Indian Journal of Physiotherapy & Occupational Therapy-An International Journal

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Comparative Evaluation of Physiotherapy and Pharmacotherapy in the Management of Temporomandibular Joint Myofascial Pain


Affiliations
1 Department of Oral Medicine and Radiology, SDM College of Dental Sciences & Hospital, Dharwad 580 009, India
2 Department of Oral Medicine and Radiology, SDM College of Dental Sciences & Hospital, India
     

   Subscribe/Renew Journal


Objectives: The present study is a prospective study carried out to evaluate the efficacy of physiotherapy methods like ultrasound, transcutaneous electrical nerve stimulation, low intensity light amplification by stimulated emission of radiation and compare the same with pharmacotherapy comprising of analgesics and muscle relaxants, in the management of temporomandibular joint myofascial pain.

Methods: A total of 40 patients included in the study. Subjects were randomly assigned to one of the two groups, each group consisting of 20 subjects. Subjects of Group A received a combination of muscle relaxants and analgesics and Group B subjects received, ultrasound, transcutaneous electrical nerve stimulation, or light amplification by stimulated emission of radiation. All the patients were evaluated for subjective and objective symptoms at baseline and then following one, four, eight, and 16 weeks post treatment. All the subjects were evaluated with visual analog scale, Global Pain Impact scale scores, number of tender muscles, and maximum comfortable mouth opening.

Results: The parameters evaluated revealed significant improvement in Group B following treatment and also during the follow period as compared to Group A subjects.

Conclusion: Physiotherapy, having the advantages of better patient compliance and lack of adverse side effects, can be considered as primary treatment modality of patients with myofascial pain.


Keywords

Myofascial Pain, Physiotherapy, Pharmacotherapy, Ultrasound, LASER, TENS
Subscription Login to verify subscription
User
Notifications
Font Size


  • Okeson J P: Current terminology and diagnostic classification schemes. Oral Surgery Oral Medicine Oral Pathology Oral Radiology Endodontology 1997;83:61-4.

  • Michelotti A, De Wijer A, Steenks M, Farella M: Home exercise regimes for the management of non-specific temporomandibular disorders. Journal of Oral Rehabilitation 2005; 32: 779–785.

  • McNeill C: Management of Temporomandibular disorders: Concepts and controversies. Journal of Prosthetic Dentistry 1997; 77: 510-22.

  • Nicolakis P, Erdogmus B, Kopf A, Nicolakis, Piehslinger E: Effectiveness of exercise therapy in patients with myofascial pain dysfunction syndrome. Journal of Oral Rehabilitation 2002; 29: 362-368.

  • Dworkin SF, LeResche L, DeRouen T, Von Korff M: Research Diagnostic criteria for Temporomandibular disorders: review, criteria, examinations, and specifications and critique. The Journal of Craniomandibular Disorders 1992; 6:310-315.

  • Mulet M, Decker KL, Look J O, Lenton P A, Schiffman E L: A Randomized clinical trial assessing the efficacy of adding 6x6 exercises to self-care for the treatment of masticatory myofascial pain. Journal of Orofacial Pain 2007; 21:318-328.

  • Shankland W E: Temporomandibular disorders: Standard treatment options. General Dentistry 2004; 349- 355.

  • De laat A: Scientific basis of masticatory disorders. Scientific Basis of Eating. Edited by Linden RWA. Front Oral Biol, Karger, 1998, pp 122-134.

  • Selby A: Physiotherapy in the management of temporomandibular disorders. Australian Dental Journal 1985; 30:273- 280.

  • Springer SP, Greenberg SM: Temporomandibular disorders. Burket’s oral medicine diagnosis and treatment 9th edition. Edited by Greenberg MS, Glick M. BC Decker, Ontario, 2003, pp 310.

  • Stegenga B, de Bont LGM, Boering G: Temporomandibular joint pain assessment. Journal of Orofacial Pain 1993; 7: 23-37.

  • Okeson JP: Management of Temporomandibular disorders and occlusion 5th edition. Mosby, St. Louis 2003, pp 260-272.

  • Greene CS, Laskin DM: Long–term evaluation of conservative treatment for myofascial pain dysfunction syndrome. Journal of American Dental Association 1974; 89: 1365-1368.

  • Murphy JG: Physical medicine modalities and trigger point injections in the management of Temporomandibular disorders and assessing treatment outcome. Oral Med Oral Pathol Oral Radiol Endodontology 1997; 83: 118- 122.

  • Feine JS, Lund JP: An assessment of physical therapy and physical modalities for the control of chronic musculoskeletal pain. Pain 1997; 71:5-23.

  • Greider A, Vinton PV, Cinotti WR, Kanjur TT: An evaluation of ultrasonic therapy for tempormandibular joint dysfunction. Oral Surgery Oral Medicine Oral Pathology Oral Radiology Endodontology 1971; 31: 25-31.

