RU2667618C1 - Method for treatment of patients with pain-dysfunction syndrome of temporomandibular joint - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, dentistry, reflexology and medical rehabilitation and can be used to treat patients with pain-dysfunction syndrome of the temporomandibular joint (TMJ). Perform reflex-medication effect on biologically active points (BAP). After treatment with an antiseptic solution, a solution of an antihomotoxic preparation of Traumeel 0.2–0.6 ml per one point pre-dialed into a syringe with a needle for pharmacopuncture or mesotherapy is injected into a projection of the BAP selected with regard to the location of the pain zones in the masticatory musculature. In the presence of painful points in the masticatory muscle (m. Masseter), medial and lateral pterygoid muscle, the drug is injected into the points IG 17, 18; E 5, 6, 7; VB 3; TR 22. In the presence of painful points in the anterior and middle portions of the temporal muscle, the drug is injected into the points E 8, VB 4, 5, 6, 7, 13. With pain in the back portion of the temporal muscle, the drug is injected into the points VB 8, 9, 10. First, the drug is injected into the points on the side of the pain zone, then to the symmetrical points on the contralateral side. Treat the TMJ zone with antiseptic solution and with the help of the second syringe prefilled with medication Target T. Inject this drug in a dose 0.2–0.5 ml in BAP VB 2; IG 19; TR 21, 22. Also affects the symmetrical points: first — on the side of the pain, then — on the contralateral side. Number of points used in one procedure is 8–14. Course of treatment is 10–15 procedures, every other day.

EFFECT: method provides a reduction in treatment time, rapid regression of clinical symptoms, no side effects, lengthening remission as a result of pathogenetically justified effects directly on the TMJ, enhancement and accelerating the appearance of the therapeutic effect and prolonging the result.

1 cl, 2 ex

Description

The present invention relates to medicine, namely to reflexology, medical rehabilitation, dentistry and is intended for the treatment of pain dysfunction of the temporomandibular joint with the possibility of using it in medical institutions of various profiles.

According to the results of various studies, temporomandibular joint (TMJ) dysfunction occurs in a population with a frequency of 20% to 76% (V.M. Bezrukov et al., 2002; V.A. Khvatova, 2005; K. Wahlund, 2003) . It should be noted the current tendency to increase this pathology recently. It has been established that it is most often observed in individuals whose work is associated with psycho-emotional stress, women are more often sick - 70-82% (O.N. Nikitin, A.L. Vyazmin, 2007; Yu.A. Petrosov, 1996; V. M. Grinin, Yu.M. Maksimovsky, 1998). A large number of scientific studies suggest that one of the reasons for the development of TMJ dysfunction can be neuromuscular disorders, which are based on psychogenic, endocrine, somatic and other types of pathologies. Pathological dental occlusion is also one of the causes of myofascial pain syndrome in the masticatory muscles. In the future, these disorders can lead to functional and organic changes in the TMJ.

The disease is clinically manifested by pain in the chewing muscles, the presence of pain trigger zones in it, changes in the trajectory of the lower jaw, a decrease or vice versa, excessive opening of the mouth, clicks and crackling in the TMJ, asymmetric movement of the condyles. Chewing pain and dysfunction can cause headaches, tinnitus, and dizziness.

The treatment of painful TMJ dysfunction is multidisciplinary, complex and includes medical, orthopedic, orthodontic, surgical, physiotherapeutic and combined treatment methods.

The methods used for its therapy, mainly medication, often do not bring a positive result, and in some cases cause undesirable side effects. Therefore, the development and widespread introduction in practice of reflex methods of treating these disorders is of great importance. There is evidence showing the high effectiveness of manual therapy and physiotherapy for this pathology. A number of studies have been carried out that have shown the high therapeutic efficacy of pharmacopuncture in various diseases, including vertebrogenic origin. However, data on its use in muscle pain dysfunctions of the temporomandibular joint are very few and scattered. Thus, our proposed method of treatment restores an existing gap in this issue and makes the therapy of this pathology the most effective, while practically safe, easily feasible with a rapidly onset and long-term therapeutic effect. Pharmacopuncture is a procedure in which various drugs are introduced into the projection of acupuncture points, and in some cases to the canonical depth of their occurrence. The mechanism of action of pharmacopuncture is due to the interaction of the drug with acupuncture points, while it is not a simple summation of their therapeutic effects. In addition to creating a drug depot of the drug and prolonged irritation of the points, the action of these two therapeutic methods is potentiated. The choice of points used is carried out according to the general rules of reflexology, taking into account the topics of clinical manifestations. Often, complex antihomotoxic drugs are used as an injectable drug. However, we also did not find data on their use in painful TMJ dysfunction.

