Ozone Therapy and Myofascial Trigger Point Injections for Masticatory Muscle Pain

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A brand new article in the Journal of Oral Rehabilitation reports on the efficacy of Ozone Therapy for treating Myofascial Mucle Pain in TMJ Patients. (abstract below)

Treatment of Orofacial Pain with Ozone Therapy vs Trigger Point Injections.

I utilize Ozone Therapy for my knees with ozone injections giving amazing relief and improved function. I personally do not find it helpful for Myofascial Trigger points and taut band and would actually prefer doing detailed and specific trigger point injections to eliminate painful area.

I have had patients who received r hyperbaric oxygen treatment after the injections and that does seem to make an amazing positive difference. I work with Dr Stephen Best at the Neuroscience Center in Deerfield, Il whose office is close to mine.

What is interesting about this report is that well ozone therapy helped, the sham therapy (placebo) showed significant improvements in the tested parameters as well.

Trigger point injections are one of the most effective treatments for Myofascial Pain. Injections of trigger points and stretching of taut bands can eliminate the pain and the myofascial issues.

It is incredibly important to understand that while trigger points can be eliminated thery are caused by repetitive muscle strain and correcting the underlying postural and bite issues is essential for long time success in treating orofacial pain, headaches, migraines, facial pain, sinus pain and TMJ disorders.

The best way of eliminating the causes of recurring trigger points is to utilize Physiologic Dentistry to set the bite , but more importantly  to carefully adjust the bite.  Permanent changes are usually best postponed iuntil significant lasting improvement has been achieved.

The use of ULF-TENS or Ultralow Frequency TENS in physiologic dentistry sets it apart from the more outdated mechanical approaches (joint based) that utilize CR or centric relation instead of the more physiological physiologic occlusion.

 

The website www.triggerpoints.net is an excellent resource for understanding pain from myofascial trigger points.  It is interactive and can be searched by symptoms, by muscle or by area of pain.  This site is based on the work of Dr Janat Travell who served as President Kennedy’s doctor.  A great piece of trivia is the Jackie Kennedy built the Rose Garden at the White House because Janet Travell loved roses and it seemed like an excellent thank you for helping the president’s chronic pain.

J Oral Rehabil. 2017 Mar 16. doi: 10.1111/joor.12506. [Epub ahead of print] Effect of high-frequency bio-oxidative ozone therapy for masticatory muscle pain: a double-blind randomized clinical trial.

Celakil T1, Muric A1, Gokcen Roehlig B2, Evlioglu G3, Keskin H3.
Author information
Abstract
OBJECTIVES:
To evaluate the effect of bio-oxidative ozone application at the points of greatest pain in patients with chronic masticatory muscle pain.
METHODS:
A total number of 40 (40 women, with a mean age of 31.7) were selected after the diagnosis of myofacial pain dysfunction syndrome according to the Research Diagnostic Criteria for Temporomandibular Disorder (RDC/TMD). The patients were randomly divided into two groups; patients received the ozone therapy at the point of greatest pain, ozone group (n = 20); patients received the sham ozone therapy at the point of greatest pain, placebo group (n = 20). Ozone and placebo were applied three times per week, for a total of 6 sessions. Mandibular movements were examined, masticator muscles tenderness were assessed and Pressure Pain Threshold (PPT) values were obtained. Subjective pain levels were evaluated using Visual Analogue Scale (VAS). These assessments were performed at baseline, 1 month and 3 months.
RESULTS:
Ozono therapy decreased pain intensity and increased PPT values significantly from baseline to 1 month and 3 months in Ozone Group (OG) compared with Placebo Group (PG). PPTs of the temporal (OG=24,85±6,65, PG=20,65±5,43, p=.035) and masseter (OG=19,03±6,42, PG=14,23±2,95, p=.007) muscles at 3 months control (T2) were significantly higher in the OG group. PPT value of the lateral pole (LP) was also significantly higher at T2 in the OG group (OG=21,25±8,43, PG=15,35±4,18, p=.012). Mandibular movements did not show significant differences between treatment groups except right lateral excursion (RLE) values at T2 (OG=8,90±1,77, PG=6,85±2,41, p=.003), however, OG demonstrated significanty better results over time. Overall improvements in VAS scores from baseline to 3 months were: OG 67.7%; PG 48,4%.
CONCLUSION:
Although ozone therapy can be accepted as an alternative treatment modality in the management of masticatory muscle pain, sham ozone therapy (placebo) showed significant improvements in the tested parameters. This article is protected by copyright. All rights reserved.

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