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Deep dry needling of trigger points located in the lateral pterygoid muscle: Efficacy and safety of treatment for management of myofascial pain and temporomandibular dysfunction.

Gonzalez-Perez LM, Infante-Cossio P, Granados-Nunez M, Urresti-Lopez FJ, Lopez-Martos R, Ruiz-Canela-Mendez P - Med Oral Patol Oral Cir Bucal (2015)

Bottom Line: Pain reduction in the test group was greater as a function of pain intensity at baseline.DDN of TPs in the LPM showed better efficacy in reducing pain and improving maximum mouth opening, laterality, and protrusion movements compared with methocarbamol/paracetamol treatment.No adverse events were observed with respect to DDN.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, "Virgen del Rocio" University Hospital, Av. Manuel Siurot s/n. 41013 Seville, Spain, lumigon@telefonica.net.

ABSTRACT

Background: To determine whether deep dry needling (DDN) of trigger points (TPs) in the lateral pterygoid muscle (LPM) would significantly reduce pain and improve function, compared with methocarbamol/paracetamol medication.

Material and methods: Forty-eight patients with chronic myofascial pain located in the LPM were selected and randomly assigned to one of two groups (DDN test group, n=24; drug-treated control group, n=24). The test group received three applications of needling of the LPM once per week for three weeks, while control group patients were given two tablets of a methocarbamol/paracetamol combination every six hours for three weeks. Assessments were carried out pre-treatment, 2 and 8 weeks after finishing the treatment.

Results: A statistically significant difference (p<0.05) was detected for both groups with respect to pain reduction at rest and with mastication, but the DDN test group had significantly better levels of pain reduction. Moreover, statistically significant differences (p<0.05) up to day 70 in the test group were seen with respect to maximum mouth opening, laterality and protrusion movements compared with pre-treatment values. Pain reduction in the test group was greater as a function of pain intensity at baseline. The evaluation of efficacy as assessed both by patients/investigators was better for the test group. 41% of the patients receiving the combination drug treatment described unpleasant side effects (mostly drowsiness).

Conclusions: DDN of TPs in the LPM showed better efficacy in reducing pain and improving maximum mouth opening, laterality, and protrusion movements compared with methocarbamol/paracetamol treatment. No adverse events were observed with respect to DDN.

No MeSH data available.


Related in: MedlinePlus

Range of mandibular movements was measured with a Therabite® ruler. For the DDN, sterile stainless steel needles (length 40 mm and caliber 0.25 mm, with a cylindrical plastic guide; Agu-punt ®) were used.
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Figure 1: Range of mandibular movements was measured with a Therabite® ruler. For the DDN, sterile stainless steel needles (length 40 mm and caliber 0.25 mm, with a cylindrical plastic guide; Agu-punt ®) were used.

Mentions: Patients were assigned randomly to one of two groups (Epidat 4.0). The DDN group received needling of the LPM once per week for 3 weeks. Clinical evaluations were carried out at the basal day (day 0), and on days 28 and 70 after the commencement of treatment. Data were collected at each visit by a same observer. For the DDN therapy, sterile stainless steel needles (length 40 mm/ caliber 0.25 mm, with a cylindrical plastic guide; Agu-punt ®) were used (Fig. 1). The preauricular area was swabbed with 90° alcohol, and the LPM manually located intra and extra-orally, unilaterally (Fig. 2). Intramuscular needling was then carried out. This was performed via a deep puncture into myofascial pain TPs without the introduction of any substance (dry needling) (Fig. 3) (4,15). The aim was to provoke a jump reaction or local twitch response (LTR) in all cases when the needle was inserted into a TP (3,15,16). The procedure was followed by compressive haemostasis for one minute.


Deep dry needling of trigger points located in the lateral pterygoid muscle: Efficacy and safety of treatment for management of myofascial pain and temporomandibular dysfunction.

Gonzalez-Perez LM, Infante-Cossio P, Granados-Nunez M, Urresti-Lopez FJ, Lopez-Martos R, Ruiz-Canela-Mendez P - Med Oral Patol Oral Cir Bucal (2015)

Range of mandibular movements was measured with a Therabite® ruler. For the DDN, sterile stainless steel needles (length 40 mm and caliber 0.25 mm, with a cylindrical plastic guide; Agu-punt ®) were used.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4464920&req=5

Figure 1: Range of mandibular movements was measured with a Therabite® ruler. For the DDN, sterile stainless steel needles (length 40 mm and caliber 0.25 mm, with a cylindrical plastic guide; Agu-punt ®) were used.
Mentions: Patients were assigned randomly to one of two groups (Epidat 4.0). The DDN group received needling of the LPM once per week for 3 weeks. Clinical evaluations were carried out at the basal day (day 0), and on days 28 and 70 after the commencement of treatment. Data were collected at each visit by a same observer. For the DDN therapy, sterile stainless steel needles (length 40 mm/ caliber 0.25 mm, with a cylindrical plastic guide; Agu-punt ®) were used (Fig. 1). The preauricular area was swabbed with 90° alcohol, and the LPM manually located intra and extra-orally, unilaterally (Fig. 2). Intramuscular needling was then carried out. This was performed via a deep puncture into myofascial pain TPs without the introduction of any substance (dry needling) (Fig. 3) (4,15). The aim was to provoke a jump reaction or local twitch response (LTR) in all cases when the needle was inserted into a TP (3,15,16). The procedure was followed by compressive haemostasis for one minute.

Bottom Line: Pain reduction in the test group was greater as a function of pain intensity at baseline.DDN of TPs in the LPM showed better efficacy in reducing pain and improving maximum mouth opening, laterality, and protrusion movements compared with methocarbamol/paracetamol treatment.No adverse events were observed with respect to DDN.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, "Virgen del Rocio" University Hospital, Av. Manuel Siurot s/n. 41013 Seville, Spain, lumigon@telefonica.net.

ABSTRACT

Background: To determine whether deep dry needling (DDN) of trigger points (TPs) in the lateral pterygoid muscle (LPM) would significantly reduce pain and improve function, compared with methocarbamol/paracetamol medication.

Material and methods: Forty-eight patients with chronic myofascial pain located in the LPM were selected and randomly assigned to one of two groups (DDN test group, n=24; drug-treated control group, n=24). The test group received three applications of needling of the LPM once per week for three weeks, while control group patients were given two tablets of a methocarbamol/paracetamol combination every six hours for three weeks. Assessments were carried out pre-treatment, 2 and 8 weeks after finishing the treatment.

Results: A statistically significant difference (p<0.05) was detected for both groups with respect to pain reduction at rest and with mastication, but the DDN test group had significantly better levels of pain reduction. Moreover, statistically significant differences (p<0.05) up to day 70 in the test group were seen with respect to maximum mouth opening, laterality and protrusion movements compared with pre-treatment values. Pain reduction in the test group was greater as a function of pain intensity at baseline. The evaluation of efficacy as assessed both by patients/investigators was better for the test group. 41% of the patients receiving the combination drug treatment described unpleasant side effects (mostly drowsiness).

Conclusions: DDN of TPs in the LPM showed better efficacy in reducing pain and improving maximum mouth opening, laterality, and protrusion movements compared with methocarbamol/paracetamol treatment. No adverse events were observed with respect to DDN.

No MeSH data available.


Related in: MedlinePlus