Effect of Scapular Stabilization Exercises on Myofascial Pain Dysfunction Syndrome: A Randomized Controlled Trial
DOI:
https://doi.org/10.48165/ajm.2026.9.02.06Keywords:
Myofascial Pain, Dysfunction Syndrome, Scapular Stabilization, Exercises Temporomandibular, Disorders PhysiotherapyAbstract
Background: Myofascial Pain Dysfunction Syndrome (MPDS) is a common musculoskeletal disorder affecting the masticatory muscles and temporomandibular joint. Altered posture, cervical dysfunction, and impaired scapular stability have been associated with the persistence of pain and functional limitations. Scapular stabilization exercises may improve postural alignment, reduce muscle overload, and alleviate symptoms in individuals with MPDS. Aim: To evaluate the effect of scapular stabilization exercises on pain intensity, mandibular function, and quality of life in patients with MPDS. Materials and Methods: This prospective interventional study included 40 patients diagnosed with MPDS, randomly allocated into two groups (n = 20 each). Group A received conventional therapy, including jaw exercises, moist heat therapy, and patient education. Group B received conventional therapy combined with a structured scapular stabilization exercise program for six weeks. Outcome measures included pain intensity using the Visual Analog Scale (VAS), maximum mouth opening (MMO), pressure pain threshold (PPT), and jaw functional limitation assessed using the Jaw Functional Limitation Scale (JFLS). Assessments were performed at baseline and after six weeks. Statistical analysis was performed using paired and independent t-tests, with a significance level of p < 0.05. Results: Both groups demonstrated significant improvement after treatment; however, Group B showed significantly greater reductions in pain intensity and functional limitation, along with greater improvements in maximum mouth opening and pressure pain threshold compared with Group A (p < 0.05). Conclusion: Incorporating scapular stabilization exercises into conventional management of MPDS provides superior improvements in pain reduction, jaw function, and overall functional outcomes compared with conventional therapy alone. These findings support the integration of postural and scapular rehabilitation into the multidisciplinary management of patients with MPDS.
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References
Alshammari, S. S., Amin, S., Siddiqui, A. A., Malik, Y. R., Alshammari, A. F., & Amin, J. (2023). An evidence-based treatment of myofascial pain and myofascial trigger points in the maxillofacial area: A narrative review. Cureus, 15(12), e49987. https://doi.org/10.7759/cureus.49987
Graff-Radford, S. B. (2004). Myofascial pain: Diagnosis and management. Current Pain and Headache Reports, 8(6), 463–467.
Graff-Radford, S. B. (2001). Regional myofascial pain syndrome and headache: Principles of diagnosis and management. Current Pain and Headache Reports, 5(4), 376–381.
Giamberardino, M. A., Affaitati, G., Fabrizio, A., & Costantini, R. (2011). Myofascial pain syndromes and their evaluation. Best Practice & Research Clinical Rheumatology, 25(2), 185–198. https://doi.org/10.1016/j.berh.2011.01.002
Shetty, S. K., Katageri, A. I., Shetty, R., Ragher, M., & Prabhu, U. M. (2025). Evaluation of the effect of temporomandibular joint disorders on craniocervical posture: A cross-sectional study. The Journal of Indian Prosthodontic Society, 25(4), 327–333.
Espinosa de Santillana, I. A., García-Juárez, A., Rebollo-Vázquez, J., & Ustarán-Aquino, A. K. (2018). Frequent postural alterations in patients with different types of temporomandibular disorders. Revista de Salud Pública, 20, 384–389.
Garstka, A. A., Brzózka, M., Bitenc-Jasiejko, A., Ardan, R., Gronwald, H., Skomro, P., & Lietz-Kijak, D. (2022). Cause effect relationships between painful TMD and postural and functional changes in the musculoskeletal system: A preliminary report. Pain Research and Management, 2022, Article 4113854. https://doi.org/10.1155/2022/4113854
Gatchel, R. J., Peng, Y. B., Peters, M. L., Fuchs, P. N., & Turk, D. C. (2007). The biopsychosocial approach to chronic pain:
Scientific advances and future directions. Psychological Bulletin, 133 (4), 581–624. https://doi.org/10.1037/0033-2909.133.4.581
Khan, A. A., Srivastava, A., Passi, D., Devi, M., Chandra, L., & Atri, M. (2018). Management of myofascial pain dysfunction syndrome with meditation and yoga: Healing through natural therapy. National Journal of Maxillofacial Surgery, 9(2), 155–159. https://doi.org/10.4103/njms.NJMS_15_17
Page, P., Frank, C. C., & Lardner, R. (2010). Assessment and treatment of muscle imbalance: The Janda approach. Human Kinetics.
Tang, L., Chen, K., Ma, Y., Huang, L., Liang, J., & Ma, Y. (2021). Scapular stabilization exercise based on the type of scapular dyskinesis versus traditional rehabilitation training in the treatment of periarthritis of the shoulder: Study protocol for a randomized controlled trial. Trials, 22(1), 713. https://doi.org/10.1186/s13063-021-05696-2
Çelik, G., & Koldaş Doğan, Ş. (2025). Effectiveness of scapular stabilization exercises on pain, postural alignment, and functional capacity in patients with myofascial pain syndrome: A retrospective study. Kastamonu Medical Journal, 5(4), 243–247.
Kim, S. E., Lee, H. O., Kim, J. S., & Kim, S. Y. (2005). The comparison of effectiveness of stretching exercise and stabilizing exercise for patients with myofascial pain syndrome at the shoulder girdle. Journal of Korean Academy of Orthopedic Manual Physical Therapy, 11(2), 49–61.
Park, S. I., Choi, Y. K., Lee, J. H., & Kim, Y. M. (2013). Effects of shoulder stabilization exercise on pain and functional recovery of shoulder impingement syndrome patients. Journal of Physical Therapy Science, 25(11), 1359–1362. https://doi.org/10.1589/jpts.25.1359
Mendhe, S., & Borkar, P. (2021). Effect of scapular stabilization exercise program on neck disability and forward head posture among computer operators. Indian Journal of Physiotherapy and Occupational Therapy, 15(4), 68–72.
Yildiz, T. I., Turgut, E., & Duzgun, I. (2018). Neck and scapula focused exercise training on patients with nonspecific neck pain: A randomized controlled trial. Journal of Sport Rehabilitation, 27 (5), 403–412. https://doi.org/10.1123/jsr.2017-0024