A known method of treating painful muscle points in case of osteochondrosis of the spine by administering drugs to painful points, proposed by I. Meshchaninov, O. V. Sinkovskaya and Ustinov E.M. This method consists in the fact that a 0.5% solution of novocaine containing hydrocortisone is used as an injection at a point in a volume of not more than 0.1-0.2 ml at each point in the form of intramuscular, subcutaneous and periarticular injections with a total volume of injection solution per procedure from 1 to 5 ml and the content of hydrocortisone in a dose of 2.5-5.0 mg (patent: RU 2421247 C2).

The disadvantage of this method is: 1) the use for the introduction of exclusively pain (trigger) points in the muscles and periarticular tissues, without taking into account biologically active points, thereby excluding the mechanisms of therapeutic effect of acupuncture itself. 2) The injected drugs have a number of very significant side effects. Novocaine is able to cause a decrease in blood pressure from the central nervous system: periosteal paresthesia, anxiety, delirium, clonic-tonic convulsions; allergic reactions (urticaria, angioedema, bronchospasm, local allergic reactions), up to anaphylactic shock; its use in conjunction with anticoagulants increases the risk of bleeding. The use of hydrocortisone can cause adverse reactions in the form of metabolic disorders; serious complications from the endocrine system; from the cardiovascular system and blood (blood formation and hemostasis); from the musculoskeletal system; from the organs of the gastrointestinal tract; from the skin; from the nervous system and sensory organs; allergic reactions.

The closest in technical essence to the proposed one is a method of treating patients with TMJ pain dysfunction with repeated dental prosthetics, which involves pharmacopuncture of drugs in the form of a solution of a glucocorticoid drug (diprospan) and local anesthetic (ultracain) in the projection of the II or III branches of the trigeminal nerve in depending on the localization of pain. In this case, the points were selected based on the indication of bioactive points using a special apparatus according to the value of the electrical conductivity of each point. Points are selected whose conductivity indices differ in their values, as well as in the asymmetry of these values on the right and left. For one procedure, 2-3 pain points are used, the amount of injected solution is 0.5 ml each (a total of 1.5 ml). Further, ultracaine and α-lipoic acid are introduced 6 times daily at the same points (S.Yu. Maksyukov, M.K. Lukyanchikov, 2009). The disadvantages of this method are: the presence of side effects in the administered drugs, the need for additional equipment to study the electrical conductivity of the points; the use of 2-3 points in one procedure, although it is often necessary to influence a greater number of them, the lack of a therapeutic effect on degenerative changes in the joint itself, the lack of information on therapeutic efficacy in cochleovestibular disorders caused by TMJ dysfunction.

The technical result of the proposed method for the treatment of patients with TMJ pain dysfunction is to increase the effectiveness of treatment, quick regression of clinical symptoms, the absence of undesirable side effects, lengthening the period of remission, the possibility of exposure (if necessary) to a larger number of points, pathogenetically substantiated effect on the TMJ itself.

The specified technical result is achieved by simultaneous exposure to biologically active points with several therapeutic factors, including mechanical irritation of the point, an anti-homotoxic drug, the introduction of which creates its deposition in the localization zone of the pathological process, which has an additional prolonged effect on biologically active points: after palpation determination of the localization of pain zones muscle dysfunction, and treatment with an antiseptic solution of this area on side of the pain and the opposite area, the drug is injected into the syringe of the drug Traumeel in the amount of 2.2 ml, while in the case of pain dysfunction in the chewing muscle (m. Masseter), the medial and lateral pterygoid muscles, the drug is injected into biologically active points, selected from: IG 17, 18; E 5, 6, 7; VB 3; TR 22; in the presence of pain in the front and middle portions of the temporal muscle, Traumeel is administered at point E8; VB 4, 5, 6, 7, 13, in the case of the location of pain in the posterior portion of the temporal muscle, the drug is administered at points VB 8, 9, 10; then the TMJ zone is treated with an antiseptic solution and a second syringe is taken with the drug Target T, previously collected into it, in an amount of 2.2 ml and this drug is injected into biologically active points: VB 2; IG 19; TR 21, 22. First, the injection is at a point

located on the side of the pain, and then to a symmetrical point on the opposite side.

