Effectiveness of TENS and home exercises as an adjunct to drug therapy in the management of myogenous masticatory pain: a comparative study

Abstract

Introduction: Pain relief is the primary goal of treatment in patients with myogenous temporomandibular disorder. This study evaluated the effectiveness of TENS and Home exercises as an adjunct to drugs in relieving myogenous masticatory pain. Materials and methods: This prospective clinical study was conducted on 60 patients with myogenous masticatory pain. Patients were randomly allocated into three groups of 20 patients each. Patients in Group A received TENS and drugs, while patients in Group B received home exercises and drugs and Group C received drugs only. The drugs prescribed were Diclofenac 50 mg and Orphenadrine 100 mg, to be taken twice daily for 5 days. All patients were followed up for three weeks. The severity of pain was recorded using the Visual Analog Scale. Inter and intragroup differences in the pain scores were analyzed using one-way ANOVA along with post hoc Tukey's test, and Paired t-test, respectively. p < 0.05 was considered as statistically significant. Results: There was a significant reduction in the mean pain scores in all the three groups at 1st, 2nd, and 3rd post-treatment weeks as compared to the baseline scores with p < 0.001. However, when the pain scores were compared across groups, maximum pain reduction was observed in group A (0.2 ± 0.04), followed by group B (0.5 ± 0.06), and the least reduction was noticed in group C (2.1 ± 0.8). This result was significant with p < 0.001. Conclusion: Both TENS and Home exercises program were effective as adjuncts to drugs, in controlling myogenous masticatory pain, as compared to drugs alone.

Effectiveness of electrotherapy for the treatment of orofacial pain: A systematic review and meta-analysis

“…After the first screening and full-text screening, 37 studies met all the study criteria and were included in this review. 35–71 Reasons for exclusion are available upon request and outlined in the PRISMA flowchart (Figure 1). After tracking included studies using Scopus and manual search, six additional studies 72–77 were included.…”

“…All the studies were included, based on the agreement of two independent reviewers. Therefore, in total 43 studies 35–77 were analyzed, including 1939 subjects in the narrative synthesis (Figure 1). Team members work in the orofacial field and have links with experts in the area.…”

“…Several studies did not report intervention parameters in detail; 19 trials 35–37,40,41,47,48,50,52–54,56,62,65,68,73,74,76,77 did not report intensity and/or frequency of the current. Related to studies that used transcutaneous electrical nerve stimulation ( n = 31), three studies 43,44,56 used low frequency (10 Hz or less), 15 36,45,46,49–51,57,58,60,63,64,66,67,69,75 used high frequency (50 Hz or more), one 59 used 35 Hz, and six 37,38,55,71,72,74 modulated the intensity. For microcurrent therapy, intervention parameters reported were more consistent; two studies 53,56 used 0.3 Hz, and one 49 used 0.5 Hz.…”

“…Twenty-eight studies used transcutaneous electrical nerve stimulation as therapy and evaluated pain intensity. [36][37][38]40,[48][49][50][51][52]54,55,[57][58][59][60]62,63,[65][66][67][68][69]71,[73][74][75][76][77] Among these 28 trials, 13 36,38,40,48,50,54,57,59,63,65,68,69,75 included patients with myogenous temporomandibular disorders (myogenic temporomandibular disorders, facial myalgia, and myofascial pain). Of those, four reported that transcutaneous electrical nerve stimulation was better than home exercise, 65 laser, 50 splint, 68 and a waiting list 36 ; however, six reported that dental program, 57 ultrasound, 48,…”

“…transcutaneous electrical nerve stimulation vs. other therapies at the end of treatment (i.e., 4-12 sessions)Although eleven trials 40,48,50,54,57,63,65,68,69,75 looked at this comparison, seven studies 40,54,57,63,65,69,75 were included in this meta-analysis.…”