Chronic Pain
Study register · detail RCT (parallel, doppelblind) · Chronic Pain · 2019

Myorelaxant Effect of Transdermal Cannabidiol Application in Patients with TMD: A Randomized, Double-Blind Trial.

Clear benefit GRADE Moderate 83 citations
Samplen = 60 Pat.
Duration14 days
ControlPlacebo formulation
EndpointsEMG masseter activity
Blindingdoppelblind
DesignRCT (parallel, doppelblind)
Cannabinoidcbd
Routetopisch
Key finding

Transdermal CBD lowered masseter activity and myofascial pain considerably more than placebo.

Summary

RCT (n=60, double-blind, parallel, TMD myofascial pain); transdermal CBD vs. placebo over 14 days; VAS pain intensity reduced by >70,2% in the CBD group vs. 9,81% in the placebo group; sEMG masseter activity significantly decreased (11% right, 12,6% left in the CBD group vs. <0,3–3,3% placebo).

P
PopulationPatients with myofascial pain (TMD, RDC/TMD Ia/Ib), mean age ~23 years, n=60
I
InterventionTransdermal CBD formulation, applied topically to the masseter 2× daily, 14 days
C
ControlPlacebo formulation (topical, identical schedule)
O
OutcomesEMG masseter activity significantly reduced in the CBD group (11% right, 12,6% left) vs. placebo (0,23% right, 3,3% left); VAS pain reduction 70,2% (CBD) vs. 9,81% (placebo)
Confidence in the evidence
Moderate

The third of four GRADE levels, the effect estimate is probably reliable.

Downgraded for
Imprecision
Quality profile
Sample size
Blinding Double-blind
Effect size Clear benefit
Citations / year
Authors
Nitecka-Buchta A, Nowak-Wachol A, Wachol K, Walczyńska-Dragon K, Olczyk P, Batoryna O, Kempa W, Baron S.
DOI 10.3390/jcm8111886
Design: RCT (parallel, doppelblind)
Share
Abstract
(1) Background: The healing properties of cannabidiol (CBD) have been known for centuries. In this study, we aimed to evaluate the efficiency of the myorelaxant effect of CBD after the transdermal application in patients with myofascial pain. (2) Methods: The Polish version of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD Ia and Ib) was used. A total of 60 patients were enrolled in the study and were randomly divided into two groups: Group1 and Group2. The average age in Group1 was 23.2 years (SD) = 1.6 years) and in Group2, it was 22.6 years (SD = 1.86). This was a parallel and double-blind trial. Group1 received CBD formulation, whereas Group2 received placebo formulation for topical use. The masseter muscle activity was measured on days 0 and 14, with surface electromyography (sEMG) (Neurobit Optima 4, Neurobit System, Gdynia, Poland). Pain intensity in VAS (Visual Analogue Scale) was measured on days 0 and 14. (3) Results: in Group1, the sEMG masseter activity significantly decreased (11% in the right and 12.6% in the left masseter muscles). In Group2, the sEMG masseter activity was recorded as 0.23% in the right and 3.3% in the left masseter muscles. Pain intensity in VAS scale was significantly decreased in Group1: 70.2% compared to Group2: 9.81% reduction. Patients were asked to apply formulation twice a day for a period of 14 days. (4) Conclusion: The application of CBD formulation over masseter muscle reduced the activity of masseter muscles and improved the condition of masticatory muscles in patients with myofascial pain.

The impediment to action advances action. — Marcus Aurelius