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Introduction <p>Myofascial pain related to the Temporomandibular joint (TMJ) is a baffling entity for many physicians because of its complex presentation and difficulty in relieving the associated pain and other symptoms. Dry needling with cervicothoracic manipulation focuses on releasing myofascial trigger points to elicit a local twitch response and on improving the biomechanics of the joint which thus produces analgesia.</p> Materials and Methods <p>This pilot study with Quasi-experimental design was conducted in the Department of Oral and Maxillofacial Surgery, in a private dental college of Chennai, India and included 12 patients with myofascial pain related to the temporomandibular joint&#xa0;and they underwent dry needling with cervical manipulation. Joint vibration analysis (JVA) and Electromyography (EMG) were used for screening the patients after which they underwent dry needling of the masticatory (temporalis and masseter) and cervical muscles and cervical manipulation (chiropractic adjustment) of the joints from C1 to C7. Dry needling included 2 sessions for a period of 4–6&#xa0;weeks with cervicothoracic manipulations done from the second or the third visit. Our primary outcome measures were pain using the visual analog scale (VAS) score, Mouth opening, referred pain (cervical and temporal pain), resolution of trigger points and secondary outcome measures were lateral excursive movements, clicking, Temporo-Mandibular Joint Disorders (TMD) disability index and TMJ surgery specific Quality of life (QoL) scale taken before and 1&#xa0;week after treatment completion.</p> Results <p>Decrease in pain was the most notable finding, followed by increase in mouth opening. Patients had resolution of cervical pain and the referred temporal pain component also reported a significant reduction or absence of pain post treatment. There was also notable improvement in the TMD Disability Index and QoL score post treatment.</p> Conclusion <p>Within the limitations of the study, Dry needling is an effective and novel treatment strategy for treating myofascial pain of the temporomandibular joint. Dry needling along with cervicothoracic manipulations can be used separately or as an adjunct to the existing treatment methods.</p>

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Dry Needling with Cervicothoracic Manipulation: A Novel Treatment Modality for the Management of Temporomandibular Associated Myofascial Pain—A Pilot Study with Quasi Experimental Design

  • 期刊论文

  • 发表日期：

    2025年7月1日

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  • Mahathi Neralla,
  • Dharmesh Kubendiran,
  • P. Kalyani,
  • Ravalika Singarappu

摘要

Introduction

Myofascial pain related to the Temporomandibular joint (TMJ) is a baffling entity for many physicians because of its complex presentation and difficulty in relieving the associated pain and other symptoms. Dry needling with cervicothoracic manipulation focuses on releasing myofascial trigger points to elicit a local twitch response and on improving the biomechanics of the joint which thus produces analgesia.

Materials and Methods

This pilot study with Quasi-experimental design was conducted in the Department of Oral and Maxillofacial Surgery, in a private dental college of Chennai, India and included 12 patients with myofascial pain related to the temporomandibular joint and they underwent dry needling with cervical manipulation. Joint vibration analysis (JVA) and Electromyography (EMG) were used for screening the patients after which they underwent dry needling of the masticatory (temporalis and masseter) and cervical muscles and cervical manipulation (chiropractic adjustment) of the joints from C1 to C7. Dry needling included 2 sessions for a period of 4–6 weeks with cervicothoracic manipulations done from the second or the third visit. Our primary outcome measures were pain using the visual analog scale (VAS) score, Mouth opening, referred pain (cervical and temporal pain), resolution of trigger points and secondary outcome measures were lateral excursive movements, clicking, Temporo-Mandibular Joint Disorders (TMD) disability index and TMJ surgery specific Quality of life (QoL) scale taken before and 1 week after treatment completion.

Results

Decrease in pain was the most notable finding, followed by increase in mouth opening. Patients had resolution of cervical pain and the referred temporal pain component also reported a significant reduction or absence of pain post treatment. There was also notable improvement in the TMD Disability Index and QoL score post treatment.

Conclusion

Within the limitations of the study, Dry needling is an effective and novel treatment strategy for treating myofascial pain of the temporomandibular joint. Dry needling along with cervicothoracic manipulations can be used separately or as an adjunct to the existing treatment methods.