Effects of Transcutaneous Electrical Nerve Stimulation, Laser Therapy, and Ultrasound in Managing Temporomandibular Disorders: A Randomised Clinical Study

Abstract

Introduction: Temporomandibular Joint Disorders (TMDs) are considered multifactorial, and several treatment approaches have been proposed for their effective management. The use of non invasive treatment modalities is recommended, which includes Transcutaneous Electric Nerve Stimulation (TENS), Low-Level Laser Therapy (LLLT), acupuncture, ultrasound, and manual therapies. Aim: To evaluate the effectiveness of TENS, LLLT, and ultrasound therapy in patients suffering from TMDs. Materials and Methods: This prospective, randomised clinical trial was conducted on thirty patients (11 males, 19 females) clinically diagnosed with TMD associated with Temporomandibular Joint (TMJ) pain, clicking joint sound, pain in the muscles of mastication, and limited mouth opening. Patients were sequentially randomised into three groups to be treated with TENS, laser beam, and ultrasound therapies, respectively. The Visual Analog Scale (VAS) Score and pain-free mouth opening were recorded before, during, and after treatment. Data were analysed using Statistical Package for Social Sciences(SPSS) version 16.0 statistical software. Statistical tests such as the paired sample t-test, Analysis of Variance (ANOVA), and post-hoc Tukey test were performed. Results: There was a significant reduction in the VAS score in the TENS group (3.15), LLLT group (5.75), and ultrasound group (5.50) post-treatment (p<0.001). In addition, improvements in Mean Mouth Opening (MMO) levels were observed with TENS (7.80 mm), LLLT (9.09 mm), and ultrasound therapy (7.15 mm). These differences were found to be statistically significant (p<0.05). The laser and ultrasound groups fared better than the TENS group in the reduction of VAS scores (p<0.05), and there was no significant difference in MMO among the three therapies. Conclusion: Reductions in VAS scores and improvements in mouth opening were noticed in all three groups post-treatment. The laser and ultrasound therapies were more effective in reducing pain compared to TENS therapy. Comparing pre-treatment and mid-treatment values, laser beam therapy proved to be more effective in reducing pain scores compared to TENS and ultrasound therapy.

Keywords

• pain measurements
• temporomandibular joint disorders
• therapeutics
• visual analog scale