Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Sep 10;18(18):9552.
doi: 10.3390/ijerph18189552.

Intramuscular Injections and Dry Needling within Masticatory Muscles in Management of Myofascial Pain. Systematic Review of Clinical Trials

Zuzanna Nowak  1 , Maciej Chęciński  2 , Aleksandra Nitecka-Buchta  1 , Sylwia Bulanda  3 , Danuta Ilczuk-Rypuła  3 , Lidia Postek-Stefańska  3 , Stefan Baron  1
Affiliations

Intramuscular Injections and Dry Needling within Masticatory Muscles in Management of Myofascial Pain. Systematic Review of Clinical Trials

Zuzanna Nowak et al. Int J Environ Res Public Health. .

Abstract

Background: Myofascial pain is an important cause of disability among the whole population, and it is a common symptom of temporomandibular joint disorders (TMDs). Its management techniques vary widely; however, in recent years, there has been a growing interest especially in needling therapies within masticatory muscles, due to their simplicity and effectiveness in pain reduction.

Methods: The construction of the following study is based on PICOS and PRISMA protocols. A systematic literature search was conducted based on the PubMed and BASE search engines. Searching the abovementioned databases yielded a total of 367 articles. The screening procedure and analysis of full texts resulted in the inclusion of 28 articles for detailed analysis.

Results: According to analyzed data, clinicians manage myofascial pain either with wet or dry needling therapies. The most thoroughly studied approach that prevails significantly within the clinical trials is injecting the botulinum toxin into the masseter and temporalis. Other common methods are the application of local anesthetics or dry needling; however, we notice the introduction of entirely new substances, such as platelet-rich plasma or collagen. In the analyzed articles, the target muscles for the needling therapies are most commonly localized by manual palpation although there are a variety of navigational support systems described: EMG, MRI or EIP electrotherapy equipment, which often aid the access to located deeper lateral and medial pterygoid muscle.

Conclusions: Needling therapies within masticatory muscles provide satisfactory effects while being simple, safe and accessible procedures although there still is a need for high quality clinical trials investigating especially injections of non-Botox substances and needling within lateral and medial pterygoid muscles.

Keywords: Botox; dry needling; intramuscular injections; myofascial pain; temporomandibular disorders; wet needling.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A PRISMA flow diagram of the literature screening and selection processes [19].
Figure 2
Figure 2
The number of interventions in the form of needling of each of the masticatory muscles in relation to the total number of patients included in the analyzed material.
Figure 3
Figure 3
The share of substances injected into the masseter muscles and dry needling in relation to the number of analyzed trials.
Figure 4
Figure 4
Navigational methods in needling of the masticatory muscles in relation to the number of analyzed studies.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Weller J.L., Comeau D., Otis J.A.D. Myofascial Pain. Semin. Neurol. 2018;38:640–643. - PubMed
    1. Osiewicz M.A., Lobbezoo F., Loster B.W., Loster J.E., Manfredini D. Frequency of temporomandibular disorders diagnoses based on RDC/TMD in a Polish patient population. CRANIO®. 2017;36:1–7. doi: 10.1080/08869634.2017.1361052. - DOI - PubMed
    1. Deregibus A., Ferrillo M., Grazia Piancino M., Chiara Domini M., de Sire A., Castroflorio T. Are occlusal splints effective in reducing myofascial pain in patients with muscle-related temporomandibular disorders? A randomized-controlled trial. Turk. J. Phys. Med. Rehabil. 2021;67:32–40. doi: 10.5606/tftrd.2021.6615. - DOI - PMC - PubMed
    1. Pal U.S., Kumar L., Mehta G., Singh N., Singh G., Singh M., Yadav H.K. Trends in management of myofacial pain. Natl. J. Maxillofac. Surg. 2014;5:109–116. doi: 10.4103/0975-5950.154810. - DOI - PMC - PubMed
    1. Schiffman E., Ohrbach R., Truelove E., Look J., Anderson G., Goulet J.P., List T., Svensson P., Gonzalez Y., Lobbezoo F., et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. J. Oral Facial Pain Headache. 2014;28:6–27. doi: 10.11607/jop.1151. - DOI - PMC - PubMed

Publication types

LinkOut - more resources