Multidisciplinary approach with traditional and complementary therapies in patients with temporomandibular disorders and fibromyalgia: a randomized study

Aim: Fibromyalgia (FM) is a chronic musculoskeletal pain syndrome characterized by widespread musculoskeletal pain and tenderness at specific anatomic sites (tender points. The association of FM with other musculoskeletal comorbidities, such as Temporo-Mandibular Dysfunction (TMD) is common. The randomized study was aimed at evaluate the analgesic effect of Okada Purifying Therapy (OPT) when administered in combination with duloxetine in patients with Temporo-Mandibular Disorders (TMDs) and Fibromyalgia (FM). Okada PurifyingTherapy (OPT) is a practice of alternative medicine in which patients are treated with a technique that uses bioenergy, or qi produced by practitioner’s palm, without physically touching. Methods: Patients with TMDs visited at Policlinico Umberto I, Head-neck Department, Rome who were diagnosed with FM were selected for the study between 2010 and 2015. The final sample was composed of 31 patients: 15 patientswere treated only with duloxetine for 8 weeks (Group I or Control Group) and 16 patients received also OPT treatment (Group II). All OPT session was performed by a single well-trained certified practitioner for a period of 50 minutes. Cranio-mandibular index, total tenderness score, Brief Pain Inventory Modified Short Form, Fibromyalgia Impact Questionnaire, Beck Depression Inventory and State and Trait Anxiety Inventory-1 were assessed at the beginning (T0), during the course (T1) and after therapy (T2). Descriptive and inferential statistics were performed. Results: In all the outcomes analyzed, both groups showed an improvement in particular between T0 and T1 and a progressive decrease of it between T1 and T2. No differences in any of the selected outcomes were observed between the two groups during the trial. No side effects due to the drug were registered in group II compared to group I. Conclusion: The additional complementary treatment (OPT) does not seem to give the patients with TMDs and FM any further benefit but it could improve pharmacological tolerability of the traditional drug therapy. in further investigations the aim could be to administer Okada therapy alone in patients who do not accept pharmacological therapy with duloxetine, comparing results with a control group with a placebo therapy.