Trigger Point Injection and Dry Needling

What Are Trigger Points?

Trigger points develop due to muscle overuse, stress, trauma, or postural imbalances. They are often found in the masseter, temporalis, sternocleidomastoid (SCM), and cervical muscles in patients with orofacial pain. These points can cause pain, restricted motion, muscle fatigue, and referred symptoms such as headaches or jaw discomfort.

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Trigger Point Injections (TPI)

Trigger point injections involve the precise insertion of a very fine needle into the trigger point, often followed by the injection of a small amount of local anesthetic (e.g., lidocaine) to relax the muscle and interrupt the pain cycle.

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Evidence-Based Benefits:

• Rapid reduction of muscle pain and tenderness

• Improved range of motion and function

• Reduced referred pain and headache frequency

• Often used as part of a multimodal approach in managing myofascial TMD, chronic headaches, and facial pain

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Clinical Support:

A 2021 review in the Journal of Oral & Facial Pain and Headache confirmed the efficacy of trigger point injections for masticatory myofascial pain, particularly when combined with self-care, physical therapy, or oral appliances.

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Dry Needling

Dry needling uses the same fine needles as acupuncture but is rooted in Western anatomical science. No medication is injected. Instead, the mechanical action of the needle disrupts dysfunctional muscle fibers and stimulates a healing response.

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How It Works:

• Mechanical disruption of the trigger point

• Increases blood flow and reduces local muscle spasm

• Modulates pain signaling pathways through neuromuscular effects

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Clinical Relevance:

Dry needling has shown promising outcomes in orofacial pain management. It is especially helpful for patients with myofascial pain, jaw clenching, tension-type headaches, and persistent postural-related muscle pain.

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Research Insight:
Studies from the Journal of Bodywork and Movement Therapies and Pain Medicine suggest that dry needling provides significant pain relief, particularly when used alongside stretching, posture correction, or oral appliance therapy.

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When Are These Treatments Recommended?

You may benefit from trigger point injections or dry needling if you have:

• Persistent jaw or facial muscle pain

• Recurrent headaches with muscular origin

• Chronic TMJ pain unresponsive to conservative therapies

• Limited jaw opening or neck mobility

• A diagnosis of myofascial TMD or chronic facial pain

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Why We Often Recommend Trigger Point Injections First

• Addresses the root cause: TPI breaks the pain cycle at its source — tight, painful muscle knots — rather than just masking symptoms.

• Supports rehabilitation: Muscle function improves quickly, allowing you to start jaw stretches, posture correction, and physical therapy sooner.

• Safe and reversible: No long-term paralysis or side effects. It's often diagnostic too — if you respond, it confirms myofascial pain as the cause.

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Common Muscles Targeted in Trigger Point Injections/ Dry Needling  for TMD & Orofacial Pain

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• Masticatory Muscles

1. Masseter

   • Most commonly injected

   • Pain refers to jaw, ear, teeth, and temple

2. Temporalis

   • Involved in clenching/grinding

   • Refers pain to the temples and supraorbital area

3. Medial Pterygoid

   • Refers pain to throat, TMJ, and inside the mouth

   • Accessed intraorally or transcutaneously (expert level)

4. Lateral Pterygoid

   • Deep muscle, rarely injected directly

   • Involved in disc displacement and jaw deviation

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• Cervical and Postural Muscles

1. Sternocleidomastoid (SCM)

   • Refers pain to jaw, around the eye, and vertex

2. Trapezius (Upper fibers)

   • Refers to occiput, jaw angle, and temporal region

3. Levator Scapulae

   • Can contribute to referred neck and TMJ-area pain

4. Splenius Capitis / Cervicis

   • Refers to vertex, occiput, and temporal area

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• Other Head and Facial Muscles

1. Occipitalis

   • Related to tension headaches and scalp tenderness

2. Digastric (especially posterior belly)

   • ​Referred pain to throat, hyoid, and submandibular region

3. Mylohyoid & Geniohyoid

   • ​Contribute to oropharyngeal or submental pain patterns

4. Others as case basis

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Why Choose Us?

At Advanced TMJ Maxillofacial Pain & Sleep Center, our board-certified Orofacial Pain specialist is extensively trained in head and neck trigger point diagnostics and needling techniques, ensuring precision, safety, and evidence-based care. Every treatment is customized and often combined with complementary therapies like oral appliances, photobiomodulation, or neuromodulators for enhanced relief.