Intramuscular Injections and Dry Needling within Masticatory Muscles in Management of Myofascial Pain. Systematic Review of Clinical Trials
Abstract
:1. Introduction
2. Materials and Methods
2.1. Protocol Registration
2.2. Data Sources and Search Strategy
2.3. Eligibility Criteria
2.4. Study Selection
2.5. Data Extraction
3. Results
4. Discussion
4.1. Intramuscular Injections (Wet Needling)
4.2. Dry Needling
4.3. Techniques Based on Manual Localization
4.4. Techniques Based on Additional Navigation Methods or Support Systems
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Search Strategy | |
---|---|
PubMed | (masseter OR temporalis OR lateral pterygoid OR medial pterygoid OR masticatory OR mastication) AND (muscle OR muscles OR intra-muscular OR intramuscular OR intra muscular OR trigger points) AND (injection OR injections OR puncture OR punctures OR administration OR needling OR dry needling OR acupuncture) AND (pain OR discomfort OR myofascial pain OR antinociceptive OR anti-nociceptive) AND (therapy OR treatment OR management OR pharmacotherapy OR diagnosis OR diagnostic OR diagnostics) AND (technique OR techniques OR method OR methods OR protocol OR protocols OR guidelines) |
BASE | (masseter OR temporalis OR pterygoid OR masticatory OR mastication) AND (muscle OR muscles OR intra-muscular OR intramuscular OR intra muscular OR trigger points) AND (injection OR injections OR puncture OR punctures OR administration OR needling OR dry needling OR acupuncture) AND (pain OR discomfort OR myofascial pain OR antinociceptive OR anti-nociceptive) AND (therapy OR treatment OR management OR pharmacotherapy OR diagnosis OR diagnostic OR diagnostics) AND (technique OR techniques OR method OR methods OR protocol OR protocols OR guidelines) |
Inclusion Criteria | Exclusion Criteria | |
---|---|---|
Population | Adult patients with myofascial orofacial pain according to the RDC/TMD or DC/TMD or ICOP | Animal patients, patients suffering with fibromyalgia, neuralgia, oromandibular dystonia, cerebral palsy, hypertrophic masseter muscles, clinically induced pain |
Intervention | Intramuscular injections into masticatory muscles, dry needling of masticatory muscles | Intramuscular injections into other than masticatory muscles, nerve blockades, acupuncture |
Comparison | Any or none | - |
Outcome | Primary outcome: Effective penetration of the masticatory muscle in the course of its needling. Secondary outcome: Any positive treatment outcome (eg. pain decrease, increase in maximum mouth opening, pressure pain threshold increase, MTPs desactivation etc.) | - |
Study design | Primary studies with an evidence level 1 to 3; description of the needling technique | Papers published prior to 2011; non-English articles |
Author, Year of Publication | Study Group Size | Wet/Dry Needling (Injected Substance) | Navigation Method or Support System | Needle Penetration Spot(s) | Amount of Injected Substance (per Muscle) | Number of Treatment Sessions |
---|---|---|---|---|---|---|
Al-Wayli, 2017 [21] | 25 | BTX | manual palpation; deposition spots located regularly in the lower part of the muscle | 3 sites | 20 IU | 1 |
Ananthan, 2019 [22] | 25 | LA (2% lidocaine) | digital palpation | MTPs | ns | 1 |
Chaurand, 2020 [23] | 22 | BTX | digital palpation | 2 sites | 30 IU | 1 |
