Research: McMILLAN and colleagues,

Listed in Issue 38

Abstract

McMILLAN and colleagues, Department of Restorative Dentistry, University of Newcastle, Newcastle upon Tyne, United Kingdom write that painful trigger points are often treated with dry needling and local anaesthetic injections; however, the therapeutic efficacy of these treatments has not been well quantified and the mechanism poorly understood. The authors conducted a randomised, double-blind, double- placeboclinical trial to compare the therapeutic efficacy of dry needling and local anaesthetic injections for myofascial pain in the jaw muscles.

Background

Methodology

: The authors measured pain-pressure thresholds in the masseter and temporalis muscles prior to and following a series of dry needling treatments, local anaesthetic injections and simulated dry needling and local anaesthetic treatments. 30 individuals, aged 23-53 years were divided into 3 treatment groups: A - Procaine + stimulated dry needling; B - dry needling + simulated local anaesthetic; C - simulated local anaesthetic + simulated dry needling. The subjects rated pain intensity and unpleasantness using visual analogue scales.

Results

Pain intensity and unpleasantness scores decreased significantly following treatment in all the groups. There were no statistically significant differences at the end of treatment between the groups regarding pain pressure thresholds and visual analogue scale scores.

Conclusion

These results suggest that the general improvement in pain symptoms resulted from non-specific, placebo-related factors rather than from a true treatment effect. Therefore, the therapeutic value of dry needling and Procaine for the management of myofascial pain in the jaw muscles is questionable.

References

McMillan AS et al. The efficacy of dry needling and procaine in the treatment of myofascial pain in the jaw muscles. J Orofac Pain 11(4): 307-14 Fall 1997.

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