Feasibility and short-term outcomes of a shamanic treatment for temporomandibular joint disorders.

CONTEXT: Temporomandibular joint disorders (TMDs) are chronic, recurrent, non-progressive pain conditions affecting the jaw and face. Patients least likely to respond to allopathic treatment are those with the most marked biological responsiveness to external stressors and concomitant emotional and psychosocial difficulties. These characteristics describe individuals who are "dispirited" and may benefit from shamanic healing, an ancient form of spiritual healing.

OBJECTIVE

This phase 1 study tested feasibility and safety of shamanic healing for TMDs.

DESIGN

Participants were randomized to 1 of 4 shamanic practitioners and attended 5 shamanic healing sessions. Self-reported pain and disability were recorded at baseline and each treatment visit and at 1, 3, 6, and 9-month follow-ups. Participants also were clinically evaluated at baseline and end of treatment. In-depth interviews, part of our mixed methods design, were conducted at baseline and end of treatment to evaluate acceptability and nonclinical changes associated with treatment.

SETTING

Portland, Oregon.

PATIENTS OR OTHER

PARTICIPANTS

Twenty-three women with diagnosed TMDs.

INTERVENTION: Shamanic treatment carried out during 5 treatment visits.

MAIN OUTCOME MEASURES: Change from baseline to posttreatment in diagnosis of TMDs by Research Diagnostic Criteria (RDC) exam and participant self-ratings on the "usual" pain, "worst" pain, and functional impact of TMDs subscales of the RDC Axis II Pain Related Disability and Psychological Status Scale. This paper reports on outcomes at end of treatment.

RESULTS

This study demonstrated the feasibility and acceptability of clinical trials of shamanic healing. The mean of usual pain went from 4.96 to 2.70, P<.0001; worst pain from 7.48 to 3.60, P<.0001, and functional impact of TMDs from 3.74 to 1.15, P<.0052. Only 4 women were clinically diagnosed with TMDs at the end of treatment.