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Title Biofeedback, Acupuncture And Possibly Massage Are Beneficial For TMD
Clinical Question Are Biofeedback, Massage and Acupuncture Beneficial for TMD?
Clinical Bottom Line Meta analysis supports the use of Biofeedback. Clinical trials support the use of acupuncture, self exercise, and massage. There is an absence of primary research articles on acupressure on PUBMED. A narrative review article argues in favor of muscle stretching, self massage, trigger point massage, biofeedback, and relaxation techniques. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 7629347 Wright/1995Review Article
Key resultsMuscle stretching, self massage, trigger point massage, biofeedback, and relaxation techniques are effective and useful for patients. Injection of trigger points with local anesthetic seems to be useful. Acupuncture is as helpful as splint therapy, but only provides temporary benefit.
#2) 10425966Crider/1999Meta Analysis
Key resultsBiofeedback treatment for TMD is superior to placebo. 69% of patients become symptom free or experience significant improvement.
#3) 18082232Katsoulis/2008 27 patients with TMDClinical Trial
Key resultsTMD patients received 6 sessions of physical therapy consisting of oral and facial massage and education about self exercise of the TM joint. This was a single group trial with no control or comparison group. 93% of patients had a significant reduction of pain, p< .05.
#4) 7629347Shen/200928 adults diagnosed with chronic myofacial painRandomized controlled trial
Key resultsAcupuncture recipients had decreased jaw pain, decreased jaw tightness, decreased neck pain, (p = .04) and increased pain tolerance in the masseter muscle (p = .001), when compared with recipients of sham acupuncture.
Evidence Search "Temporomandibular Joint Dysfunction Syndrome"[Mesh] and "complementary therapies" [Mesh] limited to Review Articles. To find more specific articles searched under"Temporomandibular Joint Dysfunction Syndrome"[Mesh] and "Biofeedback, Psychology"[Mesh]"Massage"[Mesh] and "Temporomandibular Joint Dysfunction Syndrome"[Mesh] did not yield satisfactory results, meta analysis article found because it cited narrative review."Acupuncture Therapy"[Mesh] and “Temporomandibular Joint Dysfunction Syndrome"[Mesh]
Comments on
The Evidence
The topic of complementary and alternative therapy for TMD is broad. The 1995 article is included in the evidence because it is the only review article to deal with the large topic. Many articles are available providing solid clinical evidence on specific alternative therapies for TMD. The evidence supporting biofeedback, massage and acupuncture is strong.
Applicability The alternative medicine therapies reviewed may be appropriate for TMD patients diagnosed with Myofacial Pain.
Specialty/Discipline (General Dentistry) (Behavioral Science)
Keywords Temporomandibular Joint Dysfunction Syndrome;Complementary therapies
ID# 611
Date of submission: 05/10/2010spacer
E-mail paynejr@uthscsa.edu
Author James Payne
Co-author(s) e-mail
Faculty mentor/Co-author Edward F. Wright, DDS, MS
Faculty mentor/Co-author e-mail WrightE2@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
post a comment
by Joshua Thiel, Veronica Lai, Kristin Aulds (San Antonio, TX) on 01/06/2014
The literature on this topic supports the CAT. According to the systematic review (PMID: 21354460 ) acupuncture as a symptomatic treatment for TMD is limited. Further research is required to determine its therapeutic value. Anesthetic blockage along with physical therapy is an effective treatment in reduction of TMD pain (PMID: 23229236 ). Other treatments are currently available such as decompression splints as alternative therapies (PMID: 22549668 ).

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