International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Vol. 9, Issue 1, pp: (121-125), Month: April 2021 - September 2021, Available at: www.researchpublish.com
Effect of Pain Neuroscience Education on Pain in Trismus Patient: Case Report Dr Sanket Mungikar1, Dr. Swara Sanklecha2, Dr. Santosh Dobhal3 1
Associate professor, MGM institute of physiotherapy, Aurangabad. 2
MPT 2nd year, MGM institute of physiotherapy, Aurangabad
3
Associate professor, MGM institute of physiotherapy, Aurangabad.
1
Email id- mungikarphysio@gmail.com, 2Email id:- 14swarasanklecha@gmail.com, 3Email id:- ptsantosh07@gmail.com
Abstract: Background: This is a case report. Trismus (restricted mouth opening) is a symptom that affects more than one third (38–45%) of patients treated with radiotherapy for head and neck cancer (HNC). Trismus leads to difficulties with chewing, swallowing, pain and poor oral hygiene. Furthermore, trismus can have a negative impact on health-related quality of life (HRQL). The effect of pain neuroscience education has been shown to be effective in reducing pain improving function and lowering fear and catastrophization. Case presentation: patient was 46-year-old man, clerk by occupation. He had pain at jaw and difficulty in opening mouth since 4 years. More pain on the left side of face. The pain was continuous, chronic and stabbing pain which was aggravated by opening and chewing of mouth. He was having pain at neck with tightness of upper trapezius, levator scapulae and sclene muscles. He is having sever restricted range of motion of temporomandibular joint and somewhat restriction in cervical range of motion, after his last radiation session for tongue. In this study, intervention given was electrotherapy, manual therapy, MFR and focused more on pain neuroscience education [PNE]. After two month of physiotherapy treatment pre and post outcome for pain on visual analogue scale and range were measured using maximum interincisal distance [MID]. Conclusion: We conclude that, exercises therapy, electrotherapy and PNE is effective in terms of pain and improving symptoms of patients with trismus. So this intervention is indicated in long term management of radiation induced trismus. Key words: Trismus, PNE, MFR, exercises therapy, electrotherapy.
1. INTRODUCTION Trismus (restricted mouth opening) affects more than one third (38–45%) of patients treated with radiotherapy for head and neck cancer (HNC)2. Trismus leads to difficulties with chewing, swallowing, pain and poor oral hygiene. It can have a negative impact on health-related quality of life (HRQL). The consequences of temporomandibular joint dysfunction will be pain, limitation of mouth opening, functional disability and poor quality of life (Qol) 3. The number of patients suffering from temporomandibular joint dysfunction (TMD) has been increased dramatically. It has been reported that 8 out of 10 patients seek health care primarily from a dentist complaining of symptoms that are diagnosed as bruxism or TMD. TMD is known as a group of disorders that affect the temporomandibular joint (TMJ), the masticatory system, or both, and may even extend to involve the surrounding related structures 4. The Pain is a natural occurrence in humans and is necessary for survival. However, coping with pain is not common and generally culminates in finding help with suffering5.Pain is a strong driving factor that drives the patient's behavioural treatment. For patients with LBP, multiple educational methods are promoted, including biomechanical back school style of education, evidence-based guideline training, cognitive behavioural therapy, and neuroscience education 6.
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