The drug Traumeel is administered in a volume of 0.2-0.6 ml per point, the drug Target T is administered in a dose of 0.2-0.5 ml per point. The number of points used in one procedure is from 8 to 14, the course of treatment consists of 10-15 procedures every other day.

In this case, the use of pharmacopuncture with Traumeel and Target T is pathogenetically justified, since in addition to mechanically prolonged action on biologically active points, which have a reflex effect on the structures involved in the pathological process, metabolic disorders occurring in the masticatory muscles and tissues of the TMJ itself, which and leads to increased and accelerated occurrence of the therapeutic effect, as well as to prolongation of the result.

Description of the method.

The patient is laid on the couch face up. A palpation diagnosis of painful muscle zones in the chewing muscles is performed and the most painful ones are determined. After processing the hands and ampoules with Traumeel and Target T preparations of 2.2 ml in each antiseptic solution, a set of drugs is made in two sterile syringes, 3 ml in volume, with thin needles used for pharmacopuncture and mesotherapy.

In the case of localization of painful muscle zones in the chewing muscle (m. Masseter), medial and lateral pterygoid muscles, the most painful of the biologically active points are determined:

- IG 17 - below the base of the earlobe, in the fossa between the sternocleidomastoid muscle and the angle of the lower jaw,

- IG 18 - in the cavity at the lower edge of the zygomatic bone, vertically below the outer corner of the eye,

- E5 - anterior to the angle of the lower jaw by 1.5 inches, somewhat outward from the place where the pulsation of the artery is felt.

- E6 - to the fart and up from the angle of the lower jaw, where the recess is palpated,

- E7 - anterior to the tragus of the ear, in the cavity, which is formed by the lower edge of the zygomatic bone and the notch of the lower jaw,

- VB 3 - anterior and downward from the tragus of the ear, where the recess is palpated,

- TR 22 - in the temple area, above the base of the zygomatic process of the temporal bone, slightly anteriorly and above the point TR21 ermen, posterior to the pulsation of the superficial temporal artery.

In the presence of pain zones in the front and middle bundles of the temporal muscle, the most painful of the points are selected:

- E8 - in the corner of the forehead in the scalp 1.5 cm from the corner of the forehead towards the temporal cavity or outwards from the point VG24 shen-ting for 41 12 tsun,

- VB 4 - above and behind the beginning of the scalp 1.5 cm, but slightly lower than the angle of the forehead (and point E8 tou-wei),

- VB 5 - below the point VB4 han-yan by 1.5 cm and behind it by 0.3 cm.

- VB 6 - at the horizontal level drawn through the upper edge of the auricle and anterior to the vertical drawn through the front edge of the ear, by 1.2 cm

- VB 7 - at the intersection of the horizontal, passing over the upper edge of the auricle, and the vertical drawn through the front edge of the auricle,

- VB 13 - away from the midline of the head (at the level of the VG24 shen-ting point) by 3 inches, on a vertical line rising from the outer corner of the eye.

In the event that pain zones are located in the posterior bundles of the temporal muscle, the most painful of the biologically active points are determined:

- VB 8 - above the upper edge of the sink 1 1/2 tsun, slightly posterior to point VB7 qu-bin,

- VB 9 - above the upper edge of the auricle by 2 tsuni and posterior to point VB8 shuai-gu by 1/2 tsuna, on a vertical drawn through the center of the mastoid process,

- VB 10 - above the center of the mastoid process by 1 cun and below the point VB9 tien-chun by 1 cun.

After determining the topography of these points, the drug Traumeel is administered. The drug is first administered intradermally to a small papule with the formation of a "lemon peel", and then the rest of the drug is administered subcutaneously.

Then biologically active points in the temporomandibular joint zone are determined:

-VB 2 - anterior and downward from the tragus of the ear, where the recess is palpated,

-IG 19 - between the tragus of the ear and the mandibular joint, where, when opening the mouth, a recess is palpated,

-TR 21 - in front and above the tragus of the ear, where the recess is palpated,

- TR 22 - in the temple area, above the base of the zygomatic process of the temporal bone, slightly anteriorly and above the point TR21, posterior to the pulsation of the superficial temporal artery.

Then the TMJ zone is treated with an antiseptic solution, a second syringe is taken with the Target T drug pre-collected into it, and this drug is administered at the indicated points.

In this case, both the first and second drugs are injected into symmetrically located points, first on the side of the pain zone, then on the contralateral side, the drug Traumeel is administered in a volume of 0.2-0.6 ml per point, the target T is administered in a volume of 0.2 -0.5 ml per point, first intradermally (before the formation of the “lemon peel”), then subcutaneously, the number of points used in one procedure is from 8 to 14, the course of treatment consists of 10-15 procedures every other day.

