Myofascial Pain of the Jaw Muscles: Comparison of Short-Term Effectiveness of Botulinum Toxin Injections and Fascial Manipulation Technique

No blinded randomized controlled trials were included, specifically Corum 2018 and Guarda-Nardini 2012.

“No blinded RCTs:Corum 2018 [21], Guarda-Nardini 2012 [33]”

Fascial manipulations and massage, administered by physiotherapists, demonstrated efficacy in reducing myogenic temporomandibular disorder symptoms.

“Fascial Manipulations and massage, administered by physiotherapists, demonstrated efficacy in reducing myogenic TMD symptoms [28,30,32,33].”

In this systematic review, most studies applied Axis I criteria, while a subset incorporated both Axis I and II.

“In this systematic review, most studies applied Axis I criteria [22,25,27,30,35], while a subset incorporated both Axis I and II [21,33] to identify TMD subtypes most responsive to manual therapy.”

Axis I subtypes, particularly myofascial temporomandibular disorder, responded well to manual therapy interventions.

“Axis I subtypes, particularly myofascial TMD, responded well to manual therapy interventions [28–30,33–35].”

Myofascial manipulations and trigger point releases were particularly effective in reducing subjective pain perception.

“Myofascial manipulations [28,30,33] and trigger point releases [34,35] were particularly effective in reducing subjective pain perception.”

Botulinum toxin injections, as reported by Guarda-Nardini et al., showed slightly greater improvements in jaw range of motion.

“However, botulinum toxin injections, as reported by Guarda-Nardini et al. [33], showed slightly greater improvements in jaw range of motion.”

Four studies looked at MT techniques for people with myogenous TMD.

“Four studies 64,65,77,81 looked at MT techniques, such as facial manipulation versus botulinum toxin 81 or intraoral myofascial therapy versus waiting list, and self-care education and exercises for people with myogenous TMD.64,65,77”

When pooling the results from 3 of these studies, MT significantly reduced pain at 4 to 6 weeks of treatment compared with botulinum toxin or waiting list, approaching a clinically relevant value.

“When pooling the results from 3 of these studies based on similar outcomes and diagnoses and comparing similar interventions regarding MT, 64,65,81 we found that MT significantly reduced pain at 4 to 6 weeks of treatment compared with botulinum toxin or waiting list, approaching a clinically relevant value.”