscle is examined and treated
Examination tests jaw closing and protrusion against resistance, reproduces the ache by pressing the angle of the jaw from below and behind, and checks the muscle from inside the mouth. Needling here addresses the muscle below the angle of the jaw from the outside. Assessment and treatment happen in the same visit.
Related conditions
Headaches & MigrainesNeck & Cervical PainChronic Pain Patterns
This page is educational. It describes muscle referral patterns commonly associated with pain; it does not diagnose your condition. Individual patterns vary. For evaluation of your specific pain, see a licensed clinician. Seek immediate medical care for emergencies. Eugene Baek, L.Ac. · New Jersey License 25MZ00080600