The Relaxation Response Resiliency Enhancement Program in the Management of Chronic Refractory Temporomandibular Joint Disorder: Results from a Pilot Study. Issue 3 (September 2013)

• Record Type: Journal Article
• Authors: Vranceanu, Ana-Maria; Shaefer, Jeffery R.; Saadi, Ashkan Fahandej; Slawsby, Ellen; Sarin, Jaya; Scult, Matthew; Benson, Herbert; Denninger, John W.
• Is Part Of: Journal of musculoskeletal pain. Volume 21:Issue 3(2013)
• Page Start: 224
• Page End: 230
• Publication Date: 2013-09
• Subjects: Nonarticular rheumatism -- Periodicals; Myalgia -- Periodicals; Pain -- Periodicals; Musculoskeletal system -- Diseases -- Periodicals; 616.7
• DOI: 10.3109/10582452.2013.827289
• Languages: English
• ISSNs: 1058-2452

Abstract

<abstract> <title>Abstract</title> <p> <bold>Objectives</bold>: This is an open-pilot study to evaluate the feasibility, acceptability and efficacy of a pain-specific version of an established mind–body medicine program, the Relaxation Response [RR] Resiliency Program [R<sub>3</sub>P], in patients with chronic temporomandibular disorder [TMD].</p> <p> <bold>Methods</bold>: Male and female with at least a six-month history of pain involving the masticatory muscles were sought in the Orofacial Pain Centers of the Massachusetts General Hospital [MGH] or through an advertisement sent to MGH employees from 2008 to 2010. Eligible participants underwent the R<sub>3</sub>P intervention [eight group sessions] after standard medical management. Pre- and post-group patients underwent objective measures of impairment [vertical and lateral range of motion with and without pain, temporomandibular joint and muscle pain palpation, and algometer measures] and completed psychosocial measures [Symptom Severity Index, Perceived Stress Scale, the Symptom Checklist-90-Revised and Short Form 36 Health Survey].</p> <p> <bold>Results</bold>: Twenty-four subjects [16 females, 90% from MGH Orofacial Pain Centers, 10% from among MGH employees], mean age 38 years, met eligibility criteria and participated in the study. The intervention was highly feasible and accepted by patients, as evidenced by a 92% rate of completion. Paired <italic>t</italic>-test analyses revealed improvement on self-reported pain measures: pain intensity [<italic>p</italic> < 0.02], pain frequency [<italic>p</italic> < 0.002], pain duration [<italic>p</italic> < 0.027], pain tolerability [<italic>p</italic> < 0.009] and on several objective tests.</p> <p> <bold>Conclusions</bold>: The pain specific R<sub>3</sub>P is efficacious in reducing objective and subjective symptoms in patients with chronic refractory TMD. The comprehensive intervention, which combines educational information about pain with RR, cognitive behavioral and resiliency-enhancement skills, is accepted by patients and may be more efficacious than other treatments with fewer elements.</p> </abstract>