Multimodal Physiotherapeutic Treatment in Adolescents With Temporomandibular Disorders: A Randomised Controlled Trial.

Temporomandibular disorders in teenagers are often overlooked, and there is little clarity about which physiotherapy approach actually helps at this age. This trial compared two delivery formats of the same multimodal treatment, counselling, manual therapy, and exercises, given either in person or remotely, in a small group of 26 adolescents with these disorders, following them from baseline through three weekly sessions and a 30-day follow-up. Both formats led to improvements over time in pain ratings, jaw movement range, and mandibular function, but the in-person group showed a statistically significant improvement in one measure of muscle oxygenation at rest and better pressure pain thresholds, though that pain threshold difference did not reach statistical significance. The finding is interesting because it suggests remote physiotherapy may offer comparable benefits for pain and function even if in-person care shows an edge for some muscle-level measures.

With only 26 participants split between two groups, these results should be read as preliminary rather than conclusive.

If you are a teenager dealing with jaw pain or clicking, known medically as temporomandibular disorders, this study looked at whether physiotherapy delivered face-to-face works differently than the same treatment delivered remotely, over video sessions. Both groups, whether they saw a therapist in person or worked with them online, reported improvement in pain, could open their mouths more easily, and had better jaw function after three weekly sessions and again a month later.

The main difference showed up in a muscle oxygenation measurement in the jaw muscle, which improved more with in-person treatment, and there was a promising but not statistically confirmed difference favoring in-person care for pain sensitivity at pressure points. This is encouraging for anyone who cannot easily access in-person physiotherapy, since telerehabilitation seemed to help too. However, this was a small study with just 26 teenagers total, so these findings give an early signal rather than a firm answer, and larger studies would help confirm whether remote and in-person care truly work equally well for jaw pain in adolescents.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This trial addresses a genuinely underexplored question: whether telerehabilitation can serve as an adequate substitute for in-person multimodal treatment of temporomandibular disorders in adolescents, a population where TMD management is often neglected. The protocol, comprising counselling, manual therapy, and exercise, was delivered identically in structure across both formats, with outcomes assessed via near-infrared spectroscopy for muscle oxygenation, the Numerical Rating Scale for pain, an algometer for pressure pain threshold, and standard measures of jaw range of motion and mandibular function. The decisive contrast was in the in-person group's statistically significant improvement in tissue saturation index of the masseter at rest, alongside a clinically notable but not statistically significant improvement in pressure pain threshold for the masseter and temporal muscles.

Within both groups, significant improvements were observed across all time points for pain, range of motion, and mandibular function, but this within-group change does not establish that one format outperformed the other on those measures, since between-group superiority was only demonstrated for peripheral oxygenation and pain threshold trends. With only 26 adolescents randomised between two arms, this remains a small trial, and the isolated statistical significance in one physiological measure could reflect a chance finding given the limited sample. The abstract does not report on longer-term outcomes beyond 30 days or on adverse events, so applicability to sustained TMD management in this age group stays uncertain.