ABSTRACT
Trigger point injections with different solutions have been studied mainly with regard to the management of myofascial pain (MFP) patient management. However, few studies have analyzed their effect in a chronic headache population with associated MFP. The purpose of this study was to assess if trigger point injections using botulinum toxin, lidocaine, and dry-needling injections for the management of local pain and associated headache management. Forty-five (45) myofascial pain patients with headaches that could be reproduced by activating at least one trigger point, were randomly assigned into one of the three groups: G1, dry-needling, G2, 0.25% lidocaine, at 0.25% and G3 botulinum toxin and were assessed during a 12 week period. Levels of pain intensity, frequency and duration, local postinjection sensitivity, obtainment time and duration of relief, and the use of rescue medication were evaluated. Statistically, all the groups showed favorable results for the evaluated requisites (p < or = 0.05), except for the use of rescue medication and local post injection sensitivity (G3 showed better results). Considering its reduced cost, lidocaine could be adopted as a substance of choice, and botulinum toxin should be reserved for refractory cases, in which the expected effects could not be achieved, and the use of a more expensive therapy would be mandatory.
Subject(s)
Anesthetics, Local/administration & dosage , Botulinum Toxins/administration & dosage , Headache/drug therapy , Lidocaine/administration & dosage , Myofascial Pain Syndromes/drug therapy , Neuromuscular Agents/administration & dosage , Headache/classification , Headache/etiology , Humans , Injections, Intramuscular , Myofascial Pain Syndromes/complications , Needles , Statistics, Nonparametric , Treatment OutcomeABSTRACT
Trigger point injections with different solutions have been studied mainly with regard to the management of myofascial pain (MFP) patient management. However, few studies have analyzed their effect in a chronic headache population with associated MFP. The purpose of this study was to assess if trigger point injections using lidocaine associated with corticoid would be better than lidocaine alone, as in comparison with dry-needling in for the management of local pain and associated headache management. Forty-five (45) myofascial pain patients with headaches that could be reproduced by activating at least one trigger point, were randomly assigned into one of the three groups: G1, dry-needling, G2, 0.25% lidocaine, at 0.25% and G3, 0.25% lidocaine at 0.25% associated with corticoid, and were assessed during a 12 week period. Levels of pain intensity, frequency and duration, local post-injection sensitivity, obtainment time and duration of relief, and the use of rescue medication were evaluated. Statistically, all three groups showed favorable results for the evaluated requisites (p < or = 0.05), but only for post-injection sensitivity did the association of lidocaine with corticoid present the best results and ingestion of rescue medication.
Subject(s)
Anesthetics, Local/administration & dosage , Anti-Inflammatory Agents/administration & dosage , Dexamethasone/analogs & derivatives , Glucocorticoids/administration & dosage , Headache/drug therapy , Lidocaine/administration & dosage , Needles , Temporomandibular Joint Dysfunction Syndrome/complications , Adolescent , Adult , Aged , Analgesics, Non-Narcotic/therapeutic use , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Dexamethasone/administration & dosage , Drug Combinations , Female , Follow-Up Studies , Headache/etiology , Humans , Ibuprofen/therapeutic use , Injections, Intramuscular , Male , Middle Aged , Pain Measurement , Time FactorsABSTRACT
A associação entre distúbios do sono e dor é uma queixa comum em pacientes portadores de dores orofaciais. Dentre os distúrbios do sono, o bruxismo e a apnéa são comprometimentos importantes que devem ser identificados e tratados. O intuito deste trabalho é revisar a literatura pertinente, ressaltando a etiologia, o diagnóstico e as modalidades terapêuticas empregadas no tratamento desses pacientes
Subject(s)
Sleep Bruxism/etiology , Sleep Bruxism/therapy , Sleep Bruxism , Sleep Apnea Syndromes/etiology , Sleep Apnea Syndromes/therapyABSTRACT
Cem questionários foram distribuídos em consultórios odontológicos da cidade de Ribeirão Preto - SP, com ointuito de detectar a porcentagem de profissionais que tratam as DTMs, bem como os tipos e as características dos tratamentos empregados. Os resultados obtidos mostraram, entre outras coisas, que 98 por cento dos entrevistados já receberam pacientes com DTMs, 80 por cento deles acreditam na eficiência de métodos conservadores, embora muitos ainda julguem que as terapias definitivas sejam mais indicadas. Concluiu-se que ainda predominam controvérsias a respeito da etiologia e tratamento das DTMs e que todo dentista deve estar atualizado e baseado em princípios científicos
Subject(s)
Dental Occlusion , Temporomandibular Joint , Temporomandibular Joint Dysfunction SyndromeABSTRACT
Cem pacientes, divididos em grupos, através de um índice anamnésico, (grupo 1 - ausência de DTM; grupo 2 - DTM leve; grupo 3 - DTM moderada e grupo 4 - DTM severa), responderam à Escala de Reajustamento Social, a fim de se determinar os eventos ocorridos em suas vidas, durante os últimos 12 meses. A análise estatística dos dados mostrou que a média dos eventos para o grupo 1 foi menor que aquelas observadas para os grupos 2, 3 e 4, iguais estatisticamente. Conclui-se, entäo, que fatores da vida e estresse emocional, estäo relacionados com as DTMs
