Evaluation of microcurrent electrical nerve stimulation (MENS) effectiveness on muscle pain in temporomandibular disorders patients

Zuim, Paulo Renato Junqueira; Garcia, Alício Rosalino; Túrcio, Karina Helga Leal; Hamata, Marcelo Matida

doi:10.1590/s1678-77572006000100012

Cited by 25 publications

(22 citation statements)

References 21 publications

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“…It decreases muscle tension and regulates cellular activities. 24,26,34,35 In our study, the laser at a 940 nm wavelength was irradiated and it resulted in a significant reduction in pain in all the patients. The positive outcome of LLLT was demonstrated in previous studies by Salmos-Brito et al, 36 Ahrari et al, 17 Mazzetto et al, 37 Shirani et al, 38 Ebrahimi et al, 18 Azizi et al, 22 and Khalighi et al, 39 who all found a significant reduction in pain intensity of TMD patients with LLLT.…”

Section: Discussionmentioning

confidence: 78%

Efficacy of Low-Level Laser, Hard Occlusal Appliance and Conventional Pharmacotherapy in the Management of Myofascial Pain Dysfunction Syndrome; A Preliminary Study

et al. 2020

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Introduction: Myofascial pain dysfunction syndrome (MPDS) is a common temporomandibular joint disorder. Due to its multifactorial etiology, treatment usually involves more than one modality to obtain complementary results. The purpose of this study was to compare the combined effect of a low-level laser, a hard occlusal appliance, and conventional pharmacotherapy with pharmacotherapy only in the management of patients with MPDS. Methods: In this study, 15 patients with MPDS were diagnosed and randomly assigned to 3 groups (n=5). Subjects in Group 1 were treated with pharmacotherapy (PT); Group 2 received the diode laser (940 nm gallium arsenide) every other day for a total of 10 sessions, plus pharmacotherapy (PTL) and Group 3 were given hard occlusal splint 12 h/day for 4 weeks, plus pharmacotherapy (PTO). The intensity of pain was measured using the visual analog scale (VAS) prior to the treatment, 2 and 4 weeks after the onset of treatment and 2 weeks later. The maximum painless mouth opening and pain intensity at muscle palpation were also recorded. Comparisons were made between the groups via repeated measure analysis of variance (ANOVA) (P<0.05). Results: Pain relief in the subjective VAS was observed in both laser and appliance groups in the third and fourth examination sessions (P<0.05). No statistically significant reduction in pain was noted using pharmacotherapy only. The maximum painless mouth opening and muscle tenderness were not significantly different between the 3 groups (P>0.05). Conclusion: Both the laser and the occlusal appliance combined with pharmacotherapy proved to be effective for pain reduction in patients with MPDS. All groups, however, failed to result in a significant improvement in the maximum mouth opening or tenderness in masticatory muscles.

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Section: Discussionmentioning

confidence: 78%

Efficacy of Low-Level Laser, Hard Occlusal Appliance and Conventional Pharmacotherapy in the Management of Myofascial Pain Dysfunction Syndrome; A Preliminary Study

et al. 2020

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“…8 The remaining studies used criteria that we had not pre-specified in our protocol or that were undefined/unclear: • Three had used the Helkimo index 33,34,35 • Two used arthrography 36,37 • One used MRI 38 • Six used diagnostic systems that were not possible to classify. 39,40,41,42,43,44 The two studies 45,46 examining the effects of splints on bruxism used the Lobbezzo et al 9 criteria for likelihood of a bruxism diagnosis: 'possible' self-report of bruxism; 'probable' clinical evidence of bruxism with or without self-report; and 'definite' defined by polysomnography. We classified both studies as examining 'probable' bruxism.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…14,23,30,32,33,34,35,37,41,43 Twenty had a co-intervention in each arm, with 13 having a 'minimal' co-intervention of usual treatment, counselling, information or exercise, 11,12,13,15,16,17,18,19,21,22,25,26,36 while 7 had a 'non-minimal' co-intervention of 'acuhealth' , manipulative and physical therapy, massage, Prozac, microcurrent electrical nerve stimulation, physical therapy with vapocoolant spray, arthrocentesis and sodium hyaluronate. 27,28,29,39,40,44,47 The remaining six studies had minimal treatment controls: three were self-exercises, 24,28,42 and three were information-based. 20,27,31 One trial that has been referenced twice above 27 had four arms with which we made two separate pairwise comparisons: 1) splint + co-intervention vs co-intervention alone; and 2) splint vs minimal treatment.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Oral splints for temporomandibular disorder or bruxism: a systematic review

