J Oral Facial Pain Headache. 2020;34(2):141-148. doi: 10.11607/ofph.2530.
To evaluate the effectiveness of manual therapy in the treatment of myofascial pain related to temporomandibular disorders.
Randomized clinical trials were searched in the Cochrane Library, MEDLINE, Web of Science, Scopus, LILACS, and SciELO databases using the following keywords: temporomandibular joint disorders; craniomandibular disorders; myofascial pain syndromes; myofascial pain; exercise therapy; myofunctional therapy; physical therapy modalities; clinical trial; prospective studies; and longitudinal studies. Studies using the RDC/TMD and manual therapy for myofascial pain were included. All studies were evaluated using the Cochrane Risk of Bias tool.
Five studies were included in the present review. Of 279 total patients, 156 were treated with manual therapy only or manual therapy with counseling. Manual therapy was efficient for pain relief in all studies evaluated; however, manual therapy was not better than counseling or botulinum toxin.
Manual therapy was better than no treatment in one study and better than counseling in another study; however, manual therapy combined with counseling was not statistically better than counseling alone, and manual therapy alone was not better than botulinum toxin. Manual therapy combined with home therapy was better than home therapy alone in one study. Further studies are required due to the inconclusive data and poor homogeneity found in this review.
评估手法治疗在治疗与颞下颌关节紊乱相关的肌筋膜疼痛中的疗效。
在 Cochrane 图书馆、MEDLINE、Web of Science、Scopus、LILACS 和 SciELO 数据库中使用以下关键词搜索随机临床试验：颞下颌关节紊乱；颅颌面部紊乱；肌筋膜疼痛综合征；肌筋膜疼痛；运动疗法；肌功能疗法；物理治疗方式；临床试验；前瞻性研究；和纵向研究。纳入使用 RDC/TMD 和手法治疗肌筋膜疼痛的研究。使用 Cochrane 偏倚风险工具评估所有研究。
本综述共纳入 5 项研究。在 279 名患者中，156 名接受了单纯手法治疗或手法治疗加咨询。所有评估的研究均表明手法治疗在缓解疼痛方面有效；然而，手法治疗并不优于咨询或肉毒毒素。
在一项研究中，手法治疗优于无治疗，在另一项研究中，手法治疗优于咨询；然而，手法治疗联合咨询在统计学上并不优于单独咨询，单独手法治疗也不比肉毒毒素好。在一项研究中，手法治疗联合家庭治疗优于家庭治疗单独进行。由于本综述中发现的数据不确定和同质性差，需要进一步研究。
