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Published in: Lasers in Medical Science 2/2017

01-02-2017 | Original Article

Effectiveness of low-level laser therapy on pain intensity, pressure pain threshold, and SF-MPQ indexes of women with myofascial pain

Authors: Laís Valencise Magri, Vinícius Almeida Carvalho, Flávia Cássia Cabral Rodrigues, César Bataglion, Christie Ramos Andrade Leite-Panissi

Published in: Lasers in Medical Science | Issue 2/2017

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Abstract

Women with temporomandibular disorders (TMD) frequently report pain areas in body regions. This process is associated with central sensitization phenomena, present in chronic pain. The low-level laser therapy (LLLT) has been reported as a therapeutic option for the painful TMD treatment. The aim of this study was to analyze the effect of LLLT on pain intensity (visual analogue scale, VAS), pain sensitivity in orofacial and corporal points (pressure pain threshold, PPT), and on Short Form-McGill Pain Questionnaire (SF-MPQ) indexes of women with myofascial pain (subtype of muscle TMD). Ninety-one women (18–60 years) were included in the study, among which 61 were diagnosed with myofascial pain (Research Diagnostic Criteria for Temporomandibular Disorder—Ia and Ib) and were divided into laser (n = 31) and placebo group (n = 30), and 30 were controls. The LLLT was applied at pre-established points, twice a week, eight sessions (780 nm; masseter and anterior temporal = 5 J/cm2, 20 mW, 10 s; TMJ area = 7.5 J/cm2, 30 mW, 10 s). Pain intensity, pain sensitivity, and the SF-MPQ indexes were measured at the baseline, during laser sessions, and 30 days after treatment. For intra-group comparisons, the Friedman test was performed, and for inter-group, the Mann-Whitney test. Increased pain sensitivity was found in women with myofascial pain when compared to controls (p < 0.05). There was a reduction in pain intensity for both groups after LLLT. The LLLT did not change the PPT for any group (p > 0.05). Active laser and placebo reduced the indexes of sensory, total pain, and VAS, maintaining the results after 30 days; there was a reduction in the affective pain rating index for both groups, with no maintenance after 30 days for placebo, and the present pain intensity decreased in the laser group and did not change in the placebo after LLLT. In conclusion, the LLLT active or placebo are effective in reducing the overall subjective perception of myofascial pain (VAS and SF-MPQ indexes); however, they have no effectiveness in reducing the pain sensitivity in orofacial and corporal points (PPT increase).
Literature
1.
go back to reference De Leeuw R, Klasser GD (2013) Orofacial pain: guidelines for assessment, diagnosis and management. Quintessense: Chicago De Leeuw R, Klasser GD (2013) Orofacial pain: guidelines for assessment, diagnosis and management. Quintessense: Chicago
2.
go back to reference Scrivani SJ, Keith DA, Kaban LB (2008) Temporomandibular disorders. N Engl J Med 359(25):2693–705CrossRefPubMed Scrivani SJ, Keith DA, Kaban LB (2008) Temporomandibular disorders. N Engl J Med 359(25):2693–705CrossRefPubMed
3.
go back to reference Ribeiro Da Silva MC, Fillingim RB, Wallet SM (2016) Estrogen-induced monocytic response correlates with temporomandibular disorder pain: a case control study. J Dent Res. doi: 0022034516678599 Ribeiro Da Silva MC, Fillingim RB, Wallet SM (2016) Estrogen-induced monocytic response correlates with temporomandibular disorder pain: a case control study. J Dent Res. doi: 0022034516678599
4.
go back to reference Aaron LA, Buchwald D (2003) Chronic diffuse musculoskeletal pain, fibromyalgia and co-morbid unexplained clinical conditions. Best Pract Res Clin Rheumatol 17:563–574CrossRefPubMed Aaron LA, Buchwald D (2003) Chronic diffuse musculoskeletal pain, fibromyalgia and co-morbid unexplained clinical conditions. Best Pract Res Clin Rheumatol 17:563–574CrossRefPubMed
5.
