Structured Jaw Exercise in Head and Neck Cancer Survivors with Trismus Greatly Increases Chances of Being Pain Free 3-Years After Oncological Treatment

Abstract

Background: The aim of the study was to investigate the prevalence of facial pain in patients with Head and Neck Cancer (HNC) and trismus three years after cancer treatment. Furthermore, the study aimed to assess the effect of a structured jaw exercise program on pain. Methods: One hundred patients with HNC and trismus (i.e. Maximum Interincisal Opening (MIO) ≤35 mm) post-radiotherapy were prospectively followed up to three years with regard to prevalence of facial pain. Fifty of the patients participated in a structured 10-week intervention program with jaw exercise post-cancer treatment and 50 of the patients comprised a matched control group. Facial pain during last month was reported by the patient on a 7-point Likert scale. Results: Facial pain was common in HNC patients with trismus before undergoing cancer treatment (n=59, 59%) and more than half of the patients (n=46, 51%) reported facial pain at the three-year follow-up. Patients with facial pain at the three-year follow-up had lower MIO (34.8 vs. 39.6 mm, p=0.0005) compared to pain free patients. Fewer patients in the exercise intervention group (n=13, 28%) reported facial pain compared to the control group (n=33, 77%) (p<0.0001). The odds ratio for being pain free three years post-cancer treatment was 8.63 times higher (p<0.0001) if the patients had undergone structured jaw exercise. Conclusion: There is a high prevalence of facial pain in HNC and trismus. Structured jaw exercise seems to be effective for improving facial pain in trismus patients up to three years after HNC treatment.