Pressure Release Technique Versus Placebo Applied to Cervical and Masticatory Muscles in Patients With Chronic Painful Myofascial Temporomandibular Disorder. A Randomized Clinical Trial (original) (raw)
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Manual Therapy, Posturology & Rehabilitation Journal, 2016
Introduction: Given the intimate connection of the temporomandibular joint in the cervical region and its functions of chewing, speech and swallowing, patients with temporomandibular disorders (TMD) have most painful condition in stomathognatic muscles. Objective: Check for differences in pressure pain threshold of the masseter (MS), temporalis (TM), upper trapezius (UT) and sternocleidomastoid (SCM) muscles in different types of TMD. Method: Participated in the research 97 subjects, classified according to “The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD)”: myofascial pain (TMD IA), myofascial pain with limited opening (TMD IB), disc displacement with reduction (TMD IIA), disc displacement without reduction and with limited opening (TMD IIB), disc displacement without reduction and without limited opening (TMD IIC). For measurement of the pressure pain threshold (PPT) was used the pressure algometry program (Kratos®) of the TM, MS, UT and SCM muscles. For ...
Journal of Oral & Facial Pain and Headache, 2014
Aims: To carry out a systematic review and meta-analysis comparing the effects of occlusal splint therapy ("usual treatment") and psychosocial interventions for the treatment of myofascial temporomandibular disorder (TMD) pain in adult patients. Methods: Independent screening and evaluation of randomized clinical trials included comparisons between "usual treatment" based on splint therapy and psychosocial interventions for TMD treatment within electronic databases (PubMed/MEDLINE, CENTRAL, EMBASE), ongoing trials databases (Current Controlled Trials, ClinicalTrials.gov), and additional sources. The outcomes selected for the systematic review were self-reported pain, pain interference, unassisted jaw opening without pain, muscle pain upon palpation, depression, and somatization. The effect measures were analyzed using a random-effect model (Review Manager computer program). Results: The outcomes "longterm self-reported pain" and "long-term depression" were significantly different for the comparisons of "usual treatment" and psychosocial interventions, and they favored the latter (P < .005 and P < .05, respectively). These results must be viewed with caution due to the limited number of studies available. A tendency toward greater improvements of psychological outcomes was observed for psychosocial interventions, while physical functioning was slightly more responsive to "usual treatment." Conclusion: No evidence was found to distinguish the clinical effectiveness between "usual treatment" and psychosocial interventions for myofascial TMD pain. Future studies of TMD and related subdiagnoses should be reported according to core standardized outcomes to facilitate comparisons.
The Clinical Journal of Pain, 2011
The aim of this study was to assess the influence of cranio-cervical posture on the maximal mouth opening (MMO) and pressure pain threshold (PPT) in patients with myofascial temporomandibular pain disorders. Materials and Methods: A total of 29 patients (19 females and 10 males) with myofascial temporomandibular pain disorders, aged 19 to 59 years participated in the study (mean years±SD; 34.69±10.83 y). MMO and the PPT (on the right side) of patients in neutral, retracted, and forward head postures were measured. A 1-way repeated measures analysis of variance followed by 3 pairwise comparisons were used to determine differences. Results: Comparisons indicated significant differences in PPT at 3 points within the trigeminal innervated musculature [masseter (M1 and M2) and anterior temporalis (T1)] among the 3 head postures [M1 (F=117.78; P<0.001), M2 (F=129.04; P<0.001), and T1 (F=195.44; P<0.001)]. There were also significant differences in MMO among the 3 head postures (F=208.06; P<0.001). The intrarater reliability on a given day-today basis was good with the interclass correlation coefficient ranging from 0.89 to 0.94 and 0.92 to 0.94 for PPT and MMO, respectively, among the different head postures. Conclusions: The results of this study shows that the experimental induction of different cranio-cervical postures influences the MMO and PPT values of the temporomandibular joint and muscles of mastication that receive motor and sensory innervation by the trigeminal nerve. Our results provide data that supports the biomechanical relationship between the cranio-cervical region and the dynamics of the temporomandibular joint, as well as trigeminal nociceptive processing in different cranio-cervical postures.
PubMed, 2019
Significant impact factor and psycho-emotional stress in the etiology of dysfunction indicate the need of the routine approach in the treatment of patients with temporomandibular joint disorders to be changed. The aim of the study was to obtain data, documented test results as to the effciency of progressive muscle relaxation in the treatment of pain caused by temporomandibular joint disorders, as a supplement to previous methods using occlusal splint and other physical therapies. The study included 100 patients of both sexes, aged from 20 to 35 years who were diagnosed with pain due to temporomandibular joint disorders accompanied with high muscle tension of musticatory muscles which were treatment by relaxation therapy. All patients underwent physical examination, specialized functional examination of the masticatory system in accordance with the Polish version of the study RDC/TMD (The Research Diagnostic Criteria of Temporomandibular Disorders, Axis I - physical assessment, Axis II - assessment of psychosocial status and pain - related disability) and assessment of psycho emotional factor and stress, based on the survey developed for their own purpose. The results of the research were obtained using specialized statistical package "R" i386 3.2.3. The results of examinations a er relaxation therapy showed a significant reduction in the intensity of myofascial pain in all patients. Progressive muscle relaxation can be successfully used as an supportive therapy treatment of patient with dysfunction.
