Myofacial Pain Dysfunction Syndrome [MPDS],
Is pain disorder characterised bt pain and dysfunction of the masticatory and associated muscles. Around 30% population age group of 15 to 40 suffers from this disorder and remains undiagnosed due lack of knowledge among patients. Its has significant impact on patients quality of life. If left undiagnosed, it may develops into chronic pain with overlying psychological and functional problems. This may leads to further distress, anxiety and even depression.
MPDS has mulfifactorial etiology.
-Most frequent cause of mpds is Occlusal disharmony in which person makes modification in path of jaw closer which leads to spasm of muscles.
-Faulty Comlpete denture, Partial denture, dental restorations.
-Early loss of bilateral Molars teeth.
-Joint Problems like arthritis, hyper-mobility, ligaments problem.
-Psychological stress, Bruxism, oral habits.
-Emotional Problems like pattern of over behaviors relating to care of teeth, food habits, oral habits may leads to structural damage and eventually develops pain.
-It occurs in episode of several times a day, at times with extended symptoms free intervals. Usually episodes are seen during increased emotional tension.
-Pain is localized to ear region or may be radiating to head, jaw and forehead region.
-Difficulty in chewing and restriction in mouth opening.
-Patients also complaints of Noise on rubbing, grinding, clicking, popping sounds on mandibular jaw movements.
-Tinitus, is ringing in ear with otalgia( pain in ear ) or some times hearing loss may develops.
-The management of MPDS includes pharmacological and non pharmacological methods followed by surgical methods being the last resort.
1)Pharmacologic treatment includes use of various drugs to reduce the pain and discomfort caused to the patient.
-Analgesic Drugs
-opioid pain medication
-Muscle Relaxants
-Anticonvulsants
-Antidepressants.
2)Non pharmacologic Treatment Of Myofascial Pain.
-Dry needling
-Injections of short or long acting anesthetics or steroids.
-deep pressure massage, stretch therapy with spray (where a taut band is stretched immediately after cold spray), superficial heat, and myofascial release.
-Ultrasound is a technique that has been proposed to treat myofascial pain by converting electrical energy to sound waves in order to provide heat energy to muscles.
-Transcutaneous electric nerve stimulation (TENS) is a treatment modality that utilizes an electrical current to stimulate nerve fibers in order to provide pain relief.
-Magnetic stimulation (MS) is a newer treatment that is being investigated for pain.
-Laser therapy has been used in the treatment
3)Exercise
It is essential to correct the muscle imbalance to achieve a good therapeutic result it is important to try to restore normal length and flexibility to the muscles. The following neuromuscular relaxation techniques may be applied
-Muscle relaxation by exhalation.
-Muscle relaxation by eye movement, inferiorly and in the direction in which relaxation is desired.
-Muscle relaxation following isometric contraction, byautogenic inhibition.
-Muscle relaxation following minimal activation of the antagonist muscle, by reciprocal inhibition.
4)Surgical management should be considered only as a last resort. They are listed as follows:
-Condylotomy
-High condylectomy
-Menisectomy
-Myotomy.
-Arthroscopy
