The Efficacy of Transcutaneous Electrical Nerve Stimulation in Tmj Pain- a Non Pharmacological Remedy for Immediate Pain Relief

Objective: The aim of this study is to analyze the effect of Transcutaneous electric nerve stimulation in the symptomatic relief of pain in temporomandibular disorders, compared to the administration of analgesic and anti inflammatory agents. Material and Methods: This study was conducted in the department of Oral & Maxillofacial Surgery Khyber College of Dentistry Peshawar and physiotherapy private clinics of Peshawar, Khyber Pakhtunkhwa during a period from May 2012 to June 2013. Fifty patients with temporomandibular disorders irrespective of gender were recruited in this study. Pain assessment was done before intervention by using visual analogue scale. The scoring was recorded on in such a way that a score of 1-3 was designated as mild pain, 4-6 as moderate pain and 7-10 as severe pain. Patients were randomly divided into Group I who received Naproxen 500mg twice daily for 10 days. Group II received Transcutaneous electric nerve stimulation thrice during a period of 10 days for about 30-40 minutes per session. A standard Transcutaneous electric nerve stimulation unit (BREMED, Model BD 7900, Italy) was used. Patients were asked to inform the operator in case of any discomfort. Patients were asked to report after 10 days. At this stage again pain assessment was done by visual analogue scale. Information so collected was analyzed using SPSS version 20. Results: Majority of the patients in both Group I and Group II reported severe pain before intervention (52% and 40% respectively) while there was no single patient without pain. The post intervention Group I showed 32% patients with severe pain followed by 28% patients in mild category. In Group II, there were 36% patients with moderate pain followed by 32 % patients in mild pain category. Conclusion: Transcutaneous electric nerve stimulation is superior in complete elimination of pain as well as in reduction of severity in temporomandibular joint dysfunction syndrome. This modality of treatment can be applied alone or in combination with low doses analgesics.