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.

TLDR

The study compared the short‑term efficacy of patient education alone versus patient education plus a home physical therapy program for treating myofascial jaw‑muscle pain. Seventy temporomandibular disorder patients were randomized to receive either education alone or education plus home exercises, with treatment success assessed by normalized changes in pain thresholds, jaw‑opening, and visual‑analog pain scores over three months. At three months, the education‑plus‑PT group had a higher, though not statistically significant, success rate (77% vs 57%) and showed greater jaw‑opening improvement among those who remained symptomatic, while pain‑threshold gains were larger in successfully treated patients regardless of modality; overall, the combined approach was slightly more effective.

Abstract

To compare the short-term efficacy of patient education only versus the combination of patient education and home exercises for the treatment of myofascial pain of the jaw muscles.Seventy myogenous temporomandibular disorder patients were assigned to 2 treatment groups. One group received patient education supplemented by general information about self-care of the jaw musculature. The other group received both education and a home physical therapy program. Treatment contrast, calculated from the mean normalized relative changes in anamnestic and clinical scores, was used to determine treatment success. Clinical outcome measures included pressure pain threshold (PPT) of the masseter, anterior temporalis, and Achilles tendon; pain-free maximal jaw opening; and pain on chewing, spontaneous muscle pain, and headache as rated on visual analog scales.After 3 months the success rate was 57% for the group that received education only and 77% for the group that received both education and home physical therapy (P = .157). The patients were then redivided into 2 groups: successfully treated patients and unsuccessfully treated patients. In the unsuccessfully treated group, pain-free maximal jaw opening increased significantly more among those who had been in the education and physical therapy group than among those who had been in the education-only group (P = .019). The change in PPT was significantly greater in successfully treated patients than in unsuccessfully treated patients (.009 < P < .039), independent of the treatment modality, with higher PPTs among successful patients. There were no significant differences between the successfully and unsuccessfully treated groups or between treatment modalities for any other variable.Over a period of 3 months, the combination of education and a home physical therapy regimen, as used in this protocol, is slightly more clinically effective than education alone for the treatment of myofascial pain of the jaw muscles.