Myofascial Pain Dysfunction Syndrome Patients Research Articles

Comparative Efficacy of Low-Level Laser Acupuncture and Cupping for Treatment of Patients with Myofascial Pain Dysfunction Syndrome: A Double-blinded, Randomized Clinical Trial: Comparison of the Effects of LLL Acupuncture and Cupping.

Background: Myofascial pain dysfunction syndrome (MPDS) is among the most common causes of facial pain. This study compared the efficacy of low-level laser (LLL) acupuncture and cupping for the treatment of MPDS. Materials and Methods: This double-blind, before-after, randomized clinical trial evaluated 60 MPDS patients that were divided into two groups for LLL acupuncture (808 nm, 0.5 W, 30 J, 4 J/cm2 energy density, 60 seconds; group 1), and cupping (group 2) of masticatory muscle trigger points. Both treatments were performed for maximally eight sessions once every other day. The level of pain at the trigger points was measured upon admission, before and 5 minutes after treatment in each session, at ten days, and two months after treatment completion by a visual analog scale (VAS). The painless maximum mouth opening (MMO) and patient satisfaction with treatment were also assessed at the time as mentioned earlier points. Results: Averagely, 4.5 treatment sessions were required to achieve a 50% reduction in VAS pain score, with no significant difference between the two groups (P=0.9). Both treatments significantly decreased the number of trigger points and pain score, but this reduction occurred significantly sooner in the cupping group (P=0.01). MMO significantly improved in both groups after treatment with no significant difference between them (P=0.2). Patients were significantly more satisfied with LLL acupuncture (P=0.05). Conclusion: Both cupping and LLL acupuncture are equally effective for MPDS; thus, the patient can choose the type of treatment after receiving sufficient information regarding the two modalities.

Comparing the Anxiety Level between Myofascial Pain Dysfunction Syndrome Patients and Others

Comparing the Anxiety Level between Myofascial Pain Dysfunction Syndrome Patients and Others

A Comparative Study of Low-Level Laser Therapy and Transcutaneous Electrical Nerve Stimulation as an Adjunct to Pharmaceutical Therapy for Myofascial Pain Dysfunction Syndrome: A Randomized Clinical Trial

Objectives: Myofascial pain dysfunction syndrome (MPDS) is the most common form of temporomandibular disorders. Because of the multifactorial nature of the problem, its management usually involves several treatment modalities to maximize their synergistic effects. This randomized clinical trial aimed to assess the efficacy of low-level laser therapy (LLLT) and transcutaneous electrical nerve stimulation (TENS) as an adjunct to pharmaceutical therapy for treatment of MPDS.
 Materials and Methods: This clinical trial evaluated 108 MPDS patients. First, the initial pain intensity of patients was determined using a visual analogue scale (VAS). The first phase of the study included education, awareness, self-care, behavior and relaxation therapy. After 1 month, the pain score was measured again using VAS. Patients who acquired a pain score >1 were divided into three groups of LLLT with diode (GAAlAr) laser with 0.2 W power, TENS, and control, using block randomization. All groups received 10 mg fluoxetine once daily, 0.25 mg clonazepam once daily and 10 mg baclofen three times a day. ANOVA was used to compare the recovery rate of the three groups.
 Results: Pain in the trapezius muscle and pain on mouth opening resolved faster in the laser + medication group. The recovery rate was faster in the mean muscle pain, general pain reported by patients, pain in the masseter and pterygoid muscles and pain and limitation in lateral movements in both laser + medication and TENS groups.
 Conclusion: Combination of LLLT and TENS with medication accelerated pain relief and resolved movement restrictions in MPDS patients.
 (IRCT registration number: IRCT201411113144N4)

Transcutaneous electrical nerve stimulation therapy as compared to placebo transcutaneous electrical nerve stimulation therapy for the management of myofascial pain dysfunction syndrome patients: A clinical study

Aims:The aim of this study was to determine the effectiveness of transcutaneous electrical nerve stimulation (TENS) therapy in the management of pain in myofascial pain dysfunction syndrome patients and to determine the effectiveness of placebo TENS therapy in the management of pain in myofascial pain dysfunction syndrome patients. Materials and Methods: Thirty patients received active TENS therapy and placebo TENS therapy. The Visual Analog Scale was used to measure the changes in pain and tenderness in the muscles of mastication. Results:A significant improvement was observed in active TENS therapy as compared to placebo TENS therapy regarding muscle tenderness. Conclusion:This study justifies the use of TENS therapy as well as placebo in the management of temporomandibular dysfunction. TENS therapy appears to be useful in relieving muscle pain.

