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Comparison of the Efficacies of Dry Needling and Botox Methods in the Treatment of Myofascial Pain Syndrome Affecting the Temporomandibular Joint

Kütük, Sinem Gökçe MD*; Özkan, Yasemin MD; Kütük, Mustafa MD; Özdaş, Talih MD§

doi: 10.1097/SCS.0000000000005473
Clinical Study: PDF Only

Background: To compare the efficacies of botulinum toxin-A injection and dry needling methods in the treatment of patients with myofascial pain syndrome (MPS) in the temporomandibular joint (TMJ).

Methods: In this prospective study, 40 MPS patients (29 women, 11 men) were randomly assigned to abobotulinum toxin-A injection (Group 1, n = 20) or dry needling (Group 2, n = 20) groups. Pain, crepitation, functional limitation, maximum mouth opening, jaw strength were evaluated at baseline and 6 weeks, and the results in both groups were compared.

Results: The average age of the authors’ patients was 33.8±8.1. There was a remarkable difference between 2 groups regarding visual analog scale for TMJ pain at rest (P = 0.048). The pain at rest was relieved more effectively in Group 2 at the end of 6 weeks. Improvement in jaw protrusion angles on the right (P = 0.009) and left (P = 0.002) sides was more evident in Group 2 after 6 weeks. There were significant pain relief and functional improvement after treatment in both groups. In Group 2, recovery of the TMJ function was more obvious in 6 weeks following dry needling (P = 0.002).

Conclusion: The authors suggest that abobotulinum toxin-A injection and dry needling yield satisfactory therapeutic outcomes regarding pain relief and restoration of function in patients with MPS involving TMJ. Further multicentric, randomized, controlled trials on larger series are warranted to obtain more accurate and reliable information.

*Department of Otorhinolaryngology, Aydin State Hospital

Department of Physical Therapy and Rehabilitation, Adnan Menderes University

Department of Anesthesia and Reanimation, Aydin State Hospital

§Department of Otorhinolaryngology, University of Health Sciences, Adana City Hospital, Aydin, Turkey.

Address correspondence and reprint requests to Sinem Gökçe Kütük, MD, Department of Otorhinolaryngology, Aydin State Hospital, Aydin, Turkey; E-mail:

Received 12 December, 2018

Accepted 15 February, 2019

The authors report no conflicts of interest.

© 2019 by Mutaz B. Habal, MD.