go back to reference Fernández-de-las-Peñas C, Galán-del-Río F, Fernández-Carnero J, Pesquera J, Arendt-Nielsen L, Svensson P (2009) Bilateral widespread mechanical pain sensitivity in women with myofascial temporomandibular disorder: evidence of impairment in central nociceptive processing. J Pain 10(11):1170–8CrossRefPubMed Fernández-de-las-Peñas C, Galán-del-Río F, Fernández-Carnero J, Pesquera J, Arendt-Nielsen L, Svensson P (2009) Bilateral widespread mechanical pain sensitivity in women with myofascial temporomandibular disorder: evidence of impairment in central nociceptive processing. J Pain 10(11):1170–8CrossRefPubMed
7.
go back to reference Da Cunha CO et al (2014) Determination of a pressure pain threshold cut-off value for the diagnosis of temporomandibular joint arthralgia. J Oral Rehabil 41(5):323–329CrossRefPubMed Da Cunha CO et al (2014) Determination of a pressure pain threshold cut-off value for the diagnosis of temporomandibular joint arthralgia. J Oral Rehabil 41(5):323–329CrossRefPubMed
8.
go back to reference Carlsson AM (1983) Assessment of chronic pain, aspects of the reliability and validity of the visual analogue scale. Pain 16:87–101CrossRefPubMed Carlsson AM (1983) Assessment of chronic pain, aspects of the reliability and validity of the visual analogue scale. Pain 16:87–101CrossRefPubMed
9.
go back to reference Price DD et al (1994) A comparison of pain measurement characteristics of mechanical visual analogue and simple numerical rating scales. Pain 56:217–226CrossRefPubMed Price DD et al (1994) A comparison of pain measurement characteristics of mechanical visual analogue and simple numerical rating scales. Pain 56:217–226CrossRefPubMed
10.
go back to reference Ohrbach R, Gale EM (1989) Pressure pain threshold, clinical assessment, and differential diagnosis: reliability and validity in patients with myogenic pain. Pain 39:157–169CrossRefPubMed Ohrbach R, Gale EM (1989) Pressure pain threshold, clinical assessment, and differential diagnosis: reliability and validity in patients with myogenic pain. Pain 39:157–169CrossRefPubMed
11.
go back to reference Santos Silva RS et al (2005) Pressure pain threshold in the detection of masticatory myofascial pain: an algometer-based study. J Orofac Pain 19(4):318–324 Santos Silva RS et al (2005) Pressure pain threshold in the detection of masticatory myofascial pain: an algometer-based study. J Orofac Pain 19(4):318–324
12.
go back to reference Melzack R (1975) The McGill Pain Questionnaire: major properties and scoring methods. Pain 1:277–99CrossRefPubMed Melzack R (1975) The McGill Pain Questionnaire: major properties and scoring methods. Pain 1:277–99CrossRefPubMed
13.
go back to reference Menezes Costa L da C et al (2011) The Brazilian-Portuguese versions of the McGill Pain Questionnaire were reproducible, valid, and responsive in patients with musculoskeletal pain. J Clin Epidemiol 64(8):903-912. Menezes Costa L da C et al (2011) The Brazilian-Portuguese versions of the McGill Pain Questionnaire were reproducible, valid, and responsive in patients with musculoskeletal pain. J Clin Epidemiol 64(8):903-912.
14.
go back to reference Ferreira KA, de Andrade DC, Teixeira MJ (2013) Development and validation of a Brazilian version of the short-form McGill pain questionnaire (SF-MPQ). Pain Manag Nurs 14(4):210–219CrossRefPubMed Ferreira KA, de Andrade DC, Teixeira MJ (2013) Development and validation of a Brazilian version of the short-form McGill pain questionnaire (SF-MPQ). Pain Manag Nurs 14(4):210–219CrossRefPubMed
15.
