Ba S, Zhou P, Yu M Ultrasound is Effective to Treat Temporomandibular Joint Disorder. J Pain Res. 2021 Jun 10;14:1667-1673. doi: 10.2147/JPR.S314342. eCollection 2021. (Original study)

Background: Temporomandibular joint disorder (TMD) affects millions of people. It is unclear if low intensity ultrasound (US) is effective to treat TMD.

Methods: A total of 160 patients with TMD were enrolled in this study. The subjects were randomized into two groups to receive US therapy or no therapy. Patients in the US group were given US therapy once a day for 5 days per week for 2 consecutive weeks. Before and 4 weeks and 6 months after the treatments, the patients were assessed for pain using visual analog scale (VAS) and the maximum pain-free inter-incisal distance (IID). In addition, mandibular movement (MM), jaw noise (JN), disability index (DI) and craniomandibular index (CMI) were also assessed.

Results: Compared with the patients before the therapy, VAS, IID, MM, JN, DI and CMI in the US group were significantly improved 4 weeks and 6 months after therapy. However, 6 months after the therapy, US group had a recurrence rate of 2.63%.

Conclusion: US therapy can significantly reduce the pain, and improve the functionality of the temporomandibular joint and mouth opening limit for TMD patients, and is therefore recommended for TMD patients.

Discipline Area Score
Physician 5 / 7
Rehab Clinician (OT/PT) 5 / 7
Comments from MORE raters

Physician rater

The limitations of this study make it difficult to be fully confident. I hope the Rx helps but I'd like to see more supporting evidence.

Physician rater

This is novel information for most PCP's. It's good to know there is effective therapy.

Rehab Clinician (OT/PT) rater

As a physiotherapist, I find this information useful and practical as it serves to provide an extra treatment modality for the treatment TMJ disorders.

Rehab Clinician (OT/PT) rater

The readers should be cautious in the interpretation of study results for the following two reasons: Firstly, the application of the ultrasound therapy appeared to be different from the usual practice – 1. the “ultrasound was applied by placing the probes 5cm away from the temporomandibular joints”; 2. the output was 45W but the effective dose of ultrasound in W/cm2 was not known; 3. the ultrasound was applied continuously for 5 minutes without the movement of the ultrasound head for 3 times. Therefore, it is doubtful whether the results are generalizable. Secondly, the significance of the group differences in those outcome variables should not be anchored to the p values associated with the statistical comparisons. The effect sizes of group differences with 95% confidence interval should be reported.

Rehab Clinician (OT/PT) rater

The ultrasound used in this study was 45W and frequency of 800 kHz and appears to have been a non-contact application. These are quite different parameters than what would typically be used, at least in Australia.
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