Effects of 4-Week Diacutaneous Fibrolysis on Myalgia, Mouth Opening, and Level of Functional Severity in Women With Temporomandibular Disorders: A Randomized Controlled Trial

J Manipulative Physiol Ther. 2020 Oct;43(8):806-815. doi: 10.1016/j.jmpt.2020.01.002. Epub 2020 Sep 3.

Abstract

Objective: The purpose of this study was to assess the effects of 4-week protocol of diacutaneous fibrolysis (DF) compared with simulated DF (sham-DF) on myalgia and mouth opening.

Methods: In a sham randomized controlled trial, 34 women with temporomandibular disorders and myofascial pain were randomly divided as intervention group (IG) and sham-DF group (SG). The IG received 4 weeks of real DF, and the SG received sham. Pain was assessed through the visual analog scale and pressure pain thresholds (PPTs) on the temporomandibular joint (TMJ), and over the temporal and masseter muscles. The Mandibular Function Impairment Questionnaire was used to classify the participants regarding to the severity of the functional limitation related to TMD.

Results: Pain scores decreased for both groups, but the IG showed lower values at week 4, with between-group differences. Bilateral temporal PPT showed higher values at week 4, with between-group differences. The SG had lower PPTs but the IG had higher PPTs, both compared to baseline results. The time-by-group interaction and the frequency of participants above 40 mm of mouth opening showed a significant difference for the IG over time with higher results at the 4-week assessment compared to its own baseline. Both groups showed lower MFIQ scores from baseline to 4-week assessment. There was a lower frequency of a moderate level of severity for the IG. No differences were observed for TMJ or for the masseter muscles PPT.

Conclusion: Improvements were observed for visual analog scale scores and PPTs on temporal muscles. There was a group-by-time interaction in the IG, suggesting a possible potential use of DF for mouth opening.

Keywords: Facial Pain; Physical Therapy Modalities; Temporomandibular Joint Disorders.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Facial Pain / pathology
  • Facial Pain / physiopathology
  • Facial Pain / therapy*
  • Female
  • Humans
  • Mandible / pathology
  • Mandible / physiopathology
  • Massage
  • Masseter Muscle / pathology
  • Masseter Muscle / physiopathology
  • Masticatory Muscles / pathology
  • Masticatory Muscles / physiopathology*
  • Mouth
  • Myalgia / physiopathology
  • Myalgia / therapy*
  • Myofascial Pain Syndromes / physiopathology
  • Myofascial Pain Syndromes / therapy*
  • Pain Measurement
  • Pain Threshold
  • Physical Therapy Modalities*
  • Severity of Illness Index
  • Temporal Muscle / pathology
  • Temporal Muscle / physiopathology
  • Temporomandibular Joint / pathology
  • Temporomandibular Joint / physiopathology*
  • Temporomandibular Joint Disorders / pathology
  • Temporomandibular Joint Disorders / physiopathology
  • Temporomandibular Joint Disorders / therapy*
  • Treatment Outcome
  • Young Adult