go back to reference Cetiner S, Kahraman SA, Yücetaş S (2006) Evaluation of low-level laser therapy in the treatment of temporomandibular disorders. Photomed Laser Surg 24(5):637–641CrossRefPubMed Cetiner S, Kahraman SA, Yücetaş S (2006) Evaluation of low-level laser therapy in the treatment of temporomandibular disorders. Photomed Laser Surg 24(5):637–641CrossRefPubMed
16.
go back to reference Fikácková H et al (2007) Effectiveness of low-level laser therapy in temporomandibular joint disorders: a placebo-controlled study. Photomed Laser Surg 25(4):297–303CrossRefPubMed Fikácková H et al (2007) Effectiveness of low-level laser therapy in temporomandibular joint disorders: a placebo-controlled study. Photomed Laser Surg 25(4):297–303CrossRefPubMed
17.
go back to reference Emshoff R et al (2008) Low-level laser therapy for treatment of temporomandibular joint pain: a double-blind and placebo-controlled trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 105(4):452–456CrossRefPubMed Emshoff R et al (2008) Low-level laser therapy for treatment of temporomandibular joint pain: a double-blind and placebo-controlled trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 105(4):452–456CrossRefPubMed
18.
go back to reference Melchior MO et al (2013) Does low intensity laser therapy reduce pain and change orofacial myofunctional conditions? Cranio 31(2):133–139CrossRef Melchior MO et al (2013) Does low intensity laser therapy reduce pain and change orofacial myofunctional conditions? Cranio 31(2):133–139CrossRef
19.
go back to reference Ahrari F et al (2014) The efficacy of low-level laser therapy for the treatment of myogenous temporomandibular joint disorder. Lasers Med Sci 29(2):551–557CrossRefPubMed Ahrari F et al (2014) The efficacy of low-level laser therapy for the treatment of myogenous temporomandibular joint disorder. Lasers Med Sci 29(2):551–557CrossRefPubMed
20.
go back to reference Gao X, Xing D (2009) Molecular mechanisms of cell proliferation induced by low power laser irradiation. J Biomed Sci 16:1–16CrossRef Gao X, Xing D (2009) Molecular mechanisms of cell proliferation induced by low power laser irradiation. J Biomed Sci 16:1–16CrossRef
21.
go back to reference Carrasco TG et al (2008) Low intensity laser therapy in temporomandibular disorder: a phase II double-blind study. Cranio 26(4):274–281CrossRefPubMed Carrasco TG et al (2008) Low intensity laser therapy in temporomandibular disorder: a phase II double-blind study. Cranio 26(4):274–281CrossRefPubMed
22.
go back to reference Da Silva MAMR et al (2012) Low level laser therapy as na adjunctive technique in the management of temporomandibular disorders. Cranio 30(4):264–71CrossRefPubMed Da Silva MAMR et al (2012) Low level laser therapy as na adjunctive technique in the management of temporomandibular disorders. Cranio 30(4):264–71CrossRefPubMed
23.
go back to reference De Moraes Maia ML et al (2014) Evaluation of low-level laser therapy effectiveness on the pain and masticatory performance of patients with myofascial pain. Lasers Med Sci 29(1):29–35CrossRefPubMed De Moraes Maia ML et al (2014) Evaluation of low-level laser therapy effectiveness on the pain and masticatory performance of patients with myofascial pain. Lasers Med Sci 29(1):29–35CrossRefPubMed
24.
go back to reference Da Cunha LA et al (2008) Efficacy of low-level laser therapy in the treatment of temporomandibular disorder. Int Dent J 58(4):213–217CrossRefPubMed Da Cunha LA et al (2008) Efficacy of low-level laser therapy in the treatment of temporomandibular disorder. Int Dent J 58(4):213–217CrossRefPubMed
25.
go back to reference Petrucci A et al (2011) Effectiveness of low-level laser therapy in temporomandibular disorders: a systematic review and meta-analysis. J Orofac Pain 25(4):298–307PubMed Petrucci A et al (2011) Effectiveness of low-level laser therapy in temporomandibular disorders: a systematic review and meta-analysis. J Orofac Pain 25(4):298–307PubMed
26.
