Svensson P, Houe L, Arendt-Nielsen L
Center for Sensory-Motor Interaction, Aalborg University, Denmark.
J Orofac Pain. 1997 Fall;11(4):353-62.
Certain types of jaw-muscle pain may be managed with pharmacologic treatment. This study evaluated the effect of topical and systemic nonsteroidal anti-inflammatory drugs on acute postexercise jaw-muscle soreness. Ten men without temporomandibular disorders performed six 5-minute bouts of submaximal eccentric jaw exercise. The outcome variables were pressure pain thresholds and pain tolerance thresholds at the masseter muscles, and maximum voluntary occlusal force. Surface electromyography from the masseter muscles was used to assess the development of muscle fatigue during the exercise period. Three treatment modalities were tested in a placebo-controlled, double-blind approach: (A) placebo gel and placebo tablets; (B) nonsteroidal anti-inflammatory drug gel (2 g, 5% ibuprofen) and placebo tablets; and (C) placebo gel and nonsteroidal anti-inflammatory drug tablets (400 mg ibuprofen). The subjects used their medication 3 times a day for 3 days in the postexercise period. In the exercise period, the mean power frequency of the electromyography signal, pressure pain threshold, pain tolerance threshold, and maximum voluntary occlusal force decreased significantly (analysis of variance, P < .01). In the postexercise period, the effect of treatment on pressure pain thresholds was significant (F[2,9] = 4.41, P = .02). On day 3, treatment with topical nonsteroidal anti-inflammatory drugs was associated with significantly higher pressure pain thresholds as compared to treatment with systemic nonsteroidal anti-inflammatory drugs (P < .05) and placebo (P < .05). Treatment effects on pain tolerance thresholds and on maximum voluntary occlusal force were nonsignificant. The results demonstrated that repeated eccentric jaw exercise caused muscle fatigue and low levels of postexercise pain and soreness. Topical nonsteroidal anti-inflammatory drugs seem to have some advantages over systemic nonsteroidal anti-inflammatory drugs for management of exercise-induced jaw-muscle pain.
某些类型的颌面部肌肉疼痛可用药物治疗。本研究评估了局部和全身应用非甾体抗炎药对运动后急性颌面部肌肉酸痛的影响。10名无颞下颌关节紊乱的男性进行了6次每次5分钟的次最大离心性颌部运动。观察指标为咬肌的压痛阈值和疼痛耐受阈值，以及最大自主咬合力。采用咬肌表面肌电图评估运动期间肌肉疲劳的发展情况。采用安慰剂对照、双盲方法测试了三种治疗方式：(A)安慰剂凝胶和安慰剂片剂；(B)非甾体抗炎药凝胶(2 g，5%布洛芬)和安慰剂片剂；(C)安慰剂凝胶和非甾体抗炎药片剂(400 mg布洛芬)。受试者在运动后期间每天使用药物3次，共3天。在运动期间，肌电图信号的平均功率频率、压痛阈值、疼痛耐受阈值和最大自主咬合力均显著下降(方差分析，P <.01)。在运动后期间，治疗对压痛阈值的影响显著(F[2,9]=4.41，P =.02)。在第3天，与全身应用非甾体抗炎药治疗(P <.05)和安慰剂治疗(P <.05)相比，局部应用非甾体抗炎药治疗的压痛阈值显著更高。治疗对疼痛耐受阈值和最大自主咬合力的影响不显著。结果表明，重复进行离心性颌部运动可导致肌肉疲劳以及运动后出现轻度疼痛和酸痛。在治疗运动引起的颌面部肌肉疼痛方面，局部应用非甾体抗炎药似乎比全身应用非甾体抗炎药具有一些优势。
