Efficacy of Myofascial Release Therapy and Related Soft-Tissue Techniques for Pain in Temporomandibular Disorders: A Systematic Review of Randomized Controlled Trials.

OBJECTIVE

This systematic review aimed to evaluate the effectiveness of myofascial release therapy (MFR) on pain in patients affected by myogenous temporomandibular disorders (TMD).

METHODS

PubMed, Scopus, and Web of Science were searched from inception until 31 January 2026, to identify RCTs including patients affected by TMD as participants, MFR therapy as intervention, and pain intensity as outcome. The risk of bias of studies was assessed with the Version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of evidence.

RESULTS

Out of 857 articles, 7 studies were included. All subjects had a diagnosis of TMD performed according to the RDC/TMD or DC/TMD. The rehabilitation period ranged from 10 days to 5 weeks. Treatment frequency ranged from a minimum of one session per week to a maximum of 3 sessions per week. Medium/long-term follow-up was performed in four studies. The Cochrane RoB 2 tool showed that zero studies had a low risk of bias, six had some concerns, and one had a high risk of bias. The GRADE assessment showed a low certain of evidence for pain reduction and mouth function, and a very low certain of evidence in improving QoL.

CONCLUSIONS

MFR seemed to reduce pain and improve mouth function in patients with myogenous TMD. However, when benchmarked against established clinical thresholds, clinically meaningful efficacy (surpassing the 15-22 mm MCID) is only supported by a subset of the included trials. In this context, MFR could be considered as part of a multidisciplinary approach for patients with TMD. More rigorous isolated-MFR trials are needed to better characterize the efficacy of MFR in patients affected by myogenous TMD.