go back to reference Chen J et al (2015) Efficacy of low-level laser therapy in the treatment of TMDs: a meta-analysis of 14 randomised controlled trials. J Oral Rehabil 42(4):291–299CrossRefPubMed Chen J et al (2015) Efficacy of low-level laser therapy in the treatment of TMDs: a meta-analysis of 14 randomised controlled trials. J Oral Rehabil 42(4):291–299CrossRefPubMed
27.
go back to reference De Moraes Maia ML et al (2012) Effect of low-level laser therapy on pain levels in patients with temporomandibular disorders: a systematic review. J Appl Oral Sci 20(6):594–602CrossRef De Moraes Maia ML et al (2012) Effect of low-level laser therapy on pain levels in patients with temporomandibular disorders: a systematic review. J Appl Oral Sci 20(6):594–602CrossRef
28.
go back to reference Schiffman EL et al (2010) The Research Diagnostic Criteria for Temporomandibular Disorders. V: methods used to establish and validate revised Axis I diagnostic algorithms. J Orofac Pain 24:63–78PubMedPubMedCentral Schiffman EL et al (2010) The Research Diagnostic Criteria for Temporomandibular Disorders. V: methods used to establish and validate revised Axis I diagnostic algorithms. J Orofac Pain 24:63–78PubMedPubMedCentral
29.
go back to reference Bragdon EE et al (2002) Group differences in pain modulation: pain-free women compared to pain-free men and to women with TMD. Pain 96(3):227–237CrossRefPubMed Bragdon EE et al (2002) Group differences in pain modulation: pain-free women compared to pain-free men and to women with TMD. Pain 96(3):227–237CrossRefPubMed
30.
go back to reference Fishbain DA, Lewis JE, Gao J (2012) Is there significant correlation between self-reported low back pain visual analogic scores and low back pain scores determined by pressure pain induction matching? Pain Pract 13:358–363CrossRefPubMed Fishbain DA, Lewis JE, Gao J (2012) Is there significant correlation between self-reported low back pain visual analogic scores and low back pain scores determined by pressure pain induction matching? Pain Pract 13:358–363CrossRefPubMed
31.
go back to reference Wolfe F et al (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the Multicenter Criteria Committee. Arthritis Rheum 33:160–172CrossRefPubMed Wolfe F et al (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the Multicenter Criteria Committee. Arthritis Rheum 33:160–172CrossRefPubMed
32.
go back to reference Sancakli E et al (2015) Early results of low-level laser application for masticatory muscle pain: a double-blind randomized clinical study. BMC Oral Health 15(1):131–136CrossRefPubMedPubMedCentral Sancakli E et al (2015) Early results of low-level laser application for masticatory muscle pain: a double-blind randomized clinical study. BMC Oral Health 15(1):131–136CrossRefPubMedPubMedCentral
33.
go back to reference Desiderá AC et al (2015) Laser therapy reduces gelatinolytic activity in the rat trigeminal ganglion during temporomandibular joint inflammation. Oral Dis 21(5):652–658CrossRefPubMed Desiderá AC et al (2015) Laser therapy reduces gelatinolytic activity in the rat trigeminal ganglion during temporomandibular joint inflammation. Oral Dis 21(5):652–658CrossRefPubMed
34.
go back to reference Do Nascimento GC, Leite-Panissi CR (2014) Time-dependent analysis of nociception and anxiety-like behavior in rats submitted to persistent inflammation of the temporomandibular joint. Physiol Behav 125:1–7CrossRefPubMed Do Nascimento GC, Leite-Panissi CR (2014) Time-dependent analysis of nociception and anxiety-like behavior in rats submitted to persistent inflammation of the temporomandibular joint. Physiol Behav 125:1–7CrossRefPubMed
35.
go back to reference Lund I et al (2005) Lack of interchangeability between visual analogue and verbal rating pain scales: a cross sectional description of pain etiology groups. BMC Med Res Methodol 5:31–36CrossRefPubMedPubMedCentral Lund I et al (2005) Lack of interchangeability between visual analogue and verbal rating pain scales: a cross sectional description of pain etiology groups. BMC Med Res Methodol 5:31–36CrossRefPubMedPubMedCentral
37.