et al. 2020

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This systematic review comprehensively summarised the best available evidence from randomised controlled trials on the effects of oral splints for temporomandibular disorders (TMD) and bruxism.There is no evidence to support the use of oral splints for either condition based on the results found.For TMD patients, sensitivity analyses were conducted to explore the effects of differences in: 1) diagnostic criteria; 2) splint types; and 3) outcome measures used and reported. There were no differences in the results based on these factors. AbstractObjectives To evaluate the clinical-effectiveness of oral splints for patients with TMD or bruxism for the primary outcomes: pain (TMD) and tooth wear (bruxism).Data sources Four databases including MEDLINE and EMBASE were searched from inception until 1 October 2018. Data selection and extractionRandomised controlled trials comparing all types of splints versus no/minimal treatment for patients with TMD or bruxism were eligible. Standard Cochrane review methods were used. Standardised mean differences (SMD) were pooled for the primary outcome of pain, using random effects models in TMD patients. Data synthesisThirty-seven trials were included and the evidence identified was of very low certainty using GRADE assessments. When all subtypes of TMD were pooled into one global TMD group, there was no evidence that splints reduced pain: SMD (up to 3 months) -0.18 (95% CI -0.42 to 0.06); 13 trials, 1,076 participants. There was no evidence that any other outcomes improved when using splints. There was no evidence of adverse events associated with splints, but reporting was poor regarding this outcome. No trials measured tooth wear in patients with bruxism. There was a large variation in diagnostic criteria, splint types and outcome measures used and reported. Sensitivity analyses based on these factors did not indicate a reduction in pain. ConclusionsThe very low-certainty evidence identified did not demonstrate that splints reduced pain in TMD as a group of conditions. There is insufficient evidence to determine whether splints reduce tooth wear in patients with bruxism.

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“…TENS therapy works on several interrelated theories. The first theory suggests that TENS stimulates the thick, myelinated, sensory fibers (A-fibers), which in turn blocks the impulses of thin pain-modulating fibers (C-fibers) and closes the gate to pain signals at the level of their entry into the spinal cord [ 10 ]. Another theory suggests that TENS stimulates the endogenous release of morphine-like substances that have analgesic properties.…”

Section: Discussionmentioning

confidence: 99%

“…The therapeutic efficacy of TENS has been evaluated with the help of clinical parameters such as the visual analogue scale (VAS) score, extent of mouth opening, and alteration of joint sounds, among others [ 6 7 8 9 10 ]. However, to the best of our knowledge, imaging modalities in the form of ultrasonography have not been used to determine whether TENS therapy can alter the thickness of the masseter in patients with TMD pathologies.…”

Section: Introductionmentioning

confidence: 99%

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

Patil¹,

Iyengar²,

Kotni³

et al. 2016

Korean J Pain

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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.

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Evaluation of microcurrent electrical nerve stimulation (MENS) effectiveness on muscle pain in temporomandibular disorders patients

Cited by 25 publications

References 21 publications

Efficacy of Low-Level Laser, Hard Occlusal Appliance and Conventional Pharmacotherapy in the Management of Myofascial Pain Dysfunction Syndrome; A Preliminary Study

Efficacy of Low-Level Laser, Hard Occlusal Appliance and Conventional Pharmacotherapy in the Management of Myofascial Pain Dysfunction Syndrome; A Preliminary Study

Oral splints for temporomandibular disorder or bruxism: a systematic review

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

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