Abstract
Objectives: This study compared the effectiveness of temporalis muscle pain management using three topical ointments in patients with headaches attributed to temporomandibular disorders.
Method: 30 female patients (mean age 27.1±13.4 years) diagnosed with headaches attributed to temporomandibular disorders participated in a randomized, double-blinded, placebo-controlled trial. They were either treated with Ping-On ointment (G1), Vaseline with menthol (smelling placebo) (G2), or colored Vaseline (odorless placebo) (G3) for eight weeks. Outcome measurements were as follows: (i) pain intensity at the temples as assessed by visual analogue scale (VAS); (ii) anterior temporalis muscles pressure pain threshold (PPT) obtained with an algometer (Somedic ®); and (iii) maximum tolerable pressure pain (MTPP) in anterior temporal muscles recorded with the same device. Measurements were performed at baseline (T0), repeated after 4 weeks (T1), and 8 weeks (T2).
Results: At T0, all groups had similar scores in the outcome variables. Based on VAS values, all topical medications reduced the perception of pain at the temples (P<0.05) without any significant differences between groups. As for PPT at T2, only Ping-On and Vaseline with menthol increased pain threshold and maximum pain tolerance compared with the colored Vaseline (P<0.05).
Conclusion: Ping-on topical application on temporalis muscles is effective in the management of temporalis muscle pain in patients with headaches attributed to temporomandibular disorders, with significantly different treatment outcomes as far as objective PPT measurements are concerned. Patient expectation and natural course of symptoms might explain the subjective improvement in VAS pain levels in placebo groups.