Extracorporeal shock wave therapy for temporomandibular disorders: efficacy on pain, maximal mouth opening, and dysfunction-a meta-analysis of randomized controlled trials.
Li Chen, Yuan Luo, Liyue Zhang and 3 others
ESWT reduced jaw pain by 1.28 points on a 0-to-10 scale and widened mouth opening by 3.76 mm versus controls, but did not improve the overall jaw dysfunction score.
The exact benefit varies with the protocol and the patient.
Key findings
1ESWT reduced pain by 1.28 points on a 0-to-10 VAS scale compared with controls across 17 studies and 1,036 patients (P < 0.00001).
2ESWT improved maximal mouth opening by 3.76 mm compared with controls across 12 studies and 823 patients (P = 0.0010).
3No significant difference in the jaw dysfunction index was found between ESWT and controls across 13 studies and 850 participants (P = 0.22).
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How it was doneWhat they foundWhat it means for PTs
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What it does not show
The studies varied enormously in their ESWT settings (energy level, number of shocks, treatment duration) and in what the control group received, so the pooled numbers are an average across very different protocols rather than a single tested dose. Twelve of the 18 trials were published in Chinese and most were single-centre, so the results may not generalise to patients in other countries or healthcare systems. Most studies did not report how patients were assigned to groups or whether patients and therapists were blinded, so the risk of bias is unclear for the majority of the evidence. No study provided long-term follow-up data, so it is unknown whether the pain and mouth-opening benefits last beyond the treatment period. Three of the 18 studies were rated as high risk of bias in at least one domain.
Declared interests
The authors declared that no financial support was received for the work or its publication.
The easy way to misread this
Do not read the pain and mouth-opening improvements as proof that ESWT is a complete treatment for TMD — the composite jaw dysfunction score, the broadest measure of how well the jaw actually works, showed no significant difference between groups (P = 0.22). Also, the studies used very different ESWT settings and control conditions, so the exact benefit for a given patient is uncertain, and most of the evidence comes from single-centre Chinese trials.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →