Transcutaneous electrical nerve stimulation therapy in reduction of orofacial pain

Abstract

Introduction Patients with craniomandibular disorders suffer from hypertonic, fatigued and painful masticatory muscles. This condition can lead to limitation of mandibular jaw movements. All of these symptoms and signs are included in myofascial pain dysfunction syndrome. Transcutaneous electrical nerve stimulation (TENS) has been used for treatment of these patients. Objective The aim of this study was to assess the effect of TENS therapy on chronic pain reduction in patients with the muscular dysfunction symptom. Methods In order to evaluate the effect of TENS therapy before and after the treatment, Craniomandibular Index (Helkimo) was used. Pain intensity was measured by VAS. Patients had TENS treatment over two-week period. BURST TENS modality was used. Current intensity was individually adjusted. Results Two patients did not respond to TENS therapy. Complete pain reduction was recorded in 8 patients, while pain reduction was not significantly different after TENS therapy in 10 patients. Conclusion TENS therapy was confirmed as therapeutic procedure in orofacial muscle relaxation and pain reduction.

Uvod Hiperaktivnost mastikatorne muskulature, pojačan tonus mišića, zamor i bol, uz smanjenje opsega funkcijskih kretnji donje vilice, jesu znaci i simptomi miofascijalnog bolnog disfunkcijskog sindroma. Različiti terapijski modaliteti koriste se u lečenju, među kojima je i terapija transkutanom električnom nervnom stimulacijom (TENS). Cilj rada Cilj rada bila je klinička potvrda efekta terapije TENS na intenzitet hroničnog bola kod osoba sa simptomima disfunkcije mišića. Metode rada Radi procene terapije TENS korišćen je Helkimov kraniomandibularni indeks. Za kvantifikaciju intenziteta bola pre i posle lečenja primenjena je vizuelno-analogna skala (VAS). Pacijenti su podvrgnuti terapiji tri puta nedeljno u trajanju od 40 minuta tokom dve nedelje. Primenjen je modalitet burst (kratki impulsi dužine 10 ms i frekvencije 2-3 Hz) uz individualno podešavanje intenziteta strujnog impulsa. Rezultati Nisu primećeni negativni sporedni efekti terapije TENS. Potpuno smanjenje intenziteta bola zabeleženo je kod osam ispitanika. Kod 10 ispitanika smanjenje bola nije bilo značajno. Dva pacijenta nisu reagovala na primenjenu terapiju. Zaključak Terapija TENS se preporučuje osobama s manjim stepenom kraniomandibularnih disfunkcija bez obzira na intenzitet bola.