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.