Is Dry Needling Right for Jaw Pain?

The jaw is a common area of pain affecting 15 percent of adults, primarily those aged 20 to 40. Women are 1 ½ to 2 times more likely to have jaw pain than men (Gauer et al.), commonly referred to as temporomandibular joint disorder (TMJ).

The jaw is a powerful joint consisting of a bilateral hinged joint where the mandible (jawbone) meets the skull, an intra-articular disc, and several muscles. When problems arise, it often affects the way we eat, talk, and yawn.

Pain in this area usually stems from either an intra-articular (inside the joint) or extra-articular (outside the joint) source. Intra-articular causes of pain include arthritis and/or disc problems. Extra-articular causes of pain typically involve muscular overactivity, which we classify as TMJ myofascial pain syndrome (MPS).

To diagnose someone with TMJ MPS disorder, one or more of the following signs or symptoms should be present:

• Pain or aching in the TMJ area
• Pain upon touching the TMJ muscles
• Limited range of motion or variation of jaw movement when opening the mouth
• Joint sounds
• Headache

How can dry needling help?

Dry needling is a therapy intervention that uses small monofilament needles without medication to target muscle, tendon, ligaments, connective tissue, fascia, and peripheral nerves to manage musculoskeletal pain syndromes. It is combined with manual or electrical stimulation, which helps increase blood flow and the effectiveness of dry needling.

Dry needling can be helpful when the primary source of pain arises from the masticatory muscles (temporalis, masseter, and medial and lateral pterygoids) and conservative measures of treatment such as massage, relaxation exercises, postural re-education, and modalities have failed to be helpful on their own.

Dry needling to the deep masseter and lateral pterygoids has shown to have meaningful improvement in jaw pain, mouth opening, and reduction in headache symptoms (La Touche et al., 2010) (Gonzalez-Perez et al., 2015). 

When patients describe their pain to their healthcare provider, they often assume that the pain source is the same as its location. Unfortunately, the pain can stem from another location. For example, 28 percent of people report that their jaw symptoms worsened when their neck pain worsened. It is also common for the cervical spine to play a role in orofacial pain.

An evaluation by a trained professional is always recommended to determine the root cause of pain and the specific type of treatment that is best for you. If you have questions about our dry needling therapy services or would like to request an appointment, please contact us on our website or call (804) 764-1000.

References:

Gauer RL, Semidev MJ. (2015). Diagnosis and treatment of temporomandibular disorders. Am Fam Physician, 91:378-386

Gonzalez-Perez, L., Infante-Cossio, P., Granados-Nuñez, M., & Urresti-Lopez, F. (2015). Treatment of temporomandibular myofascial pain with deep dry needling. Medicina Oral, Patología Oral Y Cirugía Bucal, 17(5), e781-e785.

La Touche et al.  (2010) Short term effects of dry needling of active myofascial triggerpoints in the masseter muscle in patients with temporomandibular disorder.  Journal Orofacial Pain, 24(1): 106-12.