Evaluation of regional nerve block efficacy in the treatment of myofascial pain of masseteric origin: Clinical Study
Main Article Content
Keywords
Myofascial Pain; Temporomandibular Disorder; Maximal Mouth Opening
Abstract
Myofascial pain dysfunction syndrome (MPS) is considered the most common temporomandibular disorder (TMD) and one of stress-related disorders that defined as a complex, non-articular and non-inflammatory musculoskeletal disorder that affects the masticatory muscles. Objective: to evaluate the regional nerve block efficacy in the treatment of myofascial pain of massetric origin. Patients and methods: This study included 30 healthy patients were randomly divided into two equal groups, fifteen patients each, Group A consisted of 15 patients who injected by local anesthesia at the masseteric nerve (nerve block). Group B consisted of 15 patients who injected by local anesthesia at trigger points in the masseter muscle. Standard pain scoring (VAS) and the maximal mouth opening (MMO) were measured. Results: Comparison between VAS for pain severity at all-time intervals in both group indicated that the groups were similar at baseline (T1) and (T2) time intervals without significant difference (p>0.05). After intervention at T3 time interval a significant reduction in group A of mean VAS compared to group B (p<0.05). At the rest of follow up sessions (T3, T4), there were statistically insignificant differences between two groups (p>0.05).Comparison between MMO at different assessment sessions in both groups showed that the groups were similar at T1 and T2 time intervals without significant difference (p>0.05). After intervention at T3 time interval, group B showed significantly higher mean MMO compared to group A (p<0.05). At the rest of follow-up intervals (T4), there were statistically insignificant differences between both groups (p>0.05). Conclusion: Masseteric nerve block, TrPs injection with local anesthetic methods are effective treatment modalities in masseteric myofascial pain treatment.MNB has a beneficial effect in managing pain that originates from the masseter muscle, MNB injection with local anesthetic are more effective
References
2. Roberto Procópio, Ana Maria Itezerote and Flávio Hojaij: Anatomical Study of the Innervation of the Masseter Muscle and Its Correlation with Myofascial Trigger Points. Journal of Pain Research 2020:13 3217–3226
3. Luz LH, Garcia HI, Rogers HL, and Plata JA.: Treatment of myofascial pain syndrome with lidocaine injection and physical therapy, alone or in combination: a single blind, randomized, controlled clinical trial. BMC Musculoskeletal Disorders (2016) 17:101.
4. Gonzalez-Perez LM, Infante-Cossio P, Granados-Nunez M, Urresti -Lopez FJ.: Treatment of temporomandibular myofascial pain with deep dry needling. Med Oral Patol Oral Cir Bucal. 2018; 17:e781-5.
5. Martos R L, Gonzalez-Perez LM 2, Canela-Mendez PR, Urresti-Lopez FJ, Gutierrez-Perez JL and Infante-Cossio P.: Randomized, double-blind study comparing percutaneous electrolysis and dry needling for the management of temporomandibular myofascial pain. Med Oral Patol Oral Cir Bucal. 2018 Jul 1; 23 (4):e454-62.
6. Bourgaize S, Newton G, Kumbhare D, et al.: A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management. J Can Chiropr Assoc 2018; 62(1):26e41.
7. Munguia F, Jang J, Salem M, et al.: Efficacy of low-level laser therapy in the treatment of temporomandibular myofascial pain: a systematic review and meta-analysis. J Oral Facial Pain Headache 2018 Jul; 32(3):287e97.
8. Magri LV, Carvalho VA, Rodrigues FCC, et al.: Effectiveness of low-level laser therapy on pain intensity, pressure pain threshold, and SF-MPQ indexes of women with myofascial pain. Lasers Med Sci 2017 Feb; 32(2):419e28.
9. Kanti V, Ananthan S, Subramanian G, et al.: Efficacy of the twin block, a peripheral nerve block for the management of chronic masticatory myofascial pain: A case series. Quintessence Int. 2017; 725–729.
10. Hayek SM, Shah A.: Nerve blocks for chronic pain. Neurosurg Clin N Am 2014; 25(4):809-17.
11. Quek SY, Subramanian G, Patel J, et al.: Efficacy of regional nerve block in management of myofascial pain of masseteric origin. Cranio 2014:2151090314y0000000026.
12. Quek SY, Young A, Subramanian G.: The twin block: a simple technique to block both the masseteric and the anterior deep temporal nerves with one anesthetic injection. Oral Surg Oral Med Oral Pathol Oral Radiol 2014;-:e1-e3.
13. Ananthan S, Kanti V, Zagury JG, et al.: The effect of the twin block compared with trigger point injections in patients with masticatory myofascial pain: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020; 129 (3):222–228.
14. Venancio Rde A, Alencar FG Jr, Zamperini C.: Botulinum toxin, lidocaine, and dry-needling injections in patients with myofascial pain and headaches. CRANIO. 2009; 27(1):46–53.
15. Taşkesen F & Cezairli B.: The effectiveness of the masseteric nerve block compared with trigger point injections and dry needling in myofascial pain. The Journal of Craniomandibular & Sleep Practice. DOI: 10.1080/08869634. 2020.1820686.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.