The effectiveness of dry needling for patients with orofacial pain associated with temporomandibular dysfunction: a systematic review and meta-analysis

Braz J Phys Ther. 2019 Jan-Feb;23(1):3-11. doi: 10.1016/j.bjpt.2018.08.008. Epub 2018 Aug 22.


Background: Orofacial pain of myofascial origin is often associated with temporomandibular joint dysfunction, affects chewing muscles and may lead to functional limitations. Dry needling is an intervention commonly used for inactivating myofascial pain trigger points.

Objective: To systematically review the effects of dry needling on orofacial pain of myofascial origin in patients with temporomandibular joint dysfunction.

Methods: This systematic review has pain intensity as primary outcome. Searches were conducted on April 13th, 2018 in eight databases, without publication date restrictions. We selected randomized controlled trials published in English, Portuguese, or Spanish, with no restrictions regarding subject ethnicity, age or sex.

Results: Seven trials were considered eligible. There was discrepancy among dry needling treatment protocols. Meta-analysis showed that dry needling is better than other interventions for pain intensity as well as than sham therapy on pressure pain threshold, but there is very low-quality evidence and a small effect size. There were no statistically significant differences in other outcomes.

Conclusion: Clinicians can use dry needling for the treatment of temporomandibular joint dysfunction, nevertheless, due the low quality of evidence and high risk of bias of some included studies, larger and low risk of bias trials are needed to assess the effects of dry needling on orofacial pain associated with temporomandibular joint dysfunction.

Keywords: Dry needling; Myofascial pain; Orofacial pain; Temporomandibular disorder; Trigger point.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Acupuncture Therapy / methods*
  • Facial Pain / physiopathology*
  • Humans
  • Myofascial Pain Syndromes / physiopathology*
  • Pain Measurement
  • Pain Threshold