Stabilization splint therapy for the treatment of temporomandibular myofascial pain: a systematic review.
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The aim of this review is to establish the effectiveness of stabilization splint (SS) therapy in reducing symptoms in patients with myofascial pain. Searching of electronic databases, handsearching of relevant key journals, and screening of reference lists of included studies were undertaken. There was no language restriction, and unpublished research was sought. The selection criteria were randomized controlled trials comparing splint therapy to either no treatment or another active treatment. Data extraction and validity assessment were carried out independently and in duplicate. Studies were grouped according to treatment type. Twenty potentially relevant Randomized Controlled Trials (RCTs) were identified. Only twelve met the inclusion criteria. There is insufficient evidence either for or against the use of stabilization splint therapy over other active interventions for the treatment of temporomandibular myofascial pain. However, it appears that stabilization splint therapy may be beneficial for reducing pain severity at rest and on palpation and depression when compared to no treatment. The authors suggested the need for well conducted RCTs that pay attention to method of allocation, blind outcome assessment, sample size, and duration of follow-up. Various measures were adopted to assess the outcomes of treatment. Standardization of the methods used to measure outcomes of the treatment of myofascial pain should be established in future RCTs. (+info)
Psychological approach to the rehabilitation of the spinal cord injured: the contribution of relaxation techniques.
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We analyse the benefit of learning relaxation techniques as an essential coping strategy in the behavioural medicine field. This has proved useful as a part of the newly spinal cord injured rehabilitation treatment or concerning later problems if there is readmission. We report the changes we have made in the relaxation standard methods to be used in spinal cord injured patients as well as the timing in the rehabilitation process when these techniques were applied. (+info)
A pilot study evaluating mindfulness-based stress reduction and massage for the management of chronic pain.
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BACKGROUND: Mindfulness-based stress reduction (MBSR) and massage may be useful adjunctive therapies for chronic musculoskeletal pain. OBJECTIVE: To evaluate the feasibility of studying MBSR and massage for the management of chronic pain and estimate their effects on pain and mood. DESIGN: Randomized trial comparing MBSR or massage with standard care. PARTICIPANTS: Thirty patients with chronic musculoskeletal pain. MEASUREMENTS: Pain was assessed with 0 to 10 numeric rating scales. Physical and mental health status was measured with the SF-12. RESULTS: The study completion rate was 76.7%. At week 8, the massage group had average difference scores for pain unpleasantness of 2.9 and mental health status of 13.6 compared with 0.13 (P<.05) and 3.9 (P<.04), respectively, for the standard care group. These differences were no longer significant at week 12. There were no significant differences in the pain outcomes for the MBSR group. At week 12, the mean change in mental health status for the MBSR group was 10.2 compared with -1.7 in the standard care group (P<.04). CONCLUSIONS: It is feasible to study MBSR and massage in patients with chronic musculoskeletal pain. Mindfulness-based stress reduction may be more effective and longer-lasting for mood improvement while massage may be more effective for reducing pain. (+info)
Applied relaxation in the treatment of long-lasting neck pain: a randomized controlled pilot study.
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OBJECTIVES: To evaluate the feasibility of study design and method for evaluating effects of interventions on patients with long-lasting neck pain and to compare treatment effects of: (i) a pain and stress management group intervention with applied relaxation, and (ii) individual physiotherapy treatment as usual. DESIGN: Randomized controlled pilot study. SUBJECTS: Thirty-seven patients with long-lasting neck pain. METHODS: The patients were randomly assigned either to applied relaxation or treatment as usual. The applied relaxation group received 7 group sessions over a period of 7 weeks and the treatment as usual group an average of 11 individual sessions spread over 20 weeks following baseline. Twenty-nine participants completed the intervention and filled in a self-assessment questionnaire before treatment, and 7 and 20 weeks after baseline. The questionnaire comprised: Neck Disability Index, Coping Strategies Questionnaire, Hospital Anxiety and Depression Scale, Tampa Scale of Kinesiophobia, and questions regarding neck pain, analgesic use, sleep, sick-leave and utilization of healthcare. RESULTS: The applied relaxation group had better perceived control over pain at the 20 weeks follow-up compared with the treatment as usual group. CONCLUSION: The design and methods of this pilot study were feasible and will be suitable for a larger randomized controlled study. (+info)
Phagophobia: a case report.
