Abstract
BackgroundSerotonin (5-HT) mediates pain by peripheral 5-HT3-receptors. Results from a few studies indicate that intramuscular injections of 5-HT3-antagonists may reduce musculoskeletal pain. The aim of this study was to investigate if repeated intramuscular tender-point injections of the 5-HT3-antagonist granisetron alleviate pain in patients with myofascial temporomandibular disorders (M-TMD).MethodsThis prospective, randomized, controlled, double blind, parallel-arm trial (RCT) was carried out during at two centers in Stockholm, Sweden. The randomization was performed by a researcher who did not participate in data collection with an internet-based application (www.randomization.com). 40 patients with a diagnose of M-TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were randomized to receive repeated injections, one week apart, with either granisetron (GRA; 3 mg) or isotonic saline as control (CTR).ResultsThe median weekly pain intensities decreased significantly at all follow-ups (1-, 2-, 6-months) in the GRA-group (Friedman test; P < 0.05), but not in the CTR-group (Friedman-test; P > 0.075). The numbers needed to treat (NNT) were 4 at the 1- and 6-month follow-ups, and 3.3 at the 2-month follow-up in favor of granisetron.ConclusionsRepeated intramuscular tender-point injections with granisetron provide a new pharmacological treatment possibility for myofascial pain patients with repeated intramuscular tender-point injections with the serotonin type 3 antagonist granisetron. It showed a clinically relevant pain reducing effect in the temporomandibular region, both in a short- and long-term aspect.Trial registrationEuropean Clinical Trials Database 2005-006042-41 as well as at Clinical Trials NCT02230371.
Highlights
Serotonin (5-HT) mediates pain by peripheral 5-HT3-receptors
The neurotransmitter serotonin (5-hydroxytryptamine; 5-HT) is an important component of the chemical milieu during inflammation [8]. It is found in high concentrations in platelets, enterochromaffin cells, and in certain regions of the brain [9]. It is released from platelets and mast cells due to tissue damage or ischemia. 5-HT concentrations have been found to be significantly elevated in painful muscles of patients with chronic myalgia [10,11,12]
In a recent study it was shown that the 5-HT3A-receptor is highly expressed in human masseter muscles and that more nerve fibers express 5-HT3A-receptors in women with M-Temporomandibular disorders (TMD) compared to healthy women [16]
Summary
Serotonin (5-HT) mediates pain by peripheral 5-HT3-receptors. Results from a few studies indicate that intramuscular injections of 5-HT3-antagonists may reduce musculoskeletal pain. The aim of this study was to investigate if repeated intramuscular tender-point injections of the 5-HT3-antagonist granisetron alleviate pain in patients with myofascial temporomandibular disorders (M-TMD). The neurotransmitter serotonin (5-hydroxytryptamine; 5-HT) is an important component of the chemical milieu during inflammation [8]. It is found in high concentrations in platelets, enterochromaffin cells, and in certain regions of the brain [9]. Targeting peripheral 5-HT3-receptors with drugs that block these receptors could be an interesting therapeutic approach for chronic muscle pain
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
