Effectiveness of continuous and pulse mode of ultrasound therapy in temporomandibular disorders associated myalgia—a randomized controlled study

Background: Temporomandibular disorders associated myalgia (TMD-M) is one of the most common patient complaints in clinics. Because of the disease’s multifactorial etiology and complexity,extensive understanding is required to determine an appropriate treatment protocol. Methods: The current randomized comparison study included 80 patients who presented to the outpatient department with a TMD-M complaint. Patients were randomly assigned to one of two groups: continuous therapeutic ultrasound or pulsed therapeutic ultrasound, according to a standard protocol. The key outcome measures were pain intensity (visual analog scale (VAS), 0–10 cm) and muscle pressure pain threshold (PPT). Secondary outcome assessments included changes in maximal mouth opening, functional movements, and depression (Beck Depression Inventory (BDI)). A descriptive analysis was performed on the dataset to get data estimates for all variables. Results: The means of the differences in the two group’s values were compared. Intergroup comparisons for normally distributed data were performed using independent sample t-tests, and intragroup comparisons using repeated-measures Analysis of variance (ANOVA). For non-normally distributed data, such as pressure pain sensitivity (PPT), BDI, left laterotrusive movement (LLT), and protrusive movement (PM), intergroup comparisons were performed using the Mann-Whitney test, and intragroup comparisons using the Friedman test followed by the Wilcoxon signed-rank test. Although the intragroup changes in visual analogue scale (VAS) score, PPT, BDI, LLT and PM were highly significant in both groups (p < 0.001), there was no significant intergroup difference in pain reduction, PPT, BDI, LLT or PM (p > 0.05). There were no significant intergroup or intragroup differences in mouth opening or right lateral movement. Conclusions: Both the pulse and continuous modes of therapeutic ultrasound (US) are equally effective in relieving pain. US therapy in both modes is a potent and independent therapeutic modality for the treatment of TMD-M. Clinical Trial Registration: NCT05211245.

Myofascial pain; Ultrasonic therapy; Temporomandibular joint disorders; Orofacial pain

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