Adding aerobic exercise to physical therapy reduces pain and central sensitization-related symptoms in temporomandibular disorder patients with nociplastic pain
In a randomized-controlled trial of 43 TMD patients with nociplastic pain, adding high-intensity interval aerobic exercise (stationary bike) to physical therapy significantly reduced central sensitization symptoms (-9.5; p=0.04), pain intensity (-23.2; p=0.04), kinesiophobia (-4.1; p=0.04), and sleep impairment (-3.8; p=0.01) at 6 weeks. Pain reductions persisted at 12-week follow-up (VAS -26.2; p=0.04). Strength training only reduced kinesiophobia at follow-up.
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Adding aerobic exercise to physical therapy reduces pain and central sensitization-related symptoms in temporomandibular disorder patients with nociplastic pain The current body of evidence comprises 1 study, including 1 randomized controlled trial. EvidenceHub rates the overall confidence at 42/100 (low).
The Claim
Adding aerobic exercise to physical therapy reduces pain and central sensitization-related symptoms in temporomandibular disorder patients with nociplastic pain
This conclusion is most relevant to: Patients with temporomandibular disorders (TMD) and nociplastic pain (N=43).
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Effects of Aerobic Exercise and Strength Training on Nociplastic Pain and Clinical Features in Temporomandibular Disorders With Myalgia: A Randomized-Controlled Trial. (Journal of oral rehabilitation, 2026) —
How It Works
The proposed biological pathway:
- ▸Aerobic exercise enhances tissue oxygenation
- ▸Improves pain inhibition pathways
- ▸Reduces central sensitization
- ▸Result: Decreased pain and improved clinical features
Who Might Benefit
Evidence fit by population:
- ▸Patients with temporomandibular disorders (TMD) and nociplastic pain (N=43)
Recommended Dose
N/A
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Small sample size (N=43) with uneven group sizes (PT+ST n=13)
- ▸No long-term follow-up beyond 12 weeks
Frequently Asked Questions
What type of aerobic exercise was used?▼
High-intensity interval aerobic exercise on a stationary bike.
How long was the intervention period?▼
6 weeks, with 12 sessions of physical therapy plus exercise.
Did strength training also reduce pain?▼
No, strength training only reduced kinesiophobia at 12-week follow-up, not pain or central sensitization.
What is nociplastic pain?▼
Pain arising from altered nociception despite no clear tissue damage, often involving central sensitization.
References
- 1.Dantony F, Romero-Rodríguez D, Blanco D, Zárate-Tejero CA, Climent-Sanz C, Pérez-Mánen C, Màcia-Martí A, Felipe-Spada N, Carrasco-Uribarren A. “Effects of Aerobic Exercise and Strength Training on Nociplastic Pain and Clinical Features in Temporomandibular Disorders With Myalgia: A Randomized-Controlled Trial..” Journal of oral rehabilitation, 2026. PMID: 42517680 DOI: 10.1111/joor.70278