Short‐term effects of physiotherapy versus counselling for the treatment of myofascial pain of the jaw muscles

Abstract

The aim of the present study was to compare the efficacy of physiotherapy and counselling for the treatment of myofascial pain of the jaw muscles. Sixty‐three consecutive myogenous TMD patients, diagnosed according to the RDC‐TMD criteria, were assigned to two treatment groups with a balanced‐block randomization. The first group received only counselling with general information about self‐care of jaw musculature. The second group received the same general information supplemented by self‐massage, application of moist heating pads and stretching exercises of the masticatory muscles.Treatment success was decided on treatment contrast (TC), based on relative changes of sufficiently large anamnestic and clinical scores (van der Glas and van Grootel, 2000). Additional measurements included pressure pain threshold (PPT) of the masseter, anterior temporalis and Achilles' tendon, pain during gum chewing and spontaneous muscle pain scores rated on visual analogue scales (VAS). Data were collected at baseline and 3 months after start of treatment. Mann–Whitney's test and Fisher's exact test were used for statistical analysis. Sixteen patients dropped out from the study: eight from the counselling and eight from the physiotherapy group. The success rate was 13 of 23 (57%) patients for counselling and 18 of 24 (75%) for the physiotherapy group (P > 0·05). There was no significant difference between groups in all the other variables. Over a short‐term period, physiotherapy, as used in this protocol, does not appear superior to counselling for the treatment of TMD myofascial pain.