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What is Temporalis Tendonitis?

Temporal tendonitis refers to inflammation & tenderness of the temporalis tendon where it inserts into the coronoid process of the mandible (lower jaw).

This condition may often feel like a migraine headache, and so is also known as the “migraine mimic”.

This disorder often presents concurrently with other cranio-facial disorders, such as anterior dislocation of the articular disk of the TMJ, Ernest syndrome, myo-fascial pain dysfunction or even maxillary sinusitis.

Diagram showing the position of the Temporalis Muscle, Temporalis Tendon & the Coronoid Process of the Lower Jaw

What are the Signs & Symptoms of Temporalis Tendonitis?

Symptoms include:

  • Constant aching behind the eye
  • Intense headache
  • Restricted jaw movement (both opening & closing & from side to side)
  • Radiation of pain from the cheek to eye, eyebrow & over the temple
  • Tender / painful teeth (upper ± lower teeth)
  • Light sensitivity
  • Swelling of the cheek
  • Ear pain & pressure

What are the causes & diagnosis of Temporalis Tendonitis?

Temporalis Tendonitis is often associated with prolonged mouth opening (such as visits to the dentist), increased stress, tooth grinding (bruxism), direct trauma to the Temporalis muscle or excessive gum chewing.

Temporalis tendonitis is often diagnosed by palpation of the tendon as it inserts into the coronoid process. Injection of local anæsthetic into this region should remove any pain & is regarded as the definitive diagnostic test.

How is it treated?

A diagnostic infiltration of LA into the Temporalis tendon insertion. This is then followed up by infiltration of an anti-inflammatory steroid. This can be repeated.

Often, Temporalis Tendonitis is part of a wider collection of symptoms. If the Temporalis Tendonitis is 2nd to bruxism, this also needs to be treated.

Infiltration of fluid (either LA or steroid) can sometimes cause bruising , swelling or if the LA diffuses away from the Temporalis Tendon, may effect the Facial Nerve causing what looks to be a stroke on that side of the face – this lasts for as long as the LA anaesthetic lasts for.