Effectiveness of exercise therapy in patients with myofascial pain dysfunction syndrome

Twenty consecutive patients suffering from myofascial pain dysfunction (MPD) were assigned to a waiting-list, serving as a no-treatment control period. Inclusion criteria were: (i) pain in the temporomandibular region for at least 3 months, (ii) no evidence of internal derangement or osteoarthritis and (iii) symptoms of postural dysfunction. Treatment consisted of active and passive jaw movement exercises, correction of body posture and relaxation techniques. The following main outcome measures were evaluated: (i) pain at rest, (ii) pain at stress, (iii) impairment, (iv) mouth opening at base-line, before and after treatment and at 6-month follow-up. All patients completed the study and no adverse effects occurred. During control period no significant changes occurred. After treatment six patients had no pain at all (chi-square: P < 0.01) and seven patients experienced no impairment (chi-square: P < 0.005). Pain at stress, impairment and incisal edge clearance improved significantly (Wilcoxon test P < 0.001). This result did not change until follow up, except pain at stress, which further improved significantly (Wilcoxon test P < 0.03). At follow up 16 patients experienced no pain at all, 13 patients were not impaired and only three patients had a restricted mouth opening, in contrast to 12 before treatment (chi-square test P < 0.001). CONCLUSION: Exercise therapy seems to be useful in the treatment of MPD Syndrome.