Randomized, double-blind study comparing percutaneous electrolysis and dry needling for the management of temporomandibular myofascial pain

R Lopez-Martos, L-M Gonzalez-Perez, P Ruiz-Canela-Mendez, F-J Urresti-Lopez, J-L Gutierrez-Perez, P Infante-Cossio, R Lopez-Martos, L-M Gonzalez-Perez, P Ruiz-Canela-Mendez, F-J Urresti-Lopez, J-L Gutierrez-Perez, P Infante-Cossio

Abstract

Background: To assess whether the techniques of percutaneous needle electrolysis (PNE) and deep dry needling (DDN) used on trigger points (TrP) of lateral pterygoid muscle (LPM) can significantly reduce pain and improve function in patients with myofascial pain syndrome (MPS) compared to a control group treated with a sham needling procedure (SNP).

Material and methods: Sixty patients diagnosed with MPS in the LPM were selected and randomly assigned to one of three groups. The PNE group received electrolysis to the LPM via transcutaneous puncture. The DDN group received a deep puncture to the TrP without the introduction of any substance. In the SNP group, pressure was applied to the skin without penetration. Procedures were performed once per week for 3 consecutive weeks. Clinical evaluation was performed before treatment, and on days 28, 42 and 70 after treatment.

Results: Statistically significant differences (p <0.01) were measured for the PNE and DDN groups with respect to pain reduction at rest, during chewing, and for maximum interincisal opening (MIO). Values for the PNE group showed significantly earlier improvement. Differences for PNE and DDN groups with respect to SNP group were significant (p <0.05) up to day 70. Evaluation of efficacy as reported by the patient and observer was better for PNE and DDN groups. No adverse events were observed for either of the techniques.

Conclusions: PNE and DDN of the LPM showed greater pain reduction efficacy and improved MIO compared to SNP. Improvement was noted earlier in the PNE group than in the DDN group.

Conflict of interest statement

Conflict of interest statement: The authors report no conflict of interest related to this study.

