Effects of physical therapy for temporomandibular disorders on headache pain intensity: A systematic review

• Published in: Musculoskeletal science & practice Vol. 50; p. 102277
• Main Authors: van der Meer, Hedwig A., Calixtre, Leticia B., Engelbert, Raoul H.H., Visscher, Corine M., Nijhuis – van der Sanden, Maria WG, Speksnijder, Caroline M.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-12-2020
• Subjects: Headache; Oral rehabilitation; Orofacial pain; Physical therapy; Temporomandibular disorder; Headache; Oral rehabilitation; Orofacial pain; Temporomandibular disorder; Physical therapy
• ISSN: 2468-7812; 2468-7812
• DOI: 10.1016/j.msksp.2020.102277

Physical therapy is regarded an effective treatment for temporomandibular disorders (TMD). Patients with TMD often report concomitant headache. There is, however, no overview of the effect of physical therapy for TMD on concomitant headache complaints.
The aim of this study is to systematically evaluate the literature on the effectiveness of physical therapy on concomitant headache pain intensity in patients with TMD.
PubMed, Cochrane and PEDro were searched.
Randomized or controlled clinical trials studying physical therapy interventions were included.
Patients with TMD and headache.
The Cochrane risk of bias tool was used to assess risk of bias.
Individual and pooled between-group effect sizes were calculated according to the standardized mean difference (SMD) and the quality of the evidence was rated using the GRADE approach.
Results: and manual therapy on both orofacial region and cervical spine. There is a very low level of certainty that TMD-treatment is effective on headache pain intensity, downgraded by high risk of bias, inconsistency and imprecision.
The methodological quality of most included articles was poor, and the interventions included were very different.
Physical therapy interventions presented small effect on reducing headache pain intensity on subjects with TMD, with low level of certainty. More studies of higher methodological quality are needed so better conclusions could be taken.
•There is a very low level of certainty that TMD-treatment reduces headache pain.•Counseling and exercises are comparable to counseling and/or splint therapy.•Orofacial and cervical therapy is superior to cervical manual therapy alone.