EXAMPLES OF IMPLEMENTATION OF THE METHOD.

EXAMPLE 1

Patient P. 41 years old, clinical diagnosis: pain dysfunction of the temporomandibular joint, cochleovestibular syndrome.

The patient complained of pain and snapping in the temporomandibular joint when opening his mouth, feeling dizzy and unstable while walking.

From the anamnesis: these complaints appeared about 6 months ago, 2 weeks before the onset of symptoms, I had a stressful situation, three months before that there was a tooth extraction.

Inspection: satisfactory condition. The physique is hypersthenic. The opening of the mouth is limited to 3.1 cm, the movement of the articular condyles is asymmetric, S-shaped deviation of the lower jaw, deviation

lower jaw with maximum left opening. Coordination tests performed confidently. The installation nystagmus was recorded when looking to the left. Painful compaction of muscle tissue was palpated in the chewing and lateral pterygoid muscles mainly on the left, as well as in the region of the left temporomandibular joint. When springing the joint, the restriction of the mobility of the left temporomandibular joint was determined. The symptom of jagular compression was positive on the left (while standing, sitting and lying down).

A study on the hardware-software complex T-SCAN showed an imbalance in the overall distribution of occlusal force, a shift in the occlusal forces to the left (64.3% versus 35.7%), which indicated an overload of the left TMJ. Opening time was increased, which indicated an increased tone of the masticatory muscles. Radiographs of both TMJs showed signs of degenerative processes in them, with a predominance of changes in the left TMJ.

In order to relieve pain, correct functional disorders and clinical symptoms, as well as improve metabolic and reparative processes in the tissues of the joint, a pharmacopuncture course was conducted with Traumeel and Target T, consisting of 10 sessions at intervals every other day. After processing the hands and ampoules with Traumeel and Target T preparations with an antiseptic solution, a set of preparations is made in two sterile syringes, 2 ml in volume, with thin needles used for pharmacopuncture and mesotherapy. The drug Traumeel was administered at the points:

- IG 17 - below the base of the earlobe, in the fossa between the sternocleidomastoid muscle and the angle of the lower jaw.

- IG 18 - in the cavity at the lower edge of the zygomatic bone, vertically below the outer corner of the eye.

- E 5 - anterior to the angle of the lower jaw by 1.5 inches, somewhat outwards from the place where the pulsation of the artery is felt.

- E 6 - perdi and upward from the angle of the lower jaw, where the recess is palpated.

- E7 - anterior to the tragus of the ear, in the cavity, which is formed by the lower edge of the zygomatic bone and the notch of the lower jaw.

- VB 3 - anterior and downward from the tragus of the ear, where the recess is palpated

- TR 22 - in the temple area, above the base of the zygomatic process of the temporal bone, slightly anteriorly and above the point TR21 ermen, posterior to the pulsation of the superficial temporal artery.

Pharmacopuncture was carried out by first, intracutaneous (until the formation of a small papule, such as a "lemon peel"), and then subcutaneous injection of the drug at these points, symmetrically from 2 sides, in an amount of 0.2 - 0.6 ml. At first they pointed a point to the left, and then to the right. The most painful of the above points were selected:

After pre-treatment with an antiseptic solution, the goal T was administered in a total volume of 2.2 ml. The drug was also administered first, intradermally, then subcutaneously to the points located on the left, and then to the points located on the right. The amount of drug per point was 0.2-0.5 ml. The combination of the following points was used:

-VB 2 - anterior and downward from the tragus of the ear, where the recess is palpated,

-IG 19 - between the tragus of the ear and the mandibular joint, where, when opening the mouth, a recess is palpated,

-TR 21 - in front and above the tragus of the ear, where the recess is palpated,

- TR 22 - in the temple area, above the base of the zygomatic process of the temporal bone, slightly anteriorly and above the point TR21, posterior to the pulsation of the superficial temporal artery.

The procedures were well tolerated, without negative adverse reactions. Positive dynamics of clinical manifestations, regression of pain symptoms and vestibular disorders were noted. Nystagmus was not recorded. The opening of the mouth increased to 4.3 cm, deviation of the lower jaw was not detected. The symptom of jagular compression is negative on 2 sides. According to the T-SCAN data, there was no imbalance in the overall distribution of occlusal forces; the opening time indicator returned to normal.

