Patients’ experiences of supervised jaw-neck exercise among patients with localized TMD pain or TMD pain associated with generalized pain

Abstract

Objective: To evaluate temporomandibular disorder (TMD) patients' experiences of a supervised jawneck exercise programme. Materials and methods: The study used a mixed method design. All patients were diagnosed with myalgia according to the Research Diagnostic Criteria for TMD and divided into local myalgia (n ¼ 50; 38 women, mean age 43 yrs, SD 14), and myalgia with generalized pain (n ¼ 28; 27 women, mean age 43 yrs, SD 13). Patients participated in a ten-session supervised exercise programme that included relaxation, coordination and resistance training of the jaw, neck and shoulders. After the 10 sessions an evaluation form was filled out including both open-and closed-ended questions. The quantitative analysis was based on closed-ended questions concerned experience, adaptation and side-effects from the exercise programme. The qualitative analysis was employing inductive content analysis of openended questions. Results: Patients reported similar positive overall experiences of exercise regardless of diagnosis, although more individuals in the general pain group experienced pain during training (57%) compared to the local pain group (26%; p ¼ .015). Patients in both groups shared similar experiences and acknowledged the possibility to participate in an individualized and demanding exercise programme. They expressed feelings of being noticed, taken seriously and respectful care management to be key factors for successful treatment outcome. The exercise programme was acknowledged as a valuable part of treatment. Conclusion: The hypothesis generated was that individualized and gradually demanding exercise in the rehabilitation process of TMD stimulates self-efficacy and confidence in chronic TMD patients regardless of whether the pain was localized or combined with widespread pain.

Effectiveness of exercise therapy versus occlusal splint therapy for the treatment of painful temporomandibular disorders: a systematic review and meta-analysis

“…Stretching of the jaw muscles could lead to a reduction in the symptoms of TMD as well as an improvement in mandibular function (13). In addition, the neuromuscular, vascular, and rehabilitationary benefits of jaw exercise and posture correction exercise for TMD patients have been reported in previous studies (31,32). The positive effect of relieving pain and improving mandibular mobility may thus be assigned to the exercise therapy for patients with The use of occlusal splints for patients with TMD is common in dentistry (7,8).…”

Smiling, Yawning, Jaw Functional Limitations and Oral Behaviors With Respect to General Health Status in Patients With Temporomandibular Disorder—Myofascial Pain With Referral

“…The biomechanical theory suggests a relationship between functional load and capacity of the masticatory system ( 8 ). Its long-lasting overuse and/or overload may induce pain and dysfunction in people with decreased resistance within the musculoskeletal system ( 9 , 10 ). Some authors emphasize that temporomandibular disorders are always related—directly or indirectly—to the myofascial component, i.e., trigger points (TrPs) of the head and neck ( 11 ).…”

Presence of widespread pain predicts comorbidities and treatment response in temporomandibular disorders patients

“…Also, a study based on myofascial TMD patients reported that conventional treatment including oral appliances resulted in significant pain reduction in both groups of localized and widespread pain at 1‐year follow‐up (Doepel et al, 2018). Another study showed that TMD patients demonstrated a positive response to exercise therapy regardless of the presence of widespread pain (Storm Mienna et al, 2019). This was also true with our study groups as both groups experienced significant decreases in pain ratings although the amount was smaller in the widespread pain group.…”

“…Chronic widespread pain has been associated with increased deterioration of general health condition (Sylwander et al, 2020), and facial pain with concomitant widespread pain is related to increased psychological disturbances such as depression (Sipilä et al, 2006). However, studies on treatment response in TMD patients with widespread pain are sparse and show conflicting results (Doepel et al, 2018; Raphael & Marbach, 2001; Storm Mienna et al, 2019). The current lack of scientific data to guide treatment planning is troublesome when considering the significant negative impact of widespread pain on long‐term overall health of TMD patients.…”