V. Bhardwaj1, M. Awasthi2, K.S. Anand3
1Manav Rachna International Institute of Research and Studies, Faculty of Allied Health Sciences, Faridabad, India, 2Manav Rachna Institute of Research and Studies, Faculty of Allied Health Sciences, Faridabad, India, 3Dr RML Hospital, Department of Neurology, New Delhi, India
Background: Research suggests that temporomandibular joint pain is the third most prevalent chronic pain condition worldwide after headaches and low back pain. It includes symptoms like pain and dysfunction of the muscles of mastication (masseter, lateral and medial pterygoids) and temporomandibular joint. Persistent musculoskeletal pain and resulting physical impairment are serious health problems that afflicts a substantial proportion of adult population. As the available options are either medicine or therapeutic like physiotherapy which includes electrotherapy & exercise therapy, Dry needling can be an option to be an evidence-based approach for the temporomandibular joint pain. As Dry needling is invasive so the ethics approval is required.
Purpose: To study the effectiveness of Dry needling in resolving temporomandibular joint pain.
Methods: A sample size of 40 subjects with temporomandibular joint pain, diagnosed as temporomandibular joint pain, were selected for the study, after signing a consent to participate. The methodology of the study was approved by the Hospital's ethical committee. They were allocated to 2 groups (by convenience sampling) of age matched 20 subjects in each of the groups. The range of motion (ROM) of temporomandibular joint was measured with scale (Depression, elevation, protrusion, retrusion & lateral deviation). The control group was treated with conventional physiotherapy treatment & sham needling for 30 minutes per day for 2 weeks (3 sessions per week). The experimental group was treated with conventional physiotherapy treatment (Moist pack, localized ultrasonic therapy followed by stretching of jaw muscles) and dry needling was done at tender areas (trigger points) in the jaw muscles (masseter, lateral and medial pterygoid). Localized muscle twitch responses were noted and muscles were released. The primary outcome measures were assessed pre and post treatment and were a. ROM (range of motion), b. pain pressure threshold (using algometer) and c. pain (numeric pain rating scale).
Results: All outcome measures were performed at baseline, 2 weeks. There was more than 20mm of gain in range of motion (mouth opening/depression) among 18 subjects (90%) of the experimental group (20). There was 70% improvement in point tenderness threshold with algometer. There was 60% decline in pain score on NPRS among the experimental group. The between group analysis revealed statistically significant difference (p <0.05) for range of motion, point tenderness and NPRS score.
Conclusion(s): Patients treated with dry needling showed significant improvement in symptoms specially the ROM (Range of motion) increased among the experimental group. The pain pressure threshold improved and the pain score declined on NPRS (numeric pain rating scale).
Implications: A noticeable change in pain and range of motion was found. Dry Needling can be incorporated as an effective intervention for the treatment of temporomandibular pain.
Funding, acknowledgements: The Study was Self-funded with partial support from the hospital authorities.
Keywords: TEMPOROMANDIBULAR JOINT PAIN, DRY NEEDLING, EVIDENCE BASED APPROACH
Topic: Musculoskeletal
Did this work require ethics approval? Yes
Institution: Jeewan Mala Hospital
Committee: Dr Naresh Jaswal, Dr Pankaj Srivastav, Supta, Neha Birla
Ethics number: EA/JAN/20/07/VB
All authors, affiliations and abstracts have been published as submitted.