Positive dynamics began to be observed by the 4th procedure, its regression was observed at the level of 55%, the most pronounced clinical effect was determined by the 8th procedure, the regression of the severity and manifestations of clinical symptoms was 90% of the initial. In a follow-up study after 6 months, the patient did not complain, a complete regression of clinical symptoms was determined.

Example 2

A 59-year-old patient complained of limited mouth opening and pain during chewing in the right TMJ; she was also bothered by bouts of systemic dizziness lasting up to an hour and a half, accompanied by nausea, vomiting and a feeling of heat, dull aching pains in the back of the head (up to half days of the month up to 4 points on the YOUR scale).

It is known that for the first time pain in the TMJ appeared about 6 months ago, dizziness and increased headache also began to appear. Over the past year and a half, he has noted a difficult psychological situation.

Objectively: In consciousness, there are no meningeal signs. The pupils are uniform, symmetrical, live photoreactions. The movement of the eyeballs in full. Tongue in the midline. Left-sided N.H. Phonation

swallowing and articulation are not disturbed. There are no paresis. Tendon and periosteal reflexes D = S. Marked soreness on palpation in the masticatory muscle, as well as in the front and middle portions of the temporal muscle. The opening of the mouth is limited to 3.4 cm, the deviation of the lower jaw to the right, the opening line of the lower jaw is Z-shaped. There is a functional limitation of the mobility of the right TMJ. According to T-SCAN, an imbalance in the overall distribution of occlusal forces is recorded. The shift of the occlusal forces to the right side, an increase in the opening time. X-ray arthrosis of the right TMJ.

Conclusion: pain dysfunction of the temporomandibular joint, cochleovestibular syndrome, cranialgia, left-sided sensorineural hearing loss.

In order to stop the pain syndrome, as well as correcting functional disorders and clinical manifestations of the disease, a pharmacopuncture course was conducted, the course consisted of 11 procedures. Pharmacopuncture was carried out by first, intracutaneous (until the formation of a small papule, such as a lemon peel), and then subcutaneous administration of the drug Traumeel, symmetrically from 2 sides. At first they pointed a point to the left, and then to the right. The amount of drug administered per point was 0.2-0.6 ml. In therapy, the most painful of the points were used:

- E 5 - anterior to the angle of the lower jaw by 1.5 inches, somewhat outwards from the place where the pulsation of the artery is felt.

- E 6 - to the fart and up from the angle of the lower jaw, where the recess is palpated.

- E7 - anterior to the tragus of the ear, in the cavity, which is formed by the lower edge of the zygomatic bone and the notch of the lower jaw.

- VB 3 - anterior and downward from the tragus of the ear, where the recess is palpated

- TR 22 - in the temple area, above the base of the zygomatic process of the temporal bone, slightly anteriorly and above the point TR21 ermen, posterior to the pulsation of the superficial temporal artery.

- E8 - in the corner of the forehead in the scalp 1.5 cm from the angle of the forehead towards the temporal cavity or the gun from the point VG24 shen-ting for 41 12 tsun.

- VB 4 - above and behind the beginning of the scalp 1.5 cm, but slightly lower than the angle of the forehead (and point E8 tou-wei).

- VB 5 - below the point VB4 han-yan by 1.5 cm and behind it by 0.3 cm.

- VB 6 - at the horizontal level drawn through the upper edge of the auricle and anterior to the vertical line drawn through the front edge of the ear, by 1.2 cm

-VB 7 - at the intersection of the horizontal passing over the upper edge of the auricle and the vertical drawn through the front edge of the auricle

-VB 13 - away from the midline of the head (at the level of point VG24 shen-ting) by 3 tsun, on a vertical line rising from the outer corner of the eye.

Then, after pre-treatment with an antiseptic solution, the goal T was administered in a total volume of 2.2 ml. The drug was also administered first, intradermally, then subcutaneously to the points located on the left, and then to the points located on the right. The amount of drug per point was 0.2-0.5 ml. In this case, the most painful of the points were used:

- VB 2 - anterior and downward from the tragus of the ear, where the recess is palpated.

- IG 19 - between the tragus of the ear and the mandibular joint, where a hole is palpated when opening the mouth.

- TR 21 - in front and above the tragus of the ear, where the recess is palpated.

- TR 22 - in the temple area, above the base of the zygomatic process of the temporal bone, slightly anteriorly and above the point TR21, posterior to the pulsation of the superficial temporal artery.

