AcuTrials

Comparative effectiveness of traditional chinese medicine and psychosocial care in the treatment of temporomandibular disorders-associated chronic facial pain

Item

Title

Comparative effectiveness of traditional chinese medicine and psychosocial care in the treatment of temporomandibular disorders-associated chronic facial pain

Journal Publication

The journal of pain : official journal of the American Pain Society

Date

2012

volume

13(11)

pages

1075-1089

Research Type

RCT

Keywords

Stomatognathic Diseases
Temporomandibular Joint Disorders
Cross-Over Design
Acu Versus Usual Care
TCM Acupuncture Style
Semi-Individualized Acupuncture Protocol
Traditional Diagnosis Based Point Selection
Restricted Modalities, Acupuncture + Other
Usual Care Control, Educational
Psychosocial Self-Care

Abstract

This dual-site study sought to identify the appropriate role for traditional Chinese medicine (TCM; acupuncture and herbs) in conjunction with a validated psychosocial self-care (SC) intervention for treating chronic temporomandibular disorders (TMD)-associated pain. Participants with Research Diagnostic Criteria for Temporomandibular Disorders-confirmed TMD (n = 168) entered a stepped-care protocol that began with a basic TMD class. At weeks 2 and 10, patients receiving SC whose worst facial pain was above predetermined levels were reallocated by minimization to SC or TCM with experienced practitioners. Characteristic facial pain (CFP: mean of worst pain, average pain when having pain, and current pain; each visual analog scale [VAS] 0-10) was the primary outcome. Social activity interference (VAS 0-10) was a secondary outcome. Patients were monitored for safety. TCM provided significantly greater short-term (8-week) relief than SC (CFP reduction difference, -.60 [standard deviation of the estimate .26], P = .020) and greater reduction in interference with social activities (-.81 [standard deviation of the estimate .33], P = .016). In 2 of 5 treatment trajectory groups, more than two thirds of participants demonstrated clinically meaningful responses (>/=30% improvement) in pain interference over 16 weeks. This study provides evidence that TMD patients referred for TCM in a community-based model will receive safe treatment that is likely to provide some short-term pain relief and improved quality of life. Similar designs may also apply to evaluations of other kinds of chronic pain. (ClinicalTrials.gov number NCT00856167). PERSPECTIVE: This short-term comparative effectiveness study of chronic facial pain suggests that TCM is safe and frequently efficacious alone or subsequent to standard psychosocial interventions. TCM is widely available throughout North America and may provide clinicians and patients with a reasonable addition or alternative to other forms of therapy.

Time in Treatment

18 Weeks

has health condition studied

Stomatognathic Diseases

has study population number

168

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