International Journal of Health Sciences, 2018
Objective: Mechanical neck pain (NP) with referred pain to upper limb is a common problem and often leads to functional impairment of common activities of daily living. The present study is undertaken to study and compare the effect of gross myofascial release (MFR) of upper limb and neck alone with conventional physiotherapy against only conventional treatment in subjects with mechanical NP referred to upper limb in terms of cervical endurance, pain, range of motion, and function. Methods: Design: This was a experimental study; a total of 40 subjects clinically diagnosed with mechanical NP along with referred pain between the age group of 20 and 50 years. Intervention: Control group was given conventional treatment of hot moist pack, TENS, and stretching and strengthening exercise, and experimental group was given gross MFR of the neck and upper limb in addition to conventional therapy. Treatment was given for 6 consecutive days. Outcome measures used were pressure biofeedback to m...
To evaluate the effectiveness of manual therapy in the treatment of myofascial pain related to temporomandibular disorders (TMD) through a systematic literature review. A systematic electronic search and manual of controlled and randomized clinical trials was carried out. Included articles were published between the years 2004 and 2021. Search was conducted in the Cochrane Library, MEDLINE, Web of Science, Scopus, LILACS and Scielo databases. Results: were found 145 titles and abstracts in the search, and 10 articles were included. A total of 493 individuals were assessed. 241 received only manual therapy or manual therapy associated with counseling as treatment. The other patients were a control group, patients undergoing other treatment modalities or patients who did not receive any treatment. Manual physical therapy is effective in the treatment of myofascial pain related to TMD. Thus, this treatment modality must be considered as one of the therapies in reducing muscle pain related to TMD.
2021
Temporomandibular disorders (TMD) are a group of disorders affecting the temporomandibular joints and the muscles of mastication. Signs of TMD primarily includes pain in and around temporomandibular joint. Although surgical options are available for treatment of many tmj dysfunctions,pain management and treatment associated with TMJ disorders could be potentially relieved with self-managed care or non surgical treatment. The rationale behind this systematic review is to evaluate the numerous physiotherapeutic treatment methods and summarize the evidence from randomized clinical trials (RCTs) that examined their effectiveness on pain relief in temporomandibular disorders (TMD). An Electronic search of PubMed, Saud digital library (SDL) and Cochrane Databases was conducted. Reviewers retrieved 475 articles from the three databases. A total of 10 articles were included in the systematic review. Physiotherapy compared to other treatment modalities was found significantly more effective ...
Journal of Musculoskeletal Pain, 2012
Objective: This study was undertaken to evaluate the comparative efficacy of four different types of muscle relaxants on the symptoms of the temporomandibular dysfunction [TMD] syndrome and to evaluate whether agents with antianxiety action provide better relief of symptoms. Method: This randomized controlled single blind clinical trial was completed on 79 patients with the clinical diagnosis of myofascial pain. Patients were randomly divided into four groups. In each of the four groups, patients were given a different type of muscle relaxant three times a day for three weeks. A fifth group of control patients, who did not receive any medication, was later studied in a similar manner. Results: A significant decrease in pain and mandibular dysfunction was found in all groups. Between-group analysis showed no differences in outcomes among five groups. Conclusions: All four groups who received muscle relaxants exhibited reduced pain and improved function over the period of follow-up. Muscle relaxants with sedative effects were not found to be more efficient in relieving the symptoms than were non-sedating medications. With all four drugs, the reduction of pain continued with time of follow-up. Patients in the control group, who did not receive any medication showed a similar improvement.
ConScientiae Saúde, 2013
Objectives: To verify the effects of the technique of muscle inhibition in individuals with Temporomandibular Disorder (TMD). Methods: A longitudinal, interventional, exploratory, comparative study was conducted of seven female subjects with a mean age of 42.8 (± 19.12) years. Participants were submitted to an active muscle inhibition technique until muscle relaxation occurred. We analyzed pain intensity, range of motion and bite force. Results: The pain decreased after use of the technique(p 0.01) from 6.3 to 2.3; the range of motion showed gains in the opening (p=0.04) and an increase by 2 mm of right laterality(p=0.01) and left laterality (p=0.01), while protrusion was not affected (p=0.35). The bite force increased by 13 mmHg after the use of the technique(p 0.01). Conclusion: The technique of muscle inhibition was responsible for significant reductions in the frequency and intensity of kinesiological episodes and in changes of the functional conditions of patients with TMD.