Clinical Efficacy of Acupuncture Combined With Manual Therapy in the Treatment of Temporomandibular Disorders Myalgia and Observation of the Changes in the Lateral Pterygoid Muscle: A Randomised Clinical Trial

ABSTRACT Background The effectiveness of acupuncture combined with manual therapy for the treatment of temporomandibular disorders myalgia (TMDM) has not been studied. Objectives To assess the effectiveness of acupuncture combined with manual therapy (MT) for the treatment of TMDM. Furthermore, this study used magnetic resonance imaging (MRI) to observe the influence of acupuncture combined with MT on the thickness, area, and signal intensity ratio (SIR) of the lateral pterygoid muscle (LPM) in patients with TMDM. Methods Sixty‐five patients with TMDM were randomly divided into M and A + M groups. The M group received manual therapy, and the A + M group received acupuncture combined with manual therapy. All of the above treatments were performed once a day, five times a week for two consecutive weeks. The visual analogue scale (VAS), pressure pain threshold (PPT), painless maximum mouth opening (MMO), jaw functional limitation scale (JFLS) score, and thickness, area, and signal intensity ratio of the LPM were determined. Statistical analyses were performed using SPSS version 23.0. p < 0.05 was considered to be statistically significant. Results The VAS and JFLS scores were significantly decreased ( p = 0.000, p = 0.000), while the PPT and MMO values were evidently increased after treatment than before treatment in all groups ( p = 0.000, p = 0.001). After treatment, compared with the M group, the VAS and JFLS scores were reduced ( p = 0.004, p = 0.010), and the PPT and MMO values were increased in the A + M group ( p = 0.041, p = 0.006). The overall effective rate in the A + M group was significantly higher than the M group ( p = 0.018). Compared with the M group, the area of the upper and lower heads of the LPM increased ( p = 0.038, p = 0.040), and the signal intensity ratios decreased in the A + M group ( p = 0.032, p = 0.014). Conclusions Acupuncture combined with MT was superior to MT alone for the treatment of TMDM. Moreover, acupuncture combined with MT significantly increased the area of the LPM and decreased its SIR. Trial Registration https://www.chictr.org.cn/ , identifier: ChiCTR2300072801