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Phagophobia is a form of psychogenic dysphagia. Although it is characterized by a fear and avoidance of swallowing food, fluids, or pills, physical examination and laboratory findings are normal. Here, we present a case of phagophobia, who at 13 years of age was brought to our hospital by his family because of his fear and avoidance of swallowing food and loss of weight. After psychiatric interview, the patient underwent an oral peripheral examination, stroboscopic laryngeal evaluation, the Bedside Swallow Evaluation, and the Modified Barium Swallow Study. His physical examination and all laboratory findings were normal. The management of this case included the combination of behavior therapy and a dysphagia management program. After approximately one month of utilizing these techniques, the case showed considerable improvement. (+info)
A systematic review of the effectiveness of physical therapy interventions for temporomandibular disorders.
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BACKGROUND AND PURPOSE: The purpose of this qualitative systematic review was to assess the evidence concerning the effectiveness of physical therapy interventions in the management of temporomandibular disorders. METHODS: A literature search of published and unpublished articles resulted in the retrieval of 36 potential articles. RESULTS: Twelve studies met all selection criteria for inclusion in the review: 4 studies addressed the use of therapeutic exercise interventions, 2 studies examined the use of acupuncture, and 6 studies examined electrophysical modalities. Two studies provided evidence in support of postural exercises to reduce pain and to improve function and oral opening. One study provided evidence for the use of manual therapy in combination with active exercises to reduce pain and to improve oral opening. One study provided evidence in support of acupuncture to reduce pain when compared with no treatment; however, in another study no significant differences in pain outcomes were found between acupuncture and sham acupuncture. Significant improvements in oral opening were found with muscular awareness relaxation therapy, biofeedback training, and low-level laser therapy treatment. DISCUSSION AND CONCLUSION: Most of the studies included in this review were of very poor methodological quality; therefore, the findings should be interpreted with caution. (+info)
A comprehensive pain management programme comprising educational, cognitive and behavioural interventions for neuropathic pain following spinal cord injury.
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OBJECTIVE: To assess whether a comprehensive multidisciplinary pain management programme could contribute to improvement regarding sleep quality, mood, life satisfaction, health-related quality of life, sense of coherence and pain for patients with a spinal cord injury and neuropathic pain. DESIGN: A prospective intervention study. PATIENTS: Twenty-seven patients with spinal cord injury and neuropathic pain participated in a pain management programme in parallel with 11 patients in a control group. METHODS: A comprehensive pain management programme comprising educational, cognitive, and behavioural interventions was created for patients with spinal cord injury and neuropathic pain. The pain management programme consisted of 20 sessions over a 10-week period and included educational sessions, behavioural therapy, relaxation, stretching, light exercise and body awareness training. All patients were followed-up 3, 6 and 12 months after completion of the programme. RESULTS: At the 12-month follow-up, levels of anxiety and depression in the treatment group decreased compared with baseline values, and a tendency towards better quality of sleep was seen. In comparison with the control group, patients in the treatment group improved regarding sense of coherence and depression. CONCLUSION: This study implies that a multidimensional pain management programme can be a valuable complement in the treatment of spinal cord injured patients with neuropathic pain. (+info)
Development of a taxonomy to describe massage treatments for musculoskeletal pain.
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BACKGROUND: One of the challenges in conducting research in the field of massage and bodywork is the lack of consistent terminology for describing the treatments given by massage therapists. The objective of this study was to develop a taxonomy to describe what massage therapists actually do when giving a massage to patients with musculoskeletal pain. METHODS: After conducting a review of the massage treatment literature for musculoskeletal pain, a list of candidate techniques was generated for possible inclusion in the taxonomy. This list was modified after discussions with a senior massage therapist educator and seven experienced massage therapists participating in a study of massage for neck pain. RESULTS: The taxonomy was conceptualized as a three level classification system, principal goals of treatment, styles, and techniques. Four categories described the principal goal of treatment (i.e., relaxation massage, clinical massage, movement re-education and energy work). Each principal goal of treatment could be met using a number of different styles, with each style consisting of a number of specific techniques. A total of 36 distinct techniques were identified and described, many of which could be included in multiple styles. CONCLUSION: A new classification system is presented whereby practitioners using different styles of massage can describe the techniques they employ using consistent terminology. This system could help facilitate standardized reporting of massage interventions. (+info)