Clinical Study Of Percutaneous Nerve Electrical Stimulation In The Treatment Of Patients With Temporomandibular Joint Pain

Part 1Study on somatosensory and jaw function of patients with temporomandibular joint painObjectives:To explore the characteristics of somatosensory and jaw function between patients with unilateral temporomandibular joint（TMJ）pain by quantitative sensory test and opening ranges（OR）.Methods:Participants included 20 patients（men:5,women:15,average age:38±13years）suffering from unilateral TMJ pain and 20 age-and gender-matched control participants were enrolled in this study.Visual analogue scale（VAS）,opening range（OR）and mechanical pain threshold（MPT）,pressure pain threshold（PPT）on both TMJ were measured and compared.Statistical analysis was performed using student’s T test to compare the difference between groups and sites.Results:VAS of patients were higher than that of controls（P<0.001）,ORs of patients were all smaller than controls’（P<0.001）.Both MPTs and PPTs of pain side TMJ of the patients were lower than ipilateral side TMJ of controls(P_MPT=0.027,P_PPT<0.001).MPTs and PPTs were also lower in pain side than contralateral side of TMJ in patients(P_MPT=0.002,P_PPT<0.001).Conclusion:TMJ pain patients demonstrated high sensitivity and limitation of jaw motion.Part 2 Effects of transcutaneous electrical nerve stimulation on somatosensory and jaw function in patients with painful temporomandibular disordersObjectives: To investigate the effect of transcutaneous electrical nerve stimulation（TENS）on somatosensory and jaw function in patients with unilateral temporomandibular joint（TMJ）pain.Methods: The study was performed in a randomized controlled and double-blinded manner.Participants included 20 patients（men: 5,women: 15,average age: 38±13 years）suffering from unilateral TMJ pain and 20 age-and gender-matched control participants.All participants were assigned randomly into two groups to receive real and sham TENS（r TENS and s TENS）stimulation both for 30 min in a randomized order.Somatosensory functions and motor functions were assessed at different time points（before（T1）,immediately after（T2）and 30 min after treatment（T3））.Visual analogue scale（VAS）,unassisted opening range（OR）without pain and maximal unassisted OR were recorded.Mechanical pain threshold（MPT）,pressure pain threshold（PPT）were tested bilaterally in both TMJ.ANOVA with repeated measurement was used to evaluated differences.Results: VASs were lower of the patients after r TENS treatment than those after s TENS and ORs,MPTs and PPTs were higher（Pvas<0.001,Pno pain=0.004,Ppain=0.004,PMPT=0.001,PPPT<0.001）.VASs,ORs,MPTs and PPTs were significantly different between pre-and post-treatment（Pvas<0.001,Pno pain <0.001,Ppain <0.001,PMPT=0.003,PPPT<0.001）.VAS decreased and ORs,MPTs and PPTs were improved after r TENS.Conclusion: The study demonstrated significant effects of TENS applied to the TMJ in terms of improvement in somatosensory and increasing opening range in patients with unilateral TMJ pain.These findings may suggest positive and therapeutic effects of TENS in sensory and motor function to humans especially in the conservative management of longer-lasting TMJ pain.