Gluten-Free Diet Reduces Pain in Women with Myofascial Pain in Masticatory Muscles: A Preliminary Randomized Controlled Trial.

Juliana Araújo Oliveira Buosi, Sandra Maria Abreu Nogueira, Morgana Pinheiro Sousa, Carla Soraya Costa Maia, Romulo Rocha Regis, Karina Matthes de Freitas Pontes, Leonardo Rigoldi Bonjardim, Lívia Maria Sales Pinto Fiamengui

Journal: Journal of oral & facial pain and headache 2021;35(3):199-207

PMID: 34609378

Abstract

AIMS

To evaluate the efficacy of a gluten-free diet (GFD) as a treatment modality for pain management in women with chronic myofascial pain in masticatory muscles.

METHODS

In this randomized controlled trial, 39 female subjects were evaluated according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and divided into three groups: a healthy group (n = 14; mean ± SD age = 34.57 ± 9.14 years); a control group (n = 12; age = 31.50 ± 7.38 years); and an experimental group (n = 13; age 30.00 ± 7.64 years). The outcome variables were: pain intensity, mechanical pain threshold (MPT), and pressure pain threshold (PPT). MPT was performed on the masseter muscle, and PPT was performed on both the masseter and anterior temporalis muscles. A nutritionist prescribed a 4-week individualized GFD for the experimental group. The healthy group was analyzed only initially, whereas the control and experimental groups were analyzed again after 4 weeks. Data were subjected to statistical analysis with a significance level of 5% (one-way analysis of variance followed by Bonferroni post hoc, paired t, Wilcoxon signed rank, Kruskal-Wallis/Dunn, and Pearson chi-square tests).

RESULTS

Participants who underwent a GFD showed reduction in pain intensity (P = .006) and an increase in PPT of the masseter (P = .017) and anterior temporalis (P = .033) muscles. The intervention did not influence the MPT of the masseter muscle (P = .26). In contrast, the control group showed no improvement in any parameter evaluated.

CONCLUSION

GFD seemed to reduce pain sensitivity in women with TMD and may be beneficial as an adjunctive therapy for chronic myofascial pain in masticatory muscles; however, further studies in the fields of orofacial pain and nutrition are required.

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