A Comparative Study of Low-Level Laser Therapy and Transcutaneous Electrical Nerve Stimulation as an Adjunct to Pharmaceutical Therapy for Myofascial Pain Dysfunction Syndrome: A Randomized Clinical Trial

Objectives:Myofascial pain dysfunction syndrome (MPDS) is the most common form of temporomandibular disorders. Because of the multifactorial nature of the problem, its management usually involves several treatment modalities to maximize their synergistic effects. This randomized clinical trial aimed to assess the efficacy of low-level laser therapy (LLLT) and transcutaneous electrical nerve stimulation (TENS) as an adjunct to pharmaceutical therapy for treatment of MPDS.Materials and Methods:This clinical trial evaluated 108 MPDS patients. First, the initial pain intensity of patients was determined using a visual analogue scale (VAS). The first phase of the study included education, awareness, self-care, behavior and relaxation therapy. After 1 month, the pain score was measured again using VAS. Patients who acquired a pain score >1 were divided into three groups of LLLT with diode (GAAlAr) laser with 0.2 W power, TENS, and control, using block randomization. All groups received 10 mg fluoxetine once daily, 0.25 mg clonazepam once daily and 10 mg baclofen three times a day. ANOVA was used to compare the recovery rate of the three groups.Results:Pain in the trapezius muscle and pain on mouth opening resolved faster in the laser + medication group. The recovery rate was faster in the mean muscle pain, general pain reported by patients, pain in the masseter and pterygoid muscles and pain and limitation in lateral movements in both laser + medication and TENS groups.Conclusion:Combination of LLLT and TENS with medication accelerated pain relief and resolved movement restrictions in MPDS patients.(IRCT registration number: IRCT201411113144N4)

Management of myofascial pain dysfunction syndrome with meditation and yoga: Healing through natural therapy.

Aims and Objectives:Aims and objectives of the study were to study the effectiveness of Raj-yoga meditation and pranayama in patients with myofascial pain dysfunction syndrome (MPDS) and compared the effects with ongoing conventional noninvasive treatment modalities.Materials and Methods:The study comprised 30 patients divided equally (10 each) into 3 group, i.e., control group (conventional, noninvasive treatment), Experimental A group (conventional, noninvasive treatment with raj-yoga meditation therapy and pranayama), and Experimental B group (Raj-yoga meditation therapy and pranayama only). Parameters such as pain, mouth opening, mandibular deviation, inflammation, swelling, clicking, occlusion, and psychologic evaluation such as anxiety, stress, and depression were assessed before the start of the study and at weekly intervals for 3 months.Results:Posttreatment pain and inflammation improved both in the control group and Experimental A group, but statistically it is highly significant in the Experimental A group. Furthermore, it is effective immediately as well as for a long period in Experimental A group. Improvement in mouth opening was statistically highly significant in control group but not in the experimental groups. Posttreatment anxiety and stress status was improved with statistically highly significant result in the Experimental A and B. The posttreatment depression status along with mandibular deviation, swelling, clicking, and occlusion has not improved significantly in any of the groups.Interpretation and Conclusion:Raj-yoga meditation and pranayama in combination with conventional, noninvasive, treatment modalities showed promising results in MPDS patients as compared to either modalities alone.

Effects of Low-level Laser in the Treatment of Myofascial Pain Dysfunction Syndrome.

Background and aims Muscular pain in the facial region is the most common cause of facial pains. Myofascial pain dysfunction syndrome (MPDS) is one of the most important facial muscle disorders comprising of signs and symptoms including pain during function, tenderness in the muscles of mastication and restricted jaw movement. Due to the lack of an accepted therapeutic approach, the purpose of this paper was to find an effective treatment to decrease the pain of such patients. Considering the analgesic and anti-inflammatory action of laser therapy, the effects of low level laser (Ga-Al-As) in the treatment of MPDS patients referred to Tehran University of Medical Sciences Faculty of Dentistry, were investigated in the present study. Materials and methods This study was a quasi-experimental research. Twenty-two MPDS patients were selected from those referred to Department of Oral Medicine, Tehran University of Medical Sciences Faculty of Dentistry. Clinical examination was performed at six stages in the following order: prior to the treatment, at 2 and 4 weeks after treatment, and monthly thereafter for a 3-months follow-up. All patients underwent low-level laser therapy for 4 weeks (12 sessions). Variables such as pain severity, pain of cheek region, pain frequency, tenderness of masticatory muscles, click, and mouth opening were evaluated at each stage. Numerical variables were investigated using Analysis of Variance test for repeated measures whereas ranking variables were studied by non-parametric Kruskal-Wallis test. Results At the end of treatment period, pain severity, pain of cheek region, pain frequency, tenderness of masseter, temporalis, medial pterygoid, and lateral pterygoid muscles showed significant improvement as compared with the commencement of any treatment which continued during the 3-months post-treatment (p<0.05). Conclusion It was shown that low-level laser (Ga-Al-As) therapy had the efficacy to alleviate pain and decrease the tenderness of masticatory muscles among MPDS patients through a continuous and regular therapeutic program.