  • Mohl DN, Ohrbach KR, Crow CH, Gross JA: Devices for the diagnosis and treatment of tempormandibular disorders. Part III: Thermography, ultrasound, electric stimulation, and electromyographic biofeed back. Journal of Prosthetic Dentistry 1990; 63: 472-7.

  • Esenyel M, Caglar N, Aldemir T: Treatment of Myofascial Pain. American Journal of Physical Medicine and Rehabilitation 2000; 79: 48-52.

  • Gray R.J.M, Quayle AA, Hall CA, Schofield MA: TemporomandibuIar Pain Dysfunction: Can Electrotherapy Help? Physiotherapy 1995; 81: 47-51.

  • Talaat AM, EL- Dibany MM, EL- GARF A: Physical therapy in the management of Myofascial pain dysfunction syndrome. Annals of Otology Rhinology Laryngology 1986 ; 95: 225-227.

  • Majlesi J, Unalan H: High-Power Pain Threshold Ultrasound Technique in the Treatment of Active Myofascial Trigger Points: A Randomized, Double-Blind, Case-Control Study. American Journal of Physical Medicine and Rehabilitation 2004; 85: 833-836.

  • Hotta TH, Vincente MFR, Candido dos Reis A, Bezzon OL, Bataglion C, Bataglion C: Combination therapies in the treatment of temporomandibular disorders: A clinical report. Journal of Prosthetic Dentistry 2003; 89:536-9.

  • Simunovic Z: Low level laser therapy with trigger points technique: a clinical study on 243 patients. Journal of Clinical Laser Medicine and Surgery 1996; 14: 163-167.

  • Dimitroulis G, Gremillion HA, Dolwick MF, Walter JH: Temporomandibular disorders.2. Non- surgical treatment. Australian Dental Journal 1995; 40: 372-6.

  • Dionne RA: Pharmacologic treatments for temporomandibular disorders: Oral Surgery Oral Medicine Oral Pathology Oral Radiology Endodontology 1997; 83: 134-42.

  • Greene CS and Laskin DM: Meprobamate therapy for the myofascial pain- dysfunction syndrome (MPD) syndrome: a double – blind evaluation. Journal of American Dental Association 1971; 82: 587-590.

  • Singer E, Dionne R: A controlled evaluation of Ibuprofen and Diazepam for chronic Orofacial Muscle Pain. Journal of Orofacial Pain 1997; 11: 139-146.

  • Andrade EDD, Barbosa CMR, Pinheiro MLP: Pharmacological guidelines for managing temporomandibular disorders. Brazilian Journal of Oral Sciences 2004; 3: 503-505.

  • Ismail F, Demling A, Hebling K, Fink M, Stiesch-scolz M: Short term efficacy of physical therapy compared to splint therapy in treatment of arthrogenous TMD. J of Oral Rehab 2007; 34: 807-813.

  • Barkin L R: Acetaminophen, Aspirin, or Ibuprofen in Combination Analgesic Products. American Journal of Therapeutics 2001; 8:433–442.


Abstract Views: 427

PDF Views: 0




  • Comparative Evaluation of Physiotherapy and Pharmacotherapy in the Management of Temporomandibular Joint Myofascial Pain

Abstract Views: 427  |  PDF Views: 0

Authors

Venkatesh G. Naikmasur
Department of Oral Medicine and Radiology, SDM College of Dental Sciences & Hospital, Dharwad 580 009, India
Kruthika S. Guttal
Department of Oral Medicine and Radiology, SDM College of Dental Sciences & Hospital, India
Puneet Bhargava
Department of Oral Medicine and Radiology, SDM College of Dental Sciences & Hospital, India
Renuka J. Bathi
Department of Oral Medicine and Radiology, SDM College of Dental Sciences & Hospital, India

Abstract


Objectives: The present study is a prospective study carried out to evaluate the efficacy of physiotherapy methods like ultrasound, transcutaneous electrical nerve stimulation, low intensity light amplification by stimulated emission of radiation and compare the same with pharmacotherapy comprising of analgesics and muscle relaxants, in the management of temporomandibular joint myofascial pain.

Methods: A total of 40 patients included in the study. Subjects were randomly assigned to one of the two groups, each group consisting of 20 subjects. Subjects of Group A received a combination of muscle relaxants and analgesics and Group B subjects received, ultrasound, transcutaneous electrical nerve stimulation, or light amplification by stimulated emission of radiation. All the patients were evaluated for subjective and objective symptoms at baseline and then following one, four, eight, and 16 weeks post treatment. All the subjects were evaluated with visual analog scale, Global Pain Impact scale scores, number of tender muscles, and maximum comfortable mouth opening.

Results: The parameters evaluated revealed significant improvement in Group B following treatment and also during the follow period as compared to Group A subjects.

Conclusion: Physiotherapy, having the advantages of better patient compliance and lack of adverse side effects, can be considered as primary treatment modality of patients with myofascial pain.


Keywords


Myofascial Pain, Physiotherapy, Pharmacotherapy, Ultrasound, LASER, TENS

References