Comparison of the Effect of Drug Therapy and Physical Therapy on  Myofascial Pain and Dysfunction

Yasamin  Mahjoobi; Sahereh  Soltani; Atefeh Baghbani  Torghabe; Bahareh  Fattahi; Seyed  Amirhossein  Rahimizadeh Hosseini

doi:10.18502/jcr.v13i1.21479

Yasamin Mahjoobi Department of Restorative Dentistry, Faculty of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
Sahereh Soltani Department of Prosthodontics, Faculty of Dentistry, North Khorasan University of Medical Sciences, Bojnurd, Iran.
Atefeh Baghbani Torghabe Department of Prosthodontics, Faculty of Dentistry, North Khorasan University of Medical Sciences, Bojnurd, Iran.
Bahareh Fattahi Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Kashan University of Medical Sciences, Kashan, Iran
Seyed Amirhossein Rahimizadeh Hosseini Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.

DOI: https://doi.org/10.18502/jcr.v13i1.21479

Keywords: Myofascial pain syndromes; Transcutaneous electric nerve stimulation; Temporomandibular joint disorders

Abstract

Introduction: Myofascial Pain Disorder (MPD), a prevalent subtype of Temporomandibular Disorders, presents with localized pain and functional limitations. While pharmacotherapy and transcutaneous electrical nerve stimulation (TENS) are common interventions, their comparative effectiveness remains underexplored, particularly in regional contexts like Bojnourd, Iran, during 2020–2021.

Materials and Methods: In this randomized controlled trial, 30 patients with MPD were randomized into two groups (n = 15 each): Group 1 received active TENS (100 Hz, 25mA, 30 minutes weekly for 4 weeks) plus placebo capsules; Group 2 received active medication (Naproxen 500mg and Diazepam 2mg twice daily for 10 days) plus sham TENS. Pain intensity (Visual Analog Scale, 0–10) and maximum pain-free mouth opening (mm) were assessed at baseline, day 10, and 4 weeks. Data were analyzed using repeated-measures ANCOVA (α = 0.05).

Results: TENS significantly outperformed pharmacotherapy in pain reduction (p < 0.001), with Group 1 achieving a 67.5% VAS reduction by day 10 versus 28.3% in Group 2. Both groups showed comparable improvements in mouth opening (p = 0.727). No adverse events were reported.

Conclusion: High-frequency TENS provides faster and more substantial pain relief than pharmacotherapy in acute MPD, with equivalent functional outcomes. These findings support TENS as a first-line, non-invasive therapy for MPD, informing evidence-based practice in regional and global contexts.