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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.

Last updated: Jul 31, 2026•1 RCTs•📖 Read as article →

Evidence Score

Evidence Score42/100
Human RCT★★☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Effects of Aerobic Exercise and Strength Training on Nociplastic Pain and Clinical Features in Temporomandibular Disorders With Myalgia: A Randomized-Controlled Trial.

observational

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 · Journal of oral rehabilitation (2026)

Participants: N/A
Duration: 6 weeks intervention, 12-week follow-up
Intervention: High-intensity interval aerobic exercise (stationary bike) added to 12 sessions of physical therapy (education, manual therapy, jaw/neck exercises) over 6 weeks
Outcome: Central sensitization-related symptoms (CSI), pain intensity (VAS), pressure pain thresholds (PPT), muscle strength, anxiety, sleep quality, kinesiophobia
Effect Size: N/A
Population: Patients with temporomandibular disorders (TMD) and nociplastic pain (N=43)

Result:

PubMed: 42517680DOI: 10.1111/joor.70278

Mechanism Graph

Aerobic exercise enhances tissue oxygenation
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Improves pain inhibition pathways
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Reduces central sensitization
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Result: Decreased pain and improved clinical features

Limitations

  • ⚠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.

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References

  1. 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
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.