Management of Myofascial Pain

Abstract

The present study was designed to compare the effects of low-level laser with occlusal splints in patients with signs and symptoms of myofascial pain (MP) dysfunction syndrome. A total of 40 (34 women and 6 men, with a mean age of 32.84 [SD, 10.70] years) were selected after the diagnosis of MP according to the Research Diagnostic Criteria for Temporomandibular Disorder. The patients were randomly divided into 2 groups: study group (n = 20) and control group (n = 20). Low-level laser was applied to patients in the study group 2 times per week, for a total of 10 sessions. Patients in the control group were instructed to wear occlusal splints 24 h/d for 3 months. The functional examination was based on Research Diagnostic Criteria for Temporomandibular Disorder and pressure pain threshold values were obtained with the aid of an algometer in both groups. Patients' self-report of pain was evaluated with visual analog scale. Comparisons were made within and between the groups before and after treatment. Vertical movements showed statistically significant improvements after the treatments in both groups (P < 0.01), but when the groups were compared with each other, there were no significant difference between the groups. In both groups, tenderness to palpation of the muscles decreased significantly. Pressure pain threshold evaluations and visual analog scale scores revealed similar results, too. This particular type of low-level laser therapy (820 nm, 3 J/cm2, 300-mW output power) is as effective as occlusal splint in pain release and mandibular movement improvement in MP.

Therapeutic and Analgesic Efficacy of Laser in Conjunction With Pharmaceutical Therapy for Trigeminal Neuralgia

“…Analgesic effects of laser in case group compared with control group was statistically significant. Our findings were not in line with those of Öz et al, 24 Dundar et al, 25 Altan et al, 26 and Hansen et al 27 The afore mentioned studies used different wavelengths and powers of laser and had different sample sizes and variable number of treatment sessions. However, they all had a case control design and yielded similar results.…”

“…Since they did not obtain favorable results and based on the suggested energy density values for GaAsAl laser, 30 we used a lower energy density. In the study by Öz et al, 24 3 J/cm 2 and in the study by Hansen et al, 27 4.7 and 9.4 J/cm 2 energy densities were chosen. Based on their findings, we selected a higher energy density.…”

“…No significant difference was noted between the 2 groups and laser therapy was as effective as occlusal splint for treatment of myofascial pain. 24 Hansen et al 27 evaluated the efficacy of treatment of patients with different types of orofacial pain (oral dysesthesia, toothache, TN, TN secondary to trauma and tension headache) with diode infrared laser at 904 nm wavelength (OKA laser). In their double blind randomized controlled trial, laser with a constant or variable pulse repetition rate of 1 to 9999 Hz with 78.9 mW/cm 2 power was used.…”

“…In the current study, a slight increase in pain scores of patients (based on VAS) was noted after completion of treatment and one month after completion of treatment in the 2 groups and significant difference was noted. The laser therapy protocol was twice a week for 10 sessions by Öz et al, 24 twice a week for 4 weeks by Carrasco et al, 29 once a day for 15 days by Dundar et al, 25 once a day for 10 days by Altan et al, 26 and 8 sessions during 4 weeks by Hansen et al 28 Considering the fact that the effects of each session of laser therapy often last for nine to 72 hours and also to prevent the cumulative effects of laser, we performed laser therapy for 3 sessions a week. Since HeNe and GaAs laser was used in some previous studies with no significant difference between the case and control groups, GaAlAs laser was used in the current study.…”

Efficacy of low-level laser therapy in temporomandibular disorders: A systematic review

“…Öz et al . [13] demonstrated that low-level laser therapy is as effective as occlusal splint in pain release and mandibular movement improvement. A study by Kulekcioglu et al .…”