Effectiveness of different physiotherapy practices in temporomandibular joint disorders

Temporomandibular disorders (TMD) are defined as complex, multifactorial, and controversial disorders. This also requires quite variable and customized treatment. The aim of this study was to examine the effects of high voltage electrical stimulation (HVES) on pain intensity, temporomandibular joint (TMJ) mobility, cervical mobility, head position, pressure pain threshold, bite force, joint sounds, and jaw muscle strength in individuals with TMD. Thirty-four volunteers with TMER were included in the study. Individuals were randomly divided into two groups as the exercise group (EG) and the HVES group (HG) which the additional to exercise. Before the treatment, the EG was given education and home exercises to be done three days a week for four weeks were taught. In addition to those performed in the EG, the HG received continuous cycle time and 100 pps cathodal HVES, three days a week for four weeks, over the anterior temporalis and masseter muscles. Before and after treatment, pain intensity with Visual Analog Scale, TMJ mobility with a ruler, cervical mobility with Cervical Range of Motion (CROM) inclinometer, head position with a goniometer, pressure pain threshold with Baseline algometer, bite force with pinch meter, joint sounds with auscultation, and jaw muscle strength with the Lafayette muscle test system were evaluated. After the treatment in both groups pain intensity significantly decreased (p<0.05); TMJ mobility, cervical mobility, head position, pressure pain threshold, bite force, and jaw muscle strength significantly increased (p<0.05). Joint sounds significantly decreased in the HG (p<0.05). The results of the study showed that, unlike exercise, YVES was effective in reducing joint sounds and increasing the cervical extension, cervical left rotation, resting pressure pain threshold of left lateral pterygoid and right upper trapezius. Due to these effects, YVES in addition to exercise can be used in the treatment program in individuals with TMD.