CC BY-NC-ND 4.0 · Eur J Dent 2016; 10(01): 046-053
DOI: 10.4103/1305-7456.175680
Original Article
Dental Investigation Society

Management of myofascial pain by therapeutic ultrasound and transcutaneous electrical nerve stimulation: A comparative study

Shalu Rai
1   Department of Oral Medicine and Radiology, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
,
Vikash Ranjan
1   Department of Oral Medicine and Radiology, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
,
Deepankar Misra
1   Department of Oral Medicine and Radiology, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
,
Sapna Panjwani
1   Department of Oral Medicine and Radiology, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
› Author Affiliations
Further Information

Publication History

Publication Date:
23 September 2019 (online)

ABSTRACT

Objective: The present comparative study was aimed to determine the effectiveness of Th US and TENS in the management of myofascial pain in TMD patients. Materials and Methods: The present randomized comparative study was on 90 patients who were further assigned in three different groups each having 30 patients; Group I was healthy control patients, Group II was receiving Th US therapy, and Group III was receiving TENS therapy. All the 90 patients were further evaluated for maximum inter incisor subjective evaluation regarding muscle pain, impediment to daily life, massage impression on visual analog scale (VAS) scale, and intensity and duration used in Th US massage. Results: The masseter muscle thickness in control group was 12.00 (standard deviation [SD] ±1.1) mm when compared with TMD patient of 13.00 (SD ± 1.1) mm before treatment. Statistical significant findings on VAS score of muscle pain, impediment to daily life, and massage impression were observed in Th US. After treatment, the anechoic areas disappeared or were reduced in Th US group by 95.6% and in TENS by 74.4%. Conclusion: Th US appeared to be subjectively better which was related to VAS score of massage impression, muscle pain, and impediment to daily life after treatment as well as sonographically related to existence of anechoic areas.

