Evaluation of Efficacy of Ultrasonography in the Assessment of Transcutaneous Electrical Nerve Stimulation in Subjects with Myositis and Myofascial Pain

Abstract

BackgroundThe study aimed to determine if ultrasonography of masseter can be used to evaluate the outcome of transcutaneous electrical nerve stimulation (TENS) in subjects with temporomandibular disorders (TMDs) such as myositis and myofascial pain.MethodsFifteen TMD subjects with myofascial pain/myositis who satisfied the RDC/McNeil criteria were included in the study. All the subjects were administered TENS therapy for a period of 6 days (30 minutes per session). The mouth opening (in millimeters) and severity of pain (visual analogue scale score) and ultrasonographic thickness of the masseter (in millimeters) in the region of trigger/tender areas was assessed in all the subjects both prior and post TENS therapy. A comparison of the pre-treatment and post-treatment values of the VAS score, mouth opening and masseter thickness was done with the help of a t-test.ResultsThere was a significant reduction in the thickness of masseter muscle (P = 0.028) and VAS scores (P < 0.001) post TENS therapy. There was also a significant improvement in the mouth opening (P = 0.011) post TENS therapy.ConclusionsIn the present study, ultrasonography was found to be an effective measuring tool in the assessment of TENS therapy in subjects with myositis and myofascial pain.

Immediate Effect of Masticatory Muscle Activity with Transcutaneous Electrical Nerve Stimulation in Muscle Pain of Temporomandibular Disorders Patients

“…In the present study, more than 88% of the patients with TMD-related muscle pain experienced a reduction in pain sufficient to allow maximum clenching, although the remaining less than 12% reported no changes or increase in pain after TENS. In previous studies for muscle pain treatment with TENS, therapeutic efficacy of TENS was shown by self-reporting questionnaires using VAS [ 21 , 22 , 23 ]. Our results had shown the same trend as previous studies.…”

“…Furthermore, the TMD group had a significant increase in maximum mouth opening after TENS treatment as post-hoc test, and the control group had no significant increase after TENS. This result indicated that the tension along the membrane of the muscle fibers in TMD patients was relaxed by intervening TENS [ 23 ]. Three previous studies evaluating the mouth opening amplitude after TENS treatment showed the increased ratio after TENS were from 8.7% to 19.5 % [ 22 , 23 , 24 ].…”

“…This result indicated that the tension along the membrane of the muscle fibers in TMD patients was relaxed by intervening TENS [ 23 ]. Three previous studies evaluating the mouth opening amplitude after TENS treatment showed the increased ratio after TENS were from 8.7% to 19.5 % [ 22 , 23 , 24 ]. The average of maximum mouth opening was 7.5% in this study, so that the value was slightly small.…”

“…The electrical stimulation inhibits the transmission of painful impulses in the spinal cord and stimulates the release of endogenous opioids in the brain [ 20 ]. This strategy of TENS treatment has already been successfully applied to reduce non-odontogenic orofacial pain [ 21 , 22 , 23 , 24 ]. Additionally, a previous study reported TENS treatment on TMD patients had improved the electromyograph (EMG) activity of chewing in comparison with TENS placebo TMD patients [ 25 ].…”

Application of Transcutaneous Electrical Nerve Stimulation in Dentistry

“…Also, many studies observed that TENS therapy was significantly reducing pain in Temporomandibular joint region, it also helps in reduced pain and discomfort alsohelped in relieving muscular and chronic painalso in improvement in mouth opening in the treatment of TMD. [22][23][24][25][26]…”