One‐year evaluation of the effect of physical therapy for masticatory muscle pain: A randomized controlled trial
Abstract
Physical therapy is widely used to decrease pain and restore function in patients suffering from masticatory muscle pain. Controlled studies on its efficacy are scarce. This study evaluated the 1-year effect of a 6-week physical therapy programme in a single blind, randomized, controlled trial. Fifty-three subjects were randomly assigned to either a physical therapy group [n = 26; 19 women, mean age (SD) 36.6 years (15.5 years)] or a control group [n = 27; 20 women, mean age (SD) 42.9 years (15.1 years)]. In the physical therapy group, the patients received education, muscle stretching, exercises and homework for nine treatments in 6 weeks. In the control group, the patients received education on the evaluation days only. At baseline and after 3, 6, 12, 26 and 52 weeks, pain and masticatory function were evaluated using visual analogue scales, the McGill Pain Questionnaire, pressure pain thresholds of the masseter and temporalis muscles, the mandibular function impairment questionnaire, and active and passive maximal mouth opening. All pain rating variables decreased and all function variables increased significantly over time in both groups. No significant differences in improvement between the groups (time-treatment interaction) were found. These data suggest that the long-term decrease in pain and the improvement of function are not related to active physical therapy.
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Five of the studies did not find significant differences between a general physical therapy exercise program targeted to the jaw or jaw and neck compared with a control or other active treatments.
“Five of them did not find significant differences between a general physical therapy exercise program targeted to the jaw 56,62,79,80 or jaw and neck 57 compared with a control or other active treatments, such as biofeedback, TENS, use of the TheraBite Jaw Motion Rehabilitation System (ATOS Medical AB, Hörby, Sweden), or oral splint therapy.”
From Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis (2016) · cites this paper as [62]
The SMD for pain intensity pooling 5 studies was 0.43 (95% CI=-0.02, 0.87).
“The SMD for pain intensity pooling 5 studies 57,58,62,63,66 was 0.43 (95% CIϭϪ0.02,0.87)”
From Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis (2016) · cites this paper as [62]
Twenty-one of the studies used the RDC/TMD established by Dworkin and LeResche to classify patients as having TMD.
“Twenty-one of the studies 57-76 used the RDC/TMD established by Dworkin and LeResche 27 to classify the patients as having TMD.”
From Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis (2016) · cites this paper as [62]
Eight studies looked at the effect of exercises alone or combined with other therapies for myogenous TMD.
“Eight studies 56 -58,62,63,66,79,80 looked at the effect of exercises alone or combined with other therapies for myogenous TMD.”
From Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis (2016) · cites this paper as [62]
Data from studies 56,58,62,66 indicated that there was a trend to favor exercise therapy for pain-free maximum mouth opening and pain intensity compared with a control group.
“Data from these studies 56,58,62,66 indicated that there was a trend to favor exercise therapy for pain-free maximum mouth opening and pain intensity compared with a control group.”
From Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis (2016) · cites this paper as [62]
When grouping studies comparing exercise therapy and education, a nonsignificant effect was found on pain-free maximum mouth opening (1.92 mm; 95% CI=-0.57, 4.41).
“When performing sensitivity analyses, grouping studies comparing exercise therapy and education, 62,66 a nonsignificant effect was found on pain-free maximum mouth opening (1.92 mm; 95% CIϭϪ0.57,4.41).”
From Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis (2016) · cites this paper as [62]
Cites
1 retracted
Physical therapy for the management of patients with temporomandibular disorders and related pain
Craane, B., De Laat, A., Dijkstra, P. U., Stappaerts, K., & Stegenga, B. (2006) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005621 · Cited by 14 · see citing works
Self-citationRetractedBehavioural treatment for chronic low-back pain
Henschke, N., Ostelo, R. W., van Tulder, M. W., Vlaeyen, J. W., Morley, S., Assendelft, W. J., & Main, C. J. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002014.pub3 · Cited by 718 · see citing works
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Armijo-Olivo, S., Pitance, L., Singh, V., Neto, F., Thie, N., & Michelotti, A. (2016) · Physical Therapy · doi:10.2522/ptj.20140548 · Cited by 413 · see citing works
- Authors
- Craane, B., Dijkstra, P. U., Stappaerts, K., & De Laat, A.
- Affiliations
- UCLouvain (BE)
- University Medical Center Groningen (NL)
- Department of Oral and Maxillofacial Surgery School of Dentistry Oral Pathology and Maxillofacial Surgery Catholic University of Leuven Leuven Belgium
- Corresponding author
- Craane, B.
- Venue
- European Journal of Pain
- Publisher
- Wiley
- Published
- 2011-12-19
- Volume
- 16
- Issue
- 5
- Pages
- 737-747
- ISSN
- 1090-3801 (ISSN-L)
- 1532-2149
- OpenAlex
- W2144579952
- Cited by
- 47
- References
- 2
- Citations by year
- 2025: 2 · 2024: 3 · 2023: 1 · 2022: 4 · 2021: 5 · 2020: 2 · 2019: 6 · 2018: 8 · 2016: 8 · 2015: 4 · 2014: 1 · 2013: 3
- FWCI
- 2.16
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Myofascial pain diagnosis and treatment
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- masticatory muscle pain, physiotherapy, long-term pain outcomes, mastication, muscle stretching, patient education, masseter muscle, temporalis muscle, pressure pain threshold, maximum mouth opening, temporomandibular disorders
- MeSH terms
- Adult, Female, Follow-Up Studies, Humans, Male, Masticatory Muscles, Middle Aged, Pain, Pain Measurement, Surveys and Questionnaires, Single-Blind Method, Treatment Outcome, Pain Threshold, Physical Therapy Modalities
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