go back to reference Gourion D, Mouchabac S (2016) Placebo effect: clinical, biological and therapeutical involvements in depression. Encéphale 42:24–30CrossRef Gourion D, Mouchabac S (2016) Placebo effect: clinical, biological and therapeutical involvements in depression. Encéphale 42:24–30CrossRef
38.
go back to reference Vedolin GM et al (2009) The impact of stress and anxiety on the pressure pain threshold of myofascial pain patients. J Oral Rehabil 36(5):313–321CrossRefPubMed Vedolin GM et al (2009) The impact of stress and anxiety on the pressure pain threshold of myofascial pain patients. J Oral Rehabil 36(5):313–321CrossRefPubMed
39.
go back to reference Sanches ML et al (2015) Correlation between pressure pain threshold and pain intensity in patients with temporomandibular disorders who are compliant or non-compliant with conservative treatment. Oral Surg Oral Med Oral Pathol Oral Radiol 120(4):459–468CrossRefPubMed Sanches ML et al (2015) Correlation between pressure pain threshold and pain intensity in patients with temporomandibular disorders who are compliant or non-compliant with conservative treatment. Oral Surg Oral Med Oral Pathol Oral Radiol 120(4):459–468CrossRefPubMed
40.
go back to reference Lauche R et al (2014) Neck pain intensity does not predict pressure pain hyperalgesia: re-analysis of seven randomized controlled trials. J Rehabil Med 46(6):553–560CrossRefPubMed Lauche R et al (2014) Neck pain intensity does not predict pressure pain hyperalgesia: re-analysis of seven randomized controlled trials. J Rehabil Med 46(6):553–560CrossRefPubMed
41.
42.
go back to reference Drobek W, De Laat A, Schoenaers J (2001) Tactile threshold and pressure pain threshold during treatment of orofacial pain: an explorative study. Clin Oral Investig 5(3):185–193CrossRefPubMed Drobek W, De Laat A, Schoenaers J (2001) Tactile threshold and pressure pain threshold during treatment of orofacial pain: an explorative study. Clin Oral Investig 5(3):185–193CrossRefPubMed
43.
go back to reference Slade GD et al (2014) Pressure pain thresholds fluctuate with, but do not usefully predict, the clinical course of painful temporomandibular disorder. Pain 55(10):2134–2143CrossRef Slade GD et al (2014) Pressure pain thresholds fluctuate with, but do not usefully predict, the clinical course of painful temporomandibular disorder. Pain 55(10):2134–2143CrossRef
44.
go back to reference Greenspan JD et al (2013) Pain sensitivity and autonomic factors associated with development of TMD: the OPPERA prospective cohort study. J Pain 14:63–74CrossRef Greenspan JD et al (2013) Pain sensitivity and autonomic factors associated with development of TMD: the OPPERA prospective cohort study. J Pain 14:63–74CrossRef
45.
go back to reference Cao Y, Chen HM, Fu KY (2008) Investigation on clinical pain features in temporomandibular disorders. Zhonghua Kou Qiang Yi Xue Za Zhi 43(5):293–295PubMed Cao Y, Chen HM, Fu KY (2008) Investigation on clinical pain features in temporomandibular disorders. Zhonghua Kou Qiang Yi Xue Za Zhi 43(5):293–295PubMed
Metadata
Title
Effectiveness of low-level laser therapy on pain intensity, pressure pain threshold, and SF-MPQ indexes of women with myofascial pain
Authors
Laís Valencise Magri
Vinícius Almeida Carvalho
Flávia Cássia Cabral Rodrigues
César Bataglion
Christie Ramos Andrade Leite-Panissi
Publication date
01-02-2017
Publisher
Springer London
Published in
Lasers in Medical Science / Issue 2/2017
Print ISSN: 0268-8921
Electronic ISSN: 1435-604X
DOI
https://doi.org/10.1007/s10103-016-2138-x

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