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

Abstract

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)

RETRACTED: Comparative effectiveness of low‐level laser therapy and transcutaneous electrical nerve stimulation in symptomatic Temporomandibular Disorders: A Randomised Control Trial

“…MPDS is one of the most important facial muscle disorders comprising of signs and symptoms including pain during function, tenderness in the muscle of mastication and restricted jaw movements.as various non‐pharmacological treatment modalities are used for pain reduction and improving muscle tenderness to improve quality of life of the patient. This study compared the effectiveness of LLLT and TENS therapy in reducing pain, improving mouth opening and lateral excursive movements 2,6,12 …”

“…The TMJ is the most complex joint in the body and a variety of clinical problems that take origin from TMJ masticatory muscles, ligaments and surrounding tissue are included under TMDs 1 . Myofascial pain dysfunction syndrome being one of the most common causes of oro‐facial pain presents as pain during function, masticatory muscle tenderness and restricted jaw movements 2,3 . This pain occurs due to various causes; however, psychological factors, 4,5 occlusion imbalance and parafunctional habits are mentioned as its most important underlying cause 6,7–9 .…”

“…The underlying mechanism of action of TENS involves the activation of peripheral nerves through the application of electrical currents 2 . These currents are delivered via electrodes placed strategically on the skin near the painful area or along the path of the affected nerves 6 .…”

“…1 Myofascial pain dysfunction syndrome being one of the most common causes of oro-facial pain presents as pain during function, masticatory muscle tenderness and restricted jaw movements. 2,3 This pain occurs due to…”

The use of photobiomodulation for the muscles of head and neck: an integrative review

“…Most of the studies included in this integrative review presented positive results for pain management in the head and neck muscles (1,6,11,13,15,(17)(18)(19)(23)(24)(25)(26)(27)(28)(29)(30)(32)(33)(34)(35)(38)(39)(40)42,44,46,(50)(51)(52)(53)(54)(55)(56)(57) . For pain, there is evidence that PBM blocks the axonal transport of thin nerves, resulting in decreased mitochondrial membrane potential with a consequent decrease in the available ATP necessary for nerve function (11,62) .…”