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Effects of a Self-Management Program for Temporomandibular Myalgia in Patients With Fibromyalgia: A Single-Arm Study
José Edgar Ferrández-Gómez1, Aitor Baño-Alcaraz2, Mariano Gacto-Sanchez2
1Translational Research Centre of Physiotherapy, Physiotherapy Area, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernandez University, Sant Joan d'Alacant, Spain; Faculty of Physiotherapy, Occupational Therapy and Podiatry, UCAM Catholic University of Murcia, Murcia, Spain.
Purpose:
Myogenic temporomandibular disorder frequently co-occurs with fibromyalgia and is associated with pain, disability, and maladaptive pain cognitions. This study evaluated the short- and long-term effects of an online Pain Neuroscience Education-informed self-management program in individuals with fibromyalgia and myogenic temporomandibular disorder.
Design:
Prospective single-arm clinical study.
Methods:
Adults with fibromyalgia and myogenic temporomandibular disorder participated in a therapist-led online group self-management program consisting of three sessions integrating Pain Neuroscience Education, temporomandibular exercises, self-care strategies, and mindfulness. Assessments were conducted at baseline, post-treatment (4 weeks), and 12-month follow-up. Pain intensity at rest and during maximum mouth opening were predefined as primary outcomes. Secondary outcomes included pain-related cognitions, pain neurophysiology knowledge, psychological symptoms, central sensitization, jaw function, oral health-related quality of life, and oral habits. Changes over time were analysed using repeated-measures analysis of variance.
Results:
A total of 107 participants were enrolled. Significant and sustained reductions were observed in temporomandibular pain during maximum mouth opening, whereas pain at rest did not change significantly. Significant, large, and sustained improvements were found in kinesiophobia, pain catastrophizing, and pain neurophysiology knowledge. Moderate short-term reductions were observed in anxiety, depression, and insomnia, but these were not maintained at 12 months. No significant changes were found in central sensitization, jaw functional limitation, oral health-related quality of life, or oral habits.
Conclusions:
A brief online Pain Neuroscience Education-informed self-management program was associated with durable improvements in movement-evoked temporomandibular pain and pain-related cognitions in individuals with fibromyalgia and myogenic temporomandibular disorder.
Clinical Implications:
A brief online self-management program incorporating Pain Neuroscience Education appears feasible for this population and may contribute to improvements in movement-evoked pain and pain-related cognitions. Controlled studies are needed to determine its clinical effectiveness.