References

    1. Gonzalez-Perez LM, Infante-Cossio P, Granados-Nunez M, Urresti-Lopez FJ. Treatment of temporomandibular myofascial pain with deep dry needling. Med Oral Patol Oral Cir Bucal. 2012;17:e781–5.
    1. Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP. 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 Orofac Pain. 2014;28:6–27.
    1. Blasco-Bonora PM, Martin-Pintado-Zugasti A. Effects of myofascial trigger point dry needling in patients with sleep bruxism and temporomandibular disorders: a prospective case series. Acupunct Med. 2017;35:69–74.
    1. Fernandez-Carnero J, La Touche R, Ortega-Santiago R, Galan-del- Rio F, Pesquera J, Ge HY. Short-Term effects of dry needling of active myofascial trigger points in the masseter muscle in patients with temporomandibular disorders. J Orofac Pain. 2010;24:106–12.
    1. Shen YF, Younger J, Goddard G, Mackey S. Randomized clinical trial of acupuncture for myofascial pain of the jaw muscles. J Orofac Pain. 2009;23:353–9.
    1. Lindfors E, Hedman E, Magnusson T, Ernberg M, Gabre P. Patient Experiences of Therapeutic Jaw Exercises in the Treatment of Masticatory Myofascial Pain: A Qualitative Study. J Oral Facial Pain Headache. 2017;31:46–54.
    1. Fernandes AC, Duarte Moura DM, Da Silva LGD, De Almeida EO, Barbosa GAS. Acupuncture in Temporomandibular Disorder Myofascial Pain Treatment: A Systematic Review. J Oral Facial Pain Headache. 2017;31:225–32.
    1. Hong CZ. Lidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response. Am J Phys Med Rehabil. 1994;73:256–63.
    1. Ay S, Evcik D, Tur BS. Comparison of injection methods in myofascial pain syndrome: a randomized controlled trial. Clin Rheumatol. 2010;29:19–23.
    1. Goddard G, Karibe H, McNeill C, Villafuerte E. Acupuncture and sham acupuncture reduce muscle pain in miofascial pain patients. J Orofac Pain. 2002;16:71–6.
    1. Gonzalez-Perez LM, Infante-Cossio P, Granados-Nunez M, Urresti-Lopez FJ, Lopez-Martos R, Ruiz-Canela-Mendez P. 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. Med Oral Patol Oral y Cir Bucal. 2015;20:e326–33.
    1. Abat F, Valles SL, Gelber PE, Polidori F, Stitik TP, Monllau JC. Mecanismos moleculares de reparación mediante la técnica Electrólisis Percutánea Intratisular en la tendinosis rotuliana. Rev Esp Cir Ortop Traumatol. 2014;58:201–5.
    1. Abat F, Gelber PE, Polidori F, Monllau JC, Sanchez-Ibanez JM. Clinical results after ultrasound-guided intratissue percutaneous electrolysis (EPI®) and eccentric exercise in the treatment of patellar tendinopathy. Knee Surg Sports Traumatol Arthrosc. 2015;23:1046–52.
    1. Arias-Buria JL, Truyols-Domínguez S, Valero-Alcaide R, Salom-Moreno J, Atin-Arratibel MA, Fernandez-de-Las-Pe-as C. Ultrasound-Guided Percutaneous Electrolysis and Eccentric Exercises for Subacromial Pain Syndrome: A Randomized Clinical Trial. Evid Based Complement Alternat Med. 2015;2015:315219.
    1. Abat F, Sanchez-Sanchez JL, Martin-Nogueras AM, Calvo-Arenillas JI, Yajeya J, Mendez-Sanchez R. Randomized controlled trial comparing the effectiveness of the ultrasound-guided galvanic electrolysis technique (USGET) versus conventional electro-physiotherapeutic treatment on patellar tendinopathy. J Exp Orthop. 2016;3:34.
    1. Garcia Naranjo J, Barroso Rosa S, Loro Ferrer JF, Liminana Canal JM, Suarez Hernandez E. A novel approach in the treatment of acute whiplash syndrome: Ultrasound-guided needle percutaneous electrolysis. A randomized controlled trial. Orthop Traumatol Surg Res. 2017;103:1229–34.
    1. Look JO, Schiffman EL, Truelove EL, Ahmad M. Reliability and validity of Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) with proposed revisions. J Oral Rehabil. 2010;37:744–59.
    1. Koole P, Beenhakker F, Jongh HJ de, Boering G. A standardized technique for the placement of electrodes in the two heads of the lateral pterygoid muscle. Cranio. 1990;8:154–62.
    1. Simons DG. Review of enigmatic MTrPs as a common cause of enigmatic musculoskeletal pain and dysfunction. J Electromyogr Kinesiol. 2004;4:95–107.
    1. Dıraçoglu D, Vural M, Karan A, Aksoy C. Effectiveness of dry needling for the treatment of temporomandibular myofascial pain: A double-blind, randomized, placebo controlled study. J Back Musculoskelet Rehabil. 2012;25:285–90.
    1. Kietrys DM, Palombaro KM, Azzaretto E, Hubler R, Schaller B, Schlussel JM. Effectiveness of dry needling for upper quarter myofascial pain: A systematic review and meta-analysis. J Orthop Sports Phys Ther. 2013;43:620–34.
    1. Pal US, Kumar L, Mehta G, Singh N, Singh G, Singh M. Trends in management of myofacial pain. Natl J Maxillofac Surg. 2014;5:109–16.
    1. Martos-Diaz P, Rodriguez-Campo FJ, Bances-Del Castillo R, Altura-Guillen O, Cho-Lee GY, Mancha-De-La Plata M. Lateral pterygoid muscle dystonia. A new technique for treatment with botulinum toxin guided by electromyography and arthroscopy. Med Oral Patol Oral Cir Bucal. 2011;16:9–12.
    1. Turp J, Minagi S. Palpation of the lateral pterygoid region in TMD-where is the evidence? J Dent. 2001;29:475.
    1. Stelzenmueller W, Umstadt H, Weber D, Goenner-Oezkan V, Kopp S, Lisson J. Evidence - The intraoral palpability of the lateral pterygoid muscle - A prospective study. Ann Anat. 2016;206:89–95.
    1. Mesa-Jimenez J, Sanchez-Gutierrez J, De-la-Hoz-Aizpurua J. Cadaveric validation of dry needle placement in the lateral pterygoid muscle. J Manipulative Physiol Ther. 2015;38:145–50.
    1. Tekin L, Akarsu S, Durmus O, Cakar E, Dincer U, Kiralp MZ. The effect of dry needling in the treatment of myofascial pain syndrome: A randomized double-blinded placebo-controlled trial. Clin Rheumatol. 2013;32:309–15.
    1. Mayoral O, Salvat I, Martin MT, Martín S, Santiago J, Cotarelo J. Efficacy of myofascial trigger point dry needling in the prevention of pain after total knee arthroplasty: a randomized, double-blinded, placebo-controlled trial. Evid Based Complement Alternat Med. 2013;2013:694941.
    1. Itoh K, Asai S, Ohyabu H, Imai K, Kitakoji H. Effects of Trigger Point Acupuncture Treatment on Temporomandibular Disorders: A Preliminary Randomized Clinical Trial. J Acupunct Meridian Stud. 2012;5:57–62.
    1. Castro-Sanchez AM, Garcia-Lopez H, Mataran-Penarrocha GA, Fernandez-Sanchez M, Aguilar-Ferrandiz ME. Effects of Dry Needling on Spinal Mobility and Trigger Points in Patients with Fibromyalgia Syndrome. Pain Physician. 2017;20:37–52.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren