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

J Craniofac Surg. 2019 Jul;30(5):1556-1559. doi: 10.1097/SCS.0000000000005473.


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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acupuncture Therapy
  • Adult
  • Botulinum Toxins, Type A / therapeutic use*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myofascial Pain Syndromes / drug therapy*
  • Myofascial Pain Syndromes / therapy
  • Pain Management
  • Prognathism / therapy
  • Prospective Studies
  • Temporomandibular Joint / drug effects*
  • Treatment Outcome
  • Visual Analog Scale
  • Young Adult


  • Botulinum Toxins, Type A