Traditional Chinese Medicine Treatment May Have Benefits for Temporomandibular Facial Pain

Traditional Chinese medicine may provide short-term pain relief for temporomandibular disorders (TMD), according to a new study. TMD, which affects an estimated 10 million Americans, is a group of disorders that cause pain and dysfunction in the jaw joint and the muscles that control jaw movement. The study also showed that traditional Chinese medicine may help improve quality of life. This short-term comparative effectiveness study, funded by NCCAM, appeared in The Journal of Pain. The researchers also plan to publish 18-month findings.

The researchers conducted the study in two real-world pain clinics within health plans, in Tucson, Arizona, and Portland, Oregon. Researchers enrolled 168 adults who had been diagnosed with TMD and at least 1 traditional Chinese medicine diagnosis. Initially, all patients attended a 2-hour class on TMD. At week 2, the researchers assigned patients with the worst TMD pain (above a predetermined level) either to a traditional Chinese medicine or self-care group. Participants whose TMD pain was less severe were assigned to self-care. At week 10, patients in the self-care group whose pain was above a second predetermined level were assigned to receive traditional Chinese medicine or continue with self-care.

The traditional Chinese medicine intervention (consisting of up to 20 visits within 1 year) was tailored to the patient and could include acupuncture, Chinese herbs, massage, and lifestyle counseling. The self-care intervention included education, jaw stretching exercises, training in relaxation and stress management, and cognitive behavioral therapy. Participants in the self-care group also received a self-help manual. 

The researchers found that traditional Chinese medicine provided significantly greater short-term pain relief than self-care, as well as greater reduction in interference with social activities. The researchers concluded that their results suggest this kind of stepped-care, community-based approach using traditional Chinese medicine is safe and could offer short-term relief of pain and improved quality of life for patients with TMD. The long-term outcomes of this study are forthcoming and will provide a more complete picture of the impact of this treatment strategy. Further, the researchers also noted that their design could be used more widely in studies of chronic pain.

Reference

• Ritenbaugh C, Hammerschlag R, Dworkin SF, et al. Comparative effectiveness of traditional Chinese medicine and psychosocial care in the treatment of temporomandibular disorders-associated chronic facial pain. Journal of Pain. 2012;13(11):1075–1089.