Myalgia is a subdivision of temporomandibular dysfunction (TMD), which in turn comprises disorders of the temporomandibular joint and surrounding musculature. Schiffman et al 1 defined myalgia as pain of muscle origin that is affected by jaw movement, function or parafunction, and replication of this pain occurs with provocation testing of the masticatory muscles. The low-cost, and reversible treatments concerning disorders of the masticatory muscles represent a vast array of regimens. Common treatments include information, 2 stretching exercises, 2 manual therapy, 3 acrylic splints 4 and cognitive behavioural therapy. 5 In addition, Norwegian national recommendations include, acupuncture, sleep, posture correction, diaphragmatic breathing and NSAIDs. 30 The National Board of Health and Welfare in Sweden also ranks the different treatments from 1 to 10, based on level of evidence, cost vs effect and probability for success. Many of the treatments prescribed by general practitioners today are labelled as self-care, implicating that the patients themselves are responsible for performing the prescribed treatment. 2,4,6-13 These reversible and low-cost treatments entail little risk for patient injury, but one would still expect the treatments to be supported by scientific evidence.While, the prevalence of TMD in Scandinavia is reported to be as This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. Abstract Background: The low-cost and reversible treatments concerning disorders of the masticatory muscles represent a vast array of regimens. Common treatments include information, stretching exercises, manual therapy, acrylic splints and cognitive behavioural therapy.Objective: The aim of this study was to evaluate the evidence behind the use of self-exercising programmes and occlusal splints in the treatment of myofascial pain.
Methods:We conducted a thorough search of five databases, using four cardinal search terms in combination with twelve supporting terms. We also assessed the evidence quality, using GRADEpro software.
Results:The search resulted in 4967 individual studies. 18 studies met the inclusion criteria and were re-evaluated.
Conclusion:The selected studies were in favour of a self-care or an occlusal splint treatment of myalgia. However, a GRADE assessment showed that 14 of the 18 selected studies had low or very low evidence quality. Studies also showed weaknesses with regard to nomenclature and reproducibility. Hence, it is our professional opinion that the evidence level for prescribing self-exercises and occlusal splints in the treatment of myalgia is low.
K E Y W O R D Sevidence-based medicine, myalgia, myofascial pain, self-care, temporomandibular dysfunction How to cite this article: Eliassen M, Hjortsjö C, Olsen-Bergem H, Bjørnland T. Self-exercise programmes and occlusal ...
