Effectiveness of physiotherapy for temporomandibular disorders: a systematic review of pain and functional outcomes

Scand J Pain. 2026 Mar 11;26(1). doi: 10.1515/sjpain-2025-0073. eCollection 2026 Jan 1.

ABSTRACT

BACKGROUND: Temporomandibular disorders (TMD) often cause pain and limited mandibular function. Physiotherapy is commonly used, but its effectiveness compared to other treatments remains unclear.

OBJECTIVE: To assess the effectiveness of physiotherapy in adults with TMD compared to no treatment, placebo, and other conservative or pharmacological therapies. It also assessed commonly used outcome measures in clinical trials.

METHODS: A systematic review of randomized controlled trials (RCTs) published between 2020 and 2025 was conducted in PubMed and MEDLINE. Eligible studies included adults with TMD treated with physiotherapy. Outcomes focused on pain, mandibular mobility, function, and quality of life. Methodological quality was assessed using the PEDro scale.

RESULTS: From 73 records, 51 RCTs were included. Physiotherapy - particularly manual therapy, therapeutic exercise, and laser therapy - was generally associated with reductions in pain and improvements in jaw mobility and function. Compared with no treatment or placebo, physiotherapy showed superior outcomes in most studies, and it was at least comparable to other conservative or pharmacological approaches. Nonetheless, heterogeneity of interventions, small sample sizes, reliance on subjective outcome measures, and frequent methodological shortcomings limited comparability and precluded meta-analysis.

CONCLUSIONS: Physiotherapy provides short-term benefits in adults with TMD, especially in reducing pain and improving function. More robust research with larger samples, consistent diagnostic approaches, and the use of objective measures is required to provide stronger evidence for clinical decision-making.

PMID:41805560 | DOI:10.1515/sjpain-2025-0073