Chaurand, 2017 [24] | 11 | BTX | manual palpation; one spot near mandibular angle and one near zygomatic arch | 2 sites | 20 IU | 1 |
Ernberg, 2011 [25] | 21 | BTX | EMG; 15 mm deep | 3 sites | 50 IU | 2 |
Ghavimi, 2019 [26] | 61 | BTX | manual palpation; deposition spots located regularly along the long axis of the muscle; 10 mm deep | 3 sites | 50 IU | 1 |
Guarda-Nardini, 2012 [27] | 15 | BTX | manual palpation; 2 cm skin surface over most prominent area of the muscle after clenching | minimum 5 sites in reverse pyramid pattern | ns | 1 |
Hosgor, 2020 [28] | 44 | BTX | manual palpation | 3 sites | 150 IU | 1 |
Ivask,2016 [29] | 20 | BTX | manual palpation; most painful spot | 5 sites | ns | 1 |
Kang, 2018 [30] | 24 | LA (1,5 or 5 mg morphine sulfate) | manual palpation; most painful spot | 1 site | 0.3 mL | 1 |
Kang, 2018 [30] | 11 | LA (2% lidocaine) | manual palpation; most painful spot | 1 site | 0.3 mL | 1 |
Kim, 2016 [30] | 21 | BTX | manual palpation | 3 sites | 150 IU | 1 |
Meral, 2019 [31] | 25 | BTX | Ns | 6 sites | 24 IU | 1 |
Nitecka-Buchta, 2019 [32] | 29 | PRP | manual palpation; 5–10 mm deep | 3 MTPs near the origin, under zygomatic arch | 1.5 mL | 1 |
Nitecka-Buchta, 2018 [9] | 18 | collagen | manual palpation; 10–15 mm deep | MTPs | 2 mL | 2 |
Nitecka-Buchta, 2018 [9] | 15 | LA (2% lidocaine) | manual palpation; 10–15 mm deep | MTPs | 2 mL | 2 |
Ozden, 2018 [33] | 20 | DDN | manual palpation and analogue algometer; 10 mm deep | MTPs | - | 3 |
Ozden, 2018 [33] | 20 | SDN | manual palpation and analogue algometer; 5 mm deep | MTPs | - | 3 |
Patel, 2017 [34] | 20 | BTX | EMG and monopolar electrode injection needle | ns | 50 IU | 1 |
Pihut, 2016 [35] | 42 | BTX | manual palpation, area of the greatest cross-section surface of both masseter bellies | ns | 21 IU | 1 |
Pons, 2018 [36] | 6 | BTX | manual palpation | 3 sites | 30 IU | 1 |
Sipahi Calis, 2019 [13] | 9 | BTX | EMG | ns | 30 IU | 1 |
Taskesen, 2020 [37] | 15 | DDN | manual palpation | MTPs | - | 2 |
Taskesen, 2020 [37] | 15 | LA (2% lidocaine) | manual palpation | MTPs | 0.2 mL | 2 |
Tesch, 2019 [38] | 5 | DDN | manual palpation | MTPs | - | 3 |
Uemoto, 2013 [39] | 7 | LA (2% lidocaine) | digital palpation; 10–20 mm deep | MTPs | 0.25 mL | 4 |
Uemoto, 2013 [39] | 7 | DDN | digital palpation | MTPs | - | 4 |
Villa, 2018 [40] | 28 | BTX | Ns | 3 sites | 50 IU | 1 |
Yilmaz, 2020 [41] | 26 | BTX | manual palpation | MTPs | 10 U/MTP | 1 |
Yilmaz, 2020 [41] | 27 | LA (3% mepivacaine) | manual palpation | MTPs | 0.5 mL/MTP | 1 |
Yilmaz, 2020 [41] | 29 | PRP | manual palpation | MTPs | 0.5 mL/MTP | 1 |
Yurttutan, 2019 [42] | 48 | BTX | manual palpation; deposition spots located regularly across the muscle mass | 5 sites | 30 IU | 1 |
Author, Year of Publication | Study Group Size | Wet/Dry Needling (Injected Substance) | Navigation Method or Support System | Needle Penetration Spot(s) | Amount of Injected Substance (per Muscle) | Number of Treatment Sessions |
---|---|---|---|---|---|---|
Ananthan, 2019 [22] | 25 | LA (2% lidocaine) | digital palpation | MTPs | ns | 1 |
Chaurand, 2020 [23] | 22 | BTX | digital palpation | 2 sites | 20 IU | 1 |
Chaurand, 2017 [23] | 11 | BTX | digital palpation | 1 MTP | 10 IU | 1 |
