Muscular disorders of temporomandibular joint treated with electroacupuncture

Background and Objectives: Temporomandibular joint (TMJ) pain and dysfunction syndrome (PDS) is a common disorder of TMJ. Treatment options include: counselling, physiotherapy, pharmacotherapy, splint therapy, intra-articular steroids, arthrocentesis, surgery and further referral (orthodontic, neurology, ENT, etc.). Physiotherapy is beneficial to any patient with PDS of TMJ in which there is muscular involvement; electroacupuncture (EA) is one physiotherapy treatment and many international studies have demonstrated its effectiveness. Our group used EA since 2001 associated with surface electromyography of the masticatory muscles. Methods: During past 5 years we have examined 503 outpatients suffering from PDS of TMJ, 80 of these patients have been treated with EA, continuous waves, 2–20Hz, 20minutes for each treatment, one course=8–10 treatments. The points used are those according to the theory of traditional Chinese medicine (named by Chinese name and international WHO code): Hegu LI-4, Jiache ST-6, Xiaguan ST-7, Tinggong SI-19, Shangguan GB-3, Ear Eliao TE-22, etc. In 35 patients we have evaluated the muscular imbalance of muscles anterior temporalis and masseter before and after EA by a surface electromyography. Results: 53 patients needed one course of EA (8–10 treatments) to have a significant reduction of the pain (by V.A.S.), 10 patients needed two courses of EA to have a satisfactory result and 17 patients did not have satisfactory results after two courses of EA. Electromyography showed that by using EA the involved muscles came back to a normal and well-balanced activity. Conclusions: Acupuncture and electroacupuncture are effective methods to treat PDS of TMJ with muscular involvement.