The procedures were well tolerated. No adverse reactions were noted. There was a positive dynamics of the clinical manifestations of the disease, pain trigger points in the muscles concerned were not determined, an increase (4.2 cm) and uniformity of mouth opening were noted. Dizziness and headache were not observed. According to T-SCAN, an imbalance in the overall distribution of occlusal forces was not detected, the opening time indicator returned to normal.

Positive dynamics began to be observed by the 6th procedure, the regression of the main clinical manifestations was noted at the level of 55%, the most pronounced clinical effect was formed by the 9th procedure, the regression of the severity and manifestations of clinical symptoms was 90% of the initial. In a follow-up study after 6 months, the patient did not complain, a complete regression of clinical symptoms was determined.

The proposed method of treatment was applied on 120 patients, aged 20 to 61 years, suffering from painful TMJ dysfunction. At the initial examination, all patients revealed the presence of pathological occlusion and TMJ dysfunction in the form of limiting the opening of the mouth, violation of the trajectory of the lower jaw, asymmetry of the condyles of the joint, soreness and clicking in it. The severity of TMJ dysfunction was determined by the indicators of the Hamburg test and averaged 5.85. At the same time, moderate and severe dysfunctions prevailed and accounted for 80.8% (97 people) of the total number of patients. It should be noted that 105 (87.5%)

In addition to complaints of pain in the TMJ and trigger points in the chewing muscles, people complained of headaches, dizziness, and / or tinnitus. In 109 (90.8%) patients, X-ray or CT revealed degenerative changes in the TMJ.

As a result of treatment with the proposed method, all patients showed a positive dynamics of the clinical symptoms of the disease, manifested by a decrease or complete regression of the pain syndrome, both in the area of the joint itself and in the area of chewing muscles, an increase in the opening of the mouth, restoration of the normal trajectory of movement of the lower jaw, restoration of symmetrical movement condyle, elimination of clicks in the joint, headache decreased or completely stopped, and the cochleovestibular symptom also regressed Tomato In the case of a severe course of the disease, the number of pharmacopuncture procedures reached 15. The rate of onset of the therapeutic effect in the overwhelming number of patients (103 people / 85.8%) was noted by the middle of the 2nd with its maximum manifestation by the end of the 3rd week of the disease.

An analysis of the effectiveness of treatment, based on the results of clinical studies and the data of hardware diagnostic methods, reliably (p <0.05) showed that significant improvement and improvement in patients receiving pharmacopuncture with antihomotoxic drugs was observed in 88.3%, and in the control group 63 3% of patients.

Thus, on the basis of the study, the feasibility of using pharmacopuncture with complex homeopathic preparations at the proposed biologically active points in painful muscular dysfunction of the TMJ has been shown and scientifically substantiated. This method allows to increase the effectiveness of the treatment of patients with muscular pain dysfunction of the TMJ, contributes to the speedy regression of the clinical manifestations of the disease and reduction of treatment time, leads to an improvement in the quality of life of patients and

improving mental status, helps to achieve prolongation of the therapeutic effect and slow the progression of the disease.

Claims (1)

A method for the treatment of patients with painful muscular dysfunction of the temporomandibular joint (TMJ), including a reflex-drug effect on biologically active points, characterized in that after pre-treatment with an antiseptic solution, in the projection of biologically active points selected taking into account the location of pain zones in the chewing muscles a solution of the antihomotoxic drug Traumel is administered in a volume of 0.2-0.6 ml per one point, previously drawn into a syringe equipped with a needle for pharmacopuncture or mesotherapy; moreover, in the presence of pain points in the chewing muscle (m. Masseter), the medial and lateral pterygoid muscles, the drug is administered at points IG 17, 18; E 5, 6, 7; VB 3; TR 22; in the presence of pain points in the front and middle portions of the temporal muscle, the drug is administered at points E 8, VB 4, 5, 6, 7, 13; if pain is located in the posterior portion of the temporal muscle, the drug is administered at points VB 8, 9, 10; first, the drug is injected into the points located on the side of the pain zone, and then into the symmetrically located points on the contralateral side, then the TMJ zone is treated with the antiseptic solution and, with the help of the second syringe, the target T is pre-injected into the drug, this drug is administered in a dose 0.2-0.5 ml in biologically active points of VB 2; IG 19; TR 21, 22; they also act on symmetrically located points, first act on a point on the side of pain, then on the contralateral side; the number of points used in one procedure is from 8 to 14, the course of treatment consists of 10-15 procedures every other day.