 
  • REFERENCES

  • 1 Grossi DB, Chaves TC. Physiotherapeutic treatment for temporomandibular disorders (TMD). Braz J Oral Sci 2004; 3: 492-7
  • 2 Al-Ani Z, Gray RJ, Davies SJ, Sloan P, Glenny AM. Stabilization splint therapy for the treatment of temporomandibular myofascial pain: A systematic review. J Dent Educ 2005; 69: 1242-50
  • 3 Ariji Y, Katsumata A, Hiraiwa Y, Izumi M, Sakuma S, Shimizu M. et al. Masseter muscle sonographic features as indices for evaluating efficacy of massage treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110: 517-26
  • 4 Gray RJ, Quayle AA, Hall CA, Schofield MA. Physiotherapy in the treatment of temporomandibular joint disorders: A comparative study of four treatment methods. Br Dent J 1994; 176: 257-61
  • 5 De Laat A, Stappaerts K, Papy S. Counseling and physical therapy as treatment for myofascial pain of the masticatory system. J Orofac Pain 2003; 17: 42-9
  • 6 Alvarez-Arenal A, Junquera LM, Fernandez JP, Gonzalez I, Olay S. Effect of occlusal splint and transcutaneous electric nerve stimulation on the signs and symptoms of temporomandibular disorders in patients with bruxism. J Oral Rehabil 2002; 29: 858-63
  • 7 Kato MT, Kogawa EM, Santos CN, Conti PC. TENS and low-level laser therapy in the management of temporomandibular disorders. J Appl Oral Sci 2006; 14: 130-5
  • 8 Esposito CJ, Shay JS, Morgan B. Electronic dental anesthesia: A pilot study. Quintessence Int 1993; 24: 167-70
  • 9 PHYSIO TENS 4000; operating manual for physio four channel tens digital. New Delhi: International electro medical co.Delhi;
  • 10 Møystad A, Krogstad BS, Larheim TA. Transcutaneous nerve stimulation in a group of patients with rheumatic disease involving the temporomandibular joint. J Prosthet Dent 1990; 64: 596-600
  • 11 Wessberg GA, Carroll WL, Dinham R, Wolford LM. Transcutaneous electrical stimulation as an adjunct in the management of myofascial pain-dysfunction syndrome. J Prosthet Dent 1981; 45: 307-14
  • 12 Speed CA. Therapeutic ultrasound in soft tissue lesions. Rheumatology (Oxford) 2001; 40: 1331-6
  • 13 Rai S, Kaur M, Goel S, Panjwani S, Singh S. Prospective utility of therapeutic ultrasound in dentistry-review with recent comprehensive update. Adv Biomed Res 2012; 1: 47
  • 14 Esposito CJ, Veal SJ, Farman AG. Alleviation of myofascial pain with ultrasonic therapy. J Prosthet Dent 1984; 51: 106-8
  • 15 Grieder A, Vinton PW, Cinotti WR, Kangur TT. An evaluation of ultrasonic therapy for temporomandibular joint dysfunction. Oral Surg Oral Med Oral Pathol 1971; 31: 25-31
  • 16 Ariji Y, Sakuma S, Izumi M, Sasaki J, Kurita K, Ogi N. et al. Ultrasonographic features of the masseter muscle in female patients with temporomandibular disorder associated with myofascial pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 98: 337-41
  • 17 Ariji E, Ariji Y, Yoshiura K, Kimura S, Horinouchi Y, Kanda S. Ultrasonographic evaluation of inflammatory changes in the masseter muscle. Oral Surg Oral Med Oral Pathol 1994; 78: 797-801
  • 18 Le Resche L, Michael R, Korff V. Research diagnostic criteria. Craniomandib Disord 1992; 6: 327-34
  • 19 Truelove EL, Sommers EE, LeResche L, Dworkin SF, Von Korff M. Clinical diagnostic criteria for TMD. New classification permits multiple diagnoses. J Am Dent Assoc 1992; 123: 47-54
  • 20 Widmer CG, Huggins KH, Fricton J. Examination and history data collection. Craniomandib Disord 1992; 6: 335-55
  • 21 Moger G, Shashikanth MC, Sunil MK, Shambulingappa P. Transcutaneous electrical nerve stimulation therapy in temporomandibular disorder: A clinical study. J Indian Acad Oral Med Radiol 2011; 23: 46-50
  • 22 Michelotti A, Steenks MH, Farella M, Parisini F, Cimino R, Martina R. The additional value of a home physical therapy regimen versus patient education only for the treatment of myofascial pain of the jaw muscles: Short-term results of a randomized clinical trial. J Oral Facial Pain 2004; 18: 114-25
  • 23 Okeson JP. Management of Temporomandibular Disorders and Occlusion. 5th ed.. St. Louis: C.V. Mosby; 2003
  • 24 Durham J. Temporomandibular disorders (TMD): An overview. Oral Surg 2008; 1: 60-8
  • 25 Byahatti SM. Evolution, epidemiology and etiology of temporomandibular joint disorders. J Indian Acad Oral Med Radiol 2010; 22: 13-8
  • 26 Dworkin SF, Huggins KH, LeResche L, Von Korff M, Howard J, Truelove E. et al. Epidemiology of signs and symptoms in temporomandibular disorders: Clinical signs in cases and controls. J Am Dent Assoc 1990; 120: 273-81
  • 27 Isacsson G, Linde C, Isberg A. Subjective symptoms in patients with temporomandibular joint disk displacement versus patients with myogenic craniomandibular disorders. J Prosthet Dent 1989; 61: 70-7
  • 28 Jensen R, Rasmussen BK, Pedersen B, Lous I, Olesen J. Prevalence of oromandibular dysfunction in a general population. J Orofac Pain 1993; 7: 175-82
  • 29 Beaton RD, Egan KJ, Nakagawa-Kogan H, Morrison KN. Self-reported symptoms of stress with temporomandibular disorders: Comparisons to healthy men and women. J Prosthet Dent 1991; 65: 289-93
  • 30 Kubota M, Nakano H, Sanjo I, Satoh K, Sanjo T, Kamegai T. et al. Maxillofacial morphology and masseter muscle thickness in adults. Eur J Orthod 1998; 20: 535-42
  • 31 Emshoff R, Bertram S, Brandlmaier I, Scheiderbauer G, Rudisch A, Bodner G. Ultrasonographic assessment of local cross-sectional dimensions of masseter muscle sites: A reproducible technique?. J Oral Rehabil 2002; 29: 1059-62
  • 32 Pereira LJ, Gavião MB, Bonjardim LR, Castelo PM, Andrade AdaS. Ultrasonography and electromyography of masticatory muscles in a group of adolescents with signs and symptoms of TMD. J Clin Pediatr Dent 2006; 30: 314-9
  • 33 Kiliaridis S, Kälebo P. Masseter muscle thickness measured by ultrasonography and its relation to facial morphology. J Dent Res 1991; 70: 1262-5
  • 34 Reimers CD, Fleckenstein JL, Witt TN, Müller-Felber W, Pongratz DE. Muscular ultrasound in idiopathic inflammatory myopathies of adults. J Neurol Sci 1993; 116: 82-92
  • 35 Fatih I, Amin E, Ali IA, Laithi ES. Efficacy of physiotherapy and intraoral splint in the management of temporomandibular disorders. Saudi Dent J 2004; 16: 16-20
  • 36 Madani AS, Mirmortazavi A. Comparison of three treatment options for painful temporomandibular joint clicking. J Oral Sci 2011; 53: 349-54
  • 37 Rodrigues D, Oliveira AS, Berzin F. Effect of TENS on the activation pattern of the masticatory muscles in TMD Patients. Braz J Oral Sci 2004; 3: 510-5
  • 38 Esenyel M, Caglar N, Aldemir T. Treatment of myofascial pain. Am J Phys Med Rehabil 2000; 79: 48-52
  • 39 Majlesi J, Unalan H. High-power pain threshold ultrasound technique in the treatment of active myofascial trigger points: A randomized, double-blind, case-control study. Arch Phys Med Rehabil 2004; 85: 833-6
  • 40 ter Haar G. Therapeutic ultrasound. Eur J Ultrasound 1999; 9: 3-9
  • 41 McNeill C. History and evolution of TMD concepts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997; 83: 51-60
  • 42 Rajpurohit B, Khatri SM, Metgud D, Bagewadi A. Effectiveness of transcutaneous electrical nerve stimulation and microcurrent electrical nerve stimulation in bruxism associated with masticatory muscle pain – A comparative study. Indian J Dent Res 2010; 21: 104-6