Guarda-Nardini, 2012 [27] | 15 | BTX | manual palpation; 2 cm skin surface over most prominent area of the muscle after clenching | multiple injections in chess-board pattern | ns | 1 |
Hosgor, 2020 [28] | 44 | BTX | manual palpation | 2 sites | 100 IU | 1 |
Ivask, 2016 [29] | 20 | BTX | manual palpation; most painful spot | 5 sites | ns | 1 |
Kim, 2016 [14] | 21 | BTX | manual palpation | 3 sites | 100 IU | 1 |
Meral, 2019 [31] | 25 | BTX | Ns | 3 sites | 12 IU | 1 |
Patel, 2017 [34] | 20 | BTX | EMG and monopolar electrode injection needle | ns | 25 IU | 1 |
Pons, 2018 [36] | 6 | BTX | manual palpation | 2 sites | 20 IU | 1 |
Sipahi Calis, 2019 [13] | 9 | BTX | EMG | ns | 20 IU | 1 |
Villa, 2018 [40] | 28 | BTX | Ns | 2 sites | 25 IU | 1 |
Yurttutan, 2019 [42] | 48 | BTX | Ns | 3 sites | 15 IU | 1 |
Author, Year of Publication | Study Group Size | Wet/Dry Needling (Injected Substance) | Navigation Method or Support System | Needle Penetration Spot(s) | Amount of Injected Substance (per Muscle) | Number of Treatment Sessions |
---|---|---|---|---|---|---|
Gonzalez-Perez, 2015 [43] | 24 | DDN | manual palpation; proper puncture confirmed by jump reaction or local twitch response | MTPs | - | 3 |
Lopez-Martos, 2018 [44] | 20 | DDN | EPI ® electrotherapy equipment | MTPs | - | 3 |
Lopez-Martos, 2018 [44] | 20 | PNE | EPI ® electrotherapy equipment | MTPs | - | 3 |
Patel, 2017 [34] | 20 | BTX | EMG and monopolar electrode injection needle | ns | 10 IU | 1 |
Pons, 2018 [36] | 6 | BTX | MRI infrared navigation; center of the upper head; about 33 mm from the skin | 1 site | 20 IU | 1 |
Author, Year of Publication | Study Group Size | Wet/Dry Needling (Injected Substance) | Navigation Method or Support System | Needle Penetration Spot(s) | Amount of Injected Substance (per Muscle) | Number of Treatment Sessions |
---|---|---|---|---|---|---|
Mesa-Jimenez, 2020 [45] | 5 | DDN | needle insertion at the inferior angle of the mandibular bone, parallelly to the mandible, advanced from an inferior to superior direction to maximum 30 mm; confirmed by pain referral during insertion | medial surface of the inferior angle of the mandible | - | 1 |
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Nowak, Z.; Chęciński, M.; Nitecka-Buchta, A.; Bulanda, S.; Ilczuk-Rypuła, D.; Postek-Stefańska, L.; Baron, S. Intramuscular Injections and Dry Needling within Masticatory Muscles in Management of Myofascial Pain. Systematic Review of Clinical Trials. Int. J. Environ. Res. Public Health 2021, 18, 9552. https://doi.org/10.3390/ijerph18189552
Nowak Z, Chęciński M, Nitecka-Buchta A, Bulanda S, Ilczuk-Rypuła D, Postek-Stefańska L, Baron S. Intramuscular Injections and Dry Needling within Masticatory Muscles in Management of Myofascial Pain. Systematic Review of Clinical Trials. International Journal of Environmental Research and Public Health. 2021; 18(18):9552. https://doi.org/10.3390/ijerph18189552
Chicago/Turabian StyleNowak, Zuzanna, Maciej Chęciński, Aleksandra Nitecka-Buchta, Sylwia Bulanda, Danuta Ilczuk-Rypuła, Lidia Postek-Stefańska, and Stefan Baron. 2021. "Intramuscular Injections and Dry Needling within Masticatory Muscles in Management of Myofascial Pain. Systematic Review of Clinical Trials" International Journal of Environmental Research and Public Health 18, no. 18: 9552. https://doi.org/10.3390/ijerph18189552