Disclusion time measurement studies: A comparison of disclusion time between chronic myofascial pain dyfunction patients and nonpatients: A population analysis

From a pool of 89 patieats, 49 patients were classified as having chronic myofascial pain dysfunction syndrome (MPDS), and 40 were classified as asymptomatic or non-MPDS patients designated as the control group for the study. To achieve balanced sample size in both groups, 40 patients were arbitrarily selected from the MPDS group. All patients from each of the two primary groups were then categorized and assigned to one or more subgroups according to the following criteria: (1) jaw classification, (2) open occlusion, (3) previous orthodontic therapy, or (4) no previous orthodontic therapy. A fifth subgroup composed of only MPDS patients and equally divided into those who had or had not experienced orthodontic therapy was established to determine whether mean disclusion time differences occur between orthodontic and nonorthodontic MPDS patients. All 80 patients were evaluated for disclusion time of their right and left mandibular excursions to determine statistical population comparisons. Statistical assessment of right and left disclusion times for women and men in the MPDS and non-MPDS groups was performed separately for each of the five subgroups. Analysis of the comparisons revealed that in all except two of the subgroups, mean disclusion time was significantly longer in the MPDS patient group than in the non-MPDS group. The two subgroups in which this was not apparent were those with open occlusion and orthodontic patients compared with nonorthodontic patients. These findings suggest that lengthy posterior disclusion time may be of diagnostic importance when the differing etiologic factors of chronic MPDS patients are evaluated.

Masseter muscle hyperactivity and myofascial pain dysfunction syndrome: a relationship under stress.

Myofascial pain dysfunction syndrome (MPD) of the temporomandibular joint (TMJ) is a psychophysiological disorder that develops because of hyperactive muscles of mastication. Ten women meeting criteria for MPD and 12 symptom-free women participated in the study. The rationale for this study was to observe cardiovascular and masseter muscle changes during four contiguous experimental periods: baseline/adaptation, reaction time, recovery, and relaxation. MPD patients showed less masseter muscle activity and higher heart rates at baseline than controls. Controls had significantly higher masseter EMG activity during reaction time. Both groups showed significant elevation in masseter muscle activity and heart rate over the 14-min reaction period. MPD patients' recovery from stress was equivalent to controls' for both heart rate and masseter muscle activity. MPD patients exhibited significantly slower reaction times than controls. The results suggest that masseter muscle hyperactivity may not account for the development and maintenance of MPD.

Characteristics of muscle fatigue in patients with myofascial pain-dysfunction syndrome

The purpose of this study was to compare the properties of muscle fatigue in the masseter and temporalis muscles of normal individuals and those with myofascial pain-dysfunction syndrome (MPD). The MPD muscle is presumed to have different characteristics of fatigue than its healthy counterpart; these characteristics can be quantitated using standard electromyogram (EMG) signal-processing techniques. A total of 18 patients diagnosed as having MPD comprised the experimental group and 15 adults with no history or present symptoms of temporomandibular joint pain and dysfunction served as controls. Surface EMG recordings were made for both the masseter and anterior temporalis muscles while the subject held an incisal bite force level of 10 N for as long as possible. The EMG data were transferred to a microcomputer where the power-density spectrum of the signals were calculated for 2-s samples at 10-s intervals. The mean power frequency (MPF) and power (root mean square, r.m.s.) of the signals were calculated from the power-density spectra. Results showed: (1) the endurance times were significantly shorter for the MPD patients; (2) the masseter was not active in three of 17 MPD patients; (3) decreases in MPF over time were significantly greater for the MPD patients than normal subjects; (4) increases in r.m.s. power were significantly greater over time for the MPD patients; (5) bandwidths of the power-density spectra were similar for the two groups. The implication of these results is the MPD muscle is not in a state of constant fatigue, as is currently believed, but rather demonstrates accelerated fatigue.

Stress-pain relationship in MPD syndrome patients and non-MPD syndrome patients

1 ff’lt o e ective y reat myofascial pain-dysfunction (MPD) syndrome, it is important to understand its etiology. Malocclusion’-” and psychologic traits’.’ have been identified as causal factors. The present study will focus on the MPD syndrome patient’s stress perception and relationship of this perception to pain assessment. Such information should be of use to dentists and other health professionals who treat MPD patients. Laskin,” for example, indicates the importance of psychophysiologic theory in the treatment of MPD syndrome. He reported that, “Initiating factors for the MPD syndrome are generally emotional, rather than physical, (and) treatment must be directed toward this aspect of the problem. . . ” syndrome patients were classified by a psychiatrist as neurotic. The remaining six patients were either psychotic or healthy. These authors note that the number of patients was too small to provide statistical evidence for clusters of these findings.

Postinjury myofascial pain dysfunction syndrome: Its etiology and prognosis

Clinical data are producted which appear to show that the response to therapy of myofascial pain dysfunction syndrome (MPDS) is much less favorable when the patient has been involved in a road traffic or similar accident which precipiated the condition. Reasons for this difference and the differences between postinjury MPDS and nonpostinjury MPDS patients may be a consequence of litigation and, in addition, may be due to the personality of the patient. Evidence to support this hypothesis is seen when the condition is compared with such disorders as low back pain. Further research is needed to explore the